Northland Western Riding Association

Northland Western Riding Association

Subscription for 2025/26 Season (April 1st 2025- March 31st 2026)
Name(s)

(For family memberships please list all names- Max two Adults and two Children)
Primary Name*

First NameLast Name
Adult Name

First NameLast Name
Youth Name

First NameLast Name
Junior Youth (13 years and under)Senior (14-18 years)
Youth Name

First NameLast Name
Junior Youth (13 years and under)Senior (14-18 years)
Email*
example@example.com
Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Adult Riding $60Youth $50Family $90Non Riding/ Social $45
Emergency Contact *

First NameLast Name
Relationship*
Emergency Contact Phone Number*

Area CodePhone Number
Do you have any medical conditions we should be aware of?*
YesNo
Please advise of any affliated clubs or associations you hold a current membership of
For example AQHANZ, NZCHA
Cash (must be handed to a committee member only)Direct Debit ASB- 12 30990082467 00(Please use your name and 'Subs' as a reference)
I/ we hereby agree to abide by the Northland Western Riding Association Constitution and rules and regulations. I/ we hereby agree to abide by the New Zealand Western Riding Federation rules and regulations. A copy of these can be obtained by emailing northlandwesternriding@gmail.com.
Signature*

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Name(s)