Membership Form

PEEL RANCH SORTING AND PENNING MEMBERSHIP FORM
FROM 01/07/2024 TO 30/06/2024
Please Note: RSNCA membership is required to enter a Sanctioned Ranch Sorting event. You must apply 7 days prior to any RSNCA Sanctioned event. www.rsnca.net.au
Name

First NameLast Name
RSNCA NUMBER:
Date

MonthDayYear
Date
Address

Street Address

Street Address Line 2

CityState

Post Code
Email
example@example.com
Date of Birth

MonthDayYear
Date
MEMBERSHIP TYPES:
Please Note:
Unifrom orders are done in runs, if you are ordering a shirt please check when the next run will be.
prevnext( X )
LADIES Individual Adult with Peel RSAP Club Shirt
$120.00 Quantity



MEN'S Individual Adult with Peel RSAP Club Shirt
$120.00 Quantity



Individual Adult without Shirt
$60.00 Quantity



Junior (8 years to under 18) with Peel RSAP Club Shirt
$110.00 Quantity



Junior (8 years to under 18) without Shirt
$50.00 Quantity



Family (2 adults and up to 3 juniors living at same address) Please fill in names of each individual member below. Shirts not included can be purchased separately.
$120.00 Quantity



Social Membership (non-rider) Without Shirt
$30.00 Quantity



Social Membership (non-rider) With Shirt
$100.00 Quantity



Total

$0.00

Family Membership Only

Payment:

Account Name: Peel Ranch Sorting and Penning

BSB Number: 633 000

Account Number: 170 814 743

Direct Deposit: Please use initial and surname as reference, ensure payment is made when membership form is submitted.
Signature:

Clear
Full Name
Verify the information given on this form is true and correct. I also understand that membership may be accepted or denied without any recourse.
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PEEL RANCH SORTING AND PENNING MEMBERSHIP FORM