Application for Membership and Consent renewals

Application for Membership and Consent renewals

NZCHA membership are valid 1st August 2024 to 31st July 2025
Membership Type - Please indicate membership renewal required by selecting applicable type.*

Full Competing Member - points recorded, 1 vote.Non-Competing Member - 1 vote, if qualified on judges list, may judge.Family Membership - full rights for two competing members, including their children under 18, youth may not vote.Youth Membership - points recorded, no vote, may only compete in Youth or Snaffle Bit events but are limited to two rides per show.First Time Member - point recorded, 1 vote, may not stand for council.Affiliate Membership - club or organisation, 1 vote, NZCHA Insurance cover for approved eventsConstituent Member - Company, Incorporation, Partnership, 1 vote.Honorary Life Member - inducted via nomination - Full Competing members rights for life.
Name*

First NameLast Name
Name

First NameLast Name
Address*

Street Address

Street Address Line 2

City

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Name - Youth

First NameLast Name
Date of Birth Youth

MonthDayYear
Date
Name - Youth

First NameLast Name
Date of Birth - Youth

MonthDayYear
Date
Name - Youth

First NameLast Name
Date of Birth - Youth

MonthDayYear
Date
Authorisation: As a member of the NZCHA I/We consent to the use of my/our name, photo/s plus information given by me/us to the association for publication in NZCHA advertising, articles, chatter, website, social media platforms & printed materials. I/We also consent to my/our name and contact details being given to sponsors and/or other members of the association upon request. These consents are given in accordance with Privacy Act 2020, unless withdrawn in writing.
Liability Wavier, Declaration and Signature:

I/We understand that the activity being undertaken is for the purpose of recreation, enjoyment or leisure which involves a degree of risk. These activities may cause me or my dependents personal injure or death. By signing this agreement, I/We understand that it waivers my/our rights to sue the NZCHA (The New Zealand Cutting Horse Association (Incorp) for losses to personal injury or death.
I/We hereby apply to become a member of the New Zealand Cutting Horse Association Incorporated (NZCHA) and acknowledge that I/We have read and accepted the Liability Wavier located on the form. In the event of my/our admission as a member and upon payment of applicable fees, I/We hereby agree to abid by the Constitution and the Rules and Regulations of the New Zealand Cutting Horse Association Incorporated.
I wish to receive my chatter as a printed copy.

Yes
Name*
Signature*

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Name
Second adult in the case of Family Membership
Signature

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