2026 BHPC Membership Application Form

Brookfield Horse and Pony Club Inc.

ABN: 94 711 488 538 PO Box 61 Kenmore 4069
BHPC Membership Application Form 2026
Steps to join or renew membership

Please read the membership information on the Becoming a Member page of our BHPC website before filling in this application form. Go to Becoming a Member – Brookfield Horse and Pony Club.

Step 1

Before you proceed with this BHPC application form, ensure that you have completed the application via Pony Club Australia (PCA) JustGo portal Member login Sign up.

Pay membership fees as set out by card through the portal. You will be required to provide your payment reference number further down on this form to be able to finalise your BHPC membership for 2026.

Step 2:

Fill out and submit this BHPC Membership Application with payment of levies as necessary and the annual maintenance fee. Membership applications must be approved by the BHPC Management Committee and applicants will be advised of ratification.

Membership Term

Membership is from date of ratification to 31 December 2026.

Please contact the membership secretary if you have any questions regarding memberships on 0402 815 041 or memberships@brookfieldponyclub.org.au

Levies and Fees

Volunteer Roster Levy $170

For existing families, the Volunteer Roster Levy is rolled over into the following year if you complete your required rosters. If your family did not complete all your rosters in 2025, you will need to pay the make-up amount as advised by the Management Committee.

If you are a new family with full-time riders, you will need to pay the Volunteer Roster Levy.

The Volunteer roster levy is not applicable to part time riders.

Brookfield Show Levy $170

All families are required to work 6 hours in the BHPC Canteen during the Brookfield Show. For existing families, this Levy is rolled over into the following year if you complete your shifts at the Show. If you are a new family, or if your family forfeited the 2025 Show Levy, you will need to pay the Brookfield Show Levy.

Annual Family Maintenance Fee $60

This is required to cover increasing maintenance and insurance costs for the Rita O’Hanlon arena, the Long yard and the cross country course.
BHPC Membership Form
Please enter you Payment Reference Number that is located on your payment confirmation (received via email) from the JustGo portal
Please ensure you fill the form in from the top and do not skip fields as the form follows conditional logic to populate fields and provide you with a better user experience
Are you interested in a full time or part time BHPC membership?
Are you/your family new to club?
Please select the option that describes your membership requirement:
Please select the option that describes your membership requirement the best:
How many riding members do you want to register (excluding social members)?

Rider 1 Details

Surname Rider 1Given Name(s) Rider 1
Rider 1 Date of Birth

DayMonthYear
Date
Pony Club ID Rider 1 (existing members only)

Rider 2 Details

Surname Rider 1Given Name(s) Rider 2
Rider 2 Date of Birth

DayMonthYear
Date
Pony Club ID Rider 2 (existing members only)

Rider 3 Details

Surname Rider 3Given Name(s) Rider 3
Rider 3 Date of Birth

DayMonthYear
Date
Pony Club ID Rider 3 (existing members only)

Rider 4 Details

Surname Rider 4Given Name(s) Rider 4
Rider 4 Date of Birth

DayMonthYear
Date
Pony Club ID Rider 4 (existing members only)

Rider 5 Details

Surname Rider 5Given Name(s) Rider 5
Rider 5 Date of Birth

DayMonthYear
Date
Pony Club ID Rider 5 (existing members only)

Rider 6 Details

Surname Rider 6Given Name(s) Rider 6
Rider 6 Date of Birth

DayMonthYear
Date
Pony Club ID Rider 6 (existing members only)

Instructors and trainee instructors - Please provide your Instructor Blue Card number
Expiry Date

MonthDayYear
Date
You have selected a membership that requires a social membership. How many social members do you want to add?

Social Member 1 Details

Surname SM 1Given Name(s) SM1
Social Member 1 Date of Birth

DayMonthYear
Date
Social Member 1 Pony Club ID/Membership nr (existing members only)

Social Member 2 Details

Surname SM2Given Name(s) SM2
Social Member 2 Date of Birth

DayMonthYear
Date
Social Member 2 Pony Club ID/ Membership nr (existing members only)

Member (if 18 years or over) or Parent / Guardian (1)

Surname Parent 1Given Name(s) Parent 1
Member (if 18 years or over) or Parent / Guardian (1)
Please enter a valid phone number Parent 1Format: 000 0000 000.
Member (if 18 years or over) or Parent / Guardian (1) Email Address 1
example@example.com
Parent / Guardian (2)

First Name Parent 2Last Name Parent 2
Parent/ Guardian 2 Phone Number
Please enter a valid phone number Parent 2Format: 000 0000 000.
Parent / Guardian (2) Email Address 2
example@example.com
Who is the primary family contact?

Other - Please enter first name, last name and phone number
Addresses for Club Correspondence

Postal Address Line 1

Postal Address Line 2

CityState/Territory

Post Code
Do you consent to photos of your children appearing on the BHPC website, members’ Facebook page, and other club correspondence or publications.
Club communication will be via email or BHPC members' only Facebook
Horse Ownership and Biosecurity Information
- The club must be informed if any of the details for the horses included in this form change during the year.
- PIC: Property Identification Code of the property where the horse is usually kept. If you keep your horse at multiple locations please specify all PIC numbers. For information go to https://www.daf.qld.gov.au/animal-industries/moving-selling-livestock/national-livestock-identification-system/property-registration
- Hendra Virus:
  - Horses must be protected against the Hendra Virus (refer BHPC By-laws) as shown by a current Hendra vaccination certificate or protected status on the Zoetis Hendra vaccination registry.
Please complete horse ownership and biosecurity information
Please upload a Hendra vaccination certificate for each horse listed. To obtain a copy of your Hendra vaccination certificate, go to https://www.health4horses.com.au registry and enter your horse’s microchip number. Download the certificate and save onto your computer. You can either ‘browse files’ and select the file for uploading, or highlight the file and ‘drag and drop’ into the space below.

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Are the horse/horses included above owned by yourself or another member of BHPC?
Please provide the details below for leased horses
Is the owner a member of BHPC?
*If a horse is leased and the owner is not a member of BHPC both parties must complete and submit Form PCAQ-39 Horse Lease. You can download the form below.
Please download and complete this form. You need to upload the completed form as part of this membership submission. We cannot progress your submission until this form is completed.
Completed Form PCAQ-39 Horse Lease

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Club Roster Details: Full-time riders only

Each Family with a full time rider is required to fill out the Volunteer Roster Hours Booking Form. Scroll down through the Booking Form directly below, to find the volunteer slots you wish to book.

A fee may be charged (refer BHPC By-laws) if members do not attend nominated rosters or provide a replacement. If families wish to be considered for exemption from Club Rosters in 2026, they must apply in writing to the BHPC Committee. Limited exemptions are available, and please note the Club Roster Levy will be forfeited.

Families with Full-time Riders - please complete the form here https://form.jotform.com/253362901343856 before you proceed to your payment.
Please Complete the 2026 Volunteer Roster Hours Booking Form Below
Payment

Please pay via direct bank transfer:

Brookfield Horse & Pony Club

BSB 633 000

A/c 151922457

Please use Surname and Initials of Primary parent in the reference/description space when using EFT.

"Please select all options that are relevant to your membership. Please note that all members/ families with Riding membership, new and existing, should select Yes in Number. 3*

Rows	Yes	No
1. New Members 2026 - Full Time members/ families with Riding membership - Volunteer Roster Levy - select Yes (if you have a Part Time Riding membership, select No)
2. New Members 2026 - Full Time & Part-Time members/families - Show Roster Levy - all select Yes
All Existing Members and New Members 2026 with Riding membership - Family Maintenance Fee - select Yes

Existing Members: a top up of the Volunteer Roster Levy or Show Roster Levy may be required if you did not fulfill all your volunteering requirements from last year. If you are unsure, please contact rostercoordinator@brookfieldponyclub.org.au. If you know the amount you agreed to top up, please add it to the amount shown as payable below.
Please contact Erika woodland at admin@brookfieldponyclub.org.au if you have any queries about the top up
Total Payable
Please upload proof of payment

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Date of EFT

DayMonthYear
Date
Date

DayMonthYear
Date
Print Name
Signature
Should be Empty:

Brookfield Horse and Pony Club Inc.

BHPC Membership Application Form 2026

BHPC Membership Form

Please ensure you fill the form in from the top and do not skip fields as the form follows conditional logic to populate fields and provide you with a better user experience

Horse Ownership and Biosecurity Information

*If a horse is leased and the owner is not a member of BHPC both parties must complete and submit Form PCAQ-39 Horse Lease. You can download the form below.

Club Roster Details: Full-time riders only

Payment