Membership Form- August 2025

Membership Form- August 2025

Membership Form

1st August 2025 to 31st July 2026
Name

First NameLast Name
Date of Birth

DayMonthYear
Date
Address

Street Address

Street Address Line 2

CityState

Zip CodeCountry
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
AQHA Member number
PHAA Member Number
AAA Member Number
RHAA Member Number

MEMBERSHIP

Single Membership

$50.00 AUD

Family Membership

$100.00 AUD

Additional Member

Competitor over 18 Years Old in the same household

$35.00 AUD Quantity

Youth Membership

Up to 18 Years Old

$40.00 AUD Quantity

Social Member

$20.00 AUD Quantity

Enter coupon

Subtotal

Tax

Total

Payment Methods

Credit Card

Apple Pay

I am a financial member of:
Type membership number here
- Additional Family Member 1
- DOB
  
  MonthDayYear
  Date
- Additional Family Member 2
- DOB
  
  MonthDayYear
  Date
- Additional Family Member 3
- DOB
  
  MonthDayYear
  Date
- Additional Family Member 4
- DOB
  
  MonthDayYear
  Date
- Additional Family Members - Must include Name, DOB & Breed Membership Number