Elcho Park Equestrian Centre, Lara, Vic, 3212
members@cmpc.org.au

New Membership and Renewal Form

Corio and Moorabool Pony Club

Please take the time to review all the information provided in the links below.

PCAV Code of Conduct Click Here

CMPC Members Booklet Click Here

Rider Details

Please Complete the form to start a new Membership or renewal a existing membership. PCAV now State the a parent or guardian must have a current working with children's check this needs to be active before membership to CMPC can be accepted by the Committee. By Completing this form you are agreeing to the Corio and Moorabool Pony Club Terms and Conditions outlined in the CMPC Manual, also by completing this form you agree to the PCAV Code of Conduct.
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Rider Health Details

Guardian 1 Details

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Guardian 2 Details

Horse Details

Membership Terms And Conditions

Rider Over 18 Years of Age

If emergency medical care is required for myself and if I, or an accompanying spouse or relative, am not able to convey permission in a timely manner, then the undersigned authorised authorises appropriate emergency medical care as deemed necessary by emergency medical personnel, a physician or the medical facility providing treatment.

Rider Under 18 Years of Age

If emergency medical care is required for my child listed on this form and if permission is not available in a timely manner, then the undersigned authorized authorities appropriate emergency medical care as deemed necessary by emergency medical personnel, a physician or the medical facility providing treatment. I agree to abide by the rules, regulations, policies, procedures and directives as stipulated by Pony Club Association of Victoria Competition rules and affiliated bodies. I acknowledge that horse sport is dangerous and that accidents causing death, bodily injury, disability and property damage can, and do happen. I acknowledge and agree that neither PCAV nor “the organizers” shall be under any liability for death, or bodily injury, loss or damage which may be sustained or incurred by the applicant, as a result of participation in or being present at PCAV endorsed events, except in regard to any rights I may have arising under the Trade Practices Act 1974. I have read and agree to abide by the Club and PCAV Code of Conduct.

CMPC Photo Policy

I give permission for Corio and Moorabool Pony Club (CMPC) to use the child listed on this form images for the sole purposed of advertising the club, promotional material for the club and/or the CMPC website and facebook page only. Corio and Moorabool Pony Club can not stop the use of photo's by others, however agree that all photo's posted will be of appropriate content.
By submitting this form you are agreeing to the Corio and Moorabool Pony Club terms outlined in the CMPC membership booklet and the PCAV Code of Conduct. Links to the CMPC Manual and PCAV Code of Conduct are available at top of this form. Please take the time to review these before requesting membership to CMPC.
Note: There are 3 option to paying your fees for membership, (1-Via this form) (2-Via PCAV Registration)( 3-Direct Deposit to CMPC)
$ 0.00