Sarawak Pony Club RM2.

00 / form
c/o Persatuan Sukan Ekuestrian Negeri Sarawak
Lot 3427 Kpg Sinar Budi Baru, Lorong 17 Tmn Desa Wira
93250 Jalan Batu Kawa, Kuching

Any person wishing to participate in the Sarawak Pony Club activities/programs, organized by the Persatuan Sukan Ekuestrian
Negeri Sarawak (Ekuestrian Sarawak) must be a Member of the PSENS & Sarawak Pony Club. Entries will not be accepted for any
individual who
Is not a Member.
Membership Application Form
(Eligible age : 7 to 17 years old only)

I wish to apply for Membership to the Sarawak Pony Club c/o Persatuan Sukan Ekuestrian Negeri Sarawak and in doing so declare that I and my
parents / legal guardian agree to abide by the Persatuan Sukan Ekuestrian Negeri Sarawaks Rules and Regulations. I declare that the information I
provide on this Application Form is true and correct.

Please take note : Supplying false, incorrect or misleading information may lead to disqualification from being a member of Ekuestrian Sarawak.

Membership Fee: RM30.00 for registration

Annual Subscription fee: RM12.00 per year
Cheques/Money Order/Cash payable to: Persatuan Sukan Ekuestrian Negeri Sarawak.

Name:
Date of Birth:
IC / Passport Number (if any):
Address:


Postcode:
Telephone: E Mail :

School Name and Address : .

Signature : .. Date : .

(This part is to be filled by the applicants parent/legal guardian)

I .. (full name) the parent/legal guardian agree to let the

named applicant to join any riding/non-riding activities/programs or taking part in the activities/programs organized by
PSENS & Sarawak Pony Club. I declare that this information is true and correct.

Full Name: .. Signature: IC No :

Please complete & return this Membership Application Form, accompanied by your recent passport size photos (2 pcs), a photocopy of your IC or
birth certificate and RM42..00 (Cash/Cheque/Money Order) Membership Fee payable to the Persatuan Sukan Ekuestrian Negeri Sarawak.
PSENS reserved the right to accept or to reject any application. Unsuccessful application will be notified and fees (membership registration & annual
subscription) will be refunded in full.

Persatuan Sukan Ekuestrian Negeri Sarawak Tel : 019-8770074 E-Mail: ekuestrian.sarawak@gmail.com

Sarawak Equestrian Sports Association