| Date: | |
| Type of Membership*: | |
| . | Family - $25.00 - includes married and domestic partners and all children under 18 years of age |
| . | Individual Sr.- $15.00 - 18 & Over and not part of a Family Membership |
| . | Junior - $6.00 - 17 & Under and not part of a Family Membership Please include your age & birthday below |
| Name(s): | . |
| Address: | . |
| City/Zip: | . |
| Phone (include area code): | . |
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| Children's Names: | Ages and Birth Dates: |
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| How many horses do you own/sponsor? | . |
| Do you have a trailer? | . |
| Special interests, what activities would you like to do as club members, e.g. trail rides, overnights, gymkhana? |
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*Membership year runs from January 1st through December 31st. New member's dues are prorated from the month of joining until December 31st. For example: A new family joins in June. Family dues = $25.00/12 = $2.00/month June - Dec = 7 months. $2.00 x 7 = $14.00 due upon joining for current year. Annual dues for next year of $25.00 payable on January 1st.