Scribd
Upload
38 views

2010 Membership Form

The document is a membership form for the Lakehead Light Horse Association for 2010. It collects names, dates of birth, contact information, and preferences for members signing up. Members can choose family, senior, or youth memberships at different price points. The form notes rules must be followed and liability is waived for any injuries from equestrian events. Signing confirms understanding and acceptance of these terms.

Uploaded by

LakeheadLightHorse
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
38 views

2010 Membership Form

The document is a membership form for the Lakehead Light Horse Association for 2010. It collects names, dates of birth, contact information, and preferences for members signing up. Members can choose family, senior, or youth memberships at different price points. The form notes rules must be followed and liability is waived for any injuries from equestrian events. Signing confirms understanding and acceptance of these terms.

Uploaded by

LakeheadLightHorse
Copyright
© Attribution Non-Commercial (BY-NC)
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
You are on page 1/ 2

Lakehead Light Horse Association 2010

Membership Form
‘Putting the Fun Back Into Horses’

ALL MEMBERS MUST FILL OUT AND SIGN A


MEMBERSHIP FORM

Please print clearly

Membership: Family $30.00_________ Senior $25.00_________ Youth


$20.00___________

NAME:_________________________________________________________D.O.B___________________(Senior
/Youth)

NAME:_________________________________________________________D.O.B___________________(Senior
/Youth)

NAME:_________________________________________________________D.O.B___________________(Senior
/Youth)

NAME:_________________________________________________________D.O.B___________________(Senior
/Youth)
Please attach any additional family members. Seniors may only include
day/month to be included in birthday reminders.

Mailing
Address:_______________________________________________________________________________________

City:_______________________________________________________________PostalCode:________________
________

Telephone:__________________________________
Email:____________________________________________________
(To receive instant
newsletters/updates/notices/reminders/invites)
Please check one:
□ I wish to receive my newsletter by email.
□ I wish to receive my newsletter by mail.

Please check:
□ I have read, and understand the rules stated by LLHA.
□ I request a copy of the rules.
□ I request a copy of the LLHA constitution.

Please check one:


□ I grant my permission for LLHA to publish photos of myself, and/or my family’s in the
newsletter and/or website.
□ I DO NOT wish to have any photos published.

Signature: __________________________________________________
□ I acknowledge that any equestrian event can, and may be dangerous. I accept all risks and
responsibilities for myself, and my family. I do not hold Lakehead Light Horse Association, or
any members, liable for any injury that may occur to me, my family, or my property. I agree to
not make claim against LLHA, and its members, for any injury or damage that may occur.
This must be signed to be a member:

Signature: _____________________________________________ DATE:


____________________________________

Print Name: ____________________________________________

Please make cheque payable to: Lakehead Light Horse Association


Mail to: Box 201, Kakabeka Falls, Ontario, P0T 1W0

You might also like