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Wcec 2011 Membership Form-2

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Stefani Tweedy
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60 views

Wcec 2011 Membership Form-2

Uploaded by

Stefani Tweedy
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Wine Country Equestrian Club (WCEC)

2011 Season Membership Application

Member___________________________________ Age for Junior as of 12/31/10_______


Address: _______________________________________________________________
Telephone: ____________________ E-Mail:___________________________________
Junior Membership - $20.00
(Juniors are riders who are 17 years or younger as of Jan 1, 2011)
Single Membership - $35.00
Family Membership - $40.00
(Please fill out below for each family member who will be participating.)
Total Enclosed:

$ __________
$ __________
$ __________

$ __________

Family members who will be participating:


Name _____________________________________________ Age ________________
Name _____________________________________________ Age ________________
Name _____________________________________________ Age ________________
Signed_____________________________________________ Date________________
(Parent or guardian must sign if under 18)
Release form: Wine Country Equestrian Club
I, the undersigned member and/or parent or guardian of member, realize that participation in equestrian
activities is a high risk undertaking. By signing this form for membership in WCEC, I agree to hold harmless
WCEC, its board members, officers, members their estate and heirs, and any representatives for any injury,
loss or accident that may occur to myself, my horse, my equipment or anyone I bring with me while
participating in all equine activities held at Bronny Friesians.
I have read the above paragraph and understand what I have signed.
Signed__________________________________________ Date_______________
(Parent or Guardian must sign if under 18)
Make checks payable to WCEC

Mail to: Wine Country Equestrian Club


Attn: Jacki Cacchiotti
3011 Marks Rd.
Yakima, WA 98903

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