Springwood Riding Club Horsley
Membership Form 2009
Full Name ………………………………………….………………….........
(Block capitals please)
Date of Birth …………………………..…Age at 1st Jan 2009 ……………
Address ……………………………………………………………………..
……………………………………………………………………………….
…………………………………………………………………….………………………………………………………..…Postcode………………….....
Telephone No ………………….………….. Mobile No …………………
e-mail address ………………………………………………………………
Horse / Pony Name
1………………………………..….Ht……….. Age at 01.01.09…………..
2…………………………….......... Ht………..Age at 01.01.09……………
3………………………………...... Ht………..Age at 01.01.09…………...
Type of Membership:-
Associate £3.00
Full Adult £15.00
Full Junior £13.00
Please Note: - There is a £1.00 reduction on full membership if paid before 31.03.09
MEMBERSHIP NUMBER…………………………. FEE PAID ………..
Declaration
I, the above member, agree to comply with the rules of Springwood Riding Club, Horsley, which I have read and understood.
Signed …………………………………………………. Date ……………...
Signature of parent / carer ………………………………Date ………………
(If member under 18yrs of age)
Please return form to:-
Lynda Izdebski
10 The Crescent
Derbyshire
DE7 6GH
