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    Wcec 2011 Membership Form-2

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    Stefani Tweedy

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    Wcec 2011 Membership Form-2

    Uploaded by

    Stefani Tweedy
    58 views1 page

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    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    58 views1 page

    Wcec 2011 Membership Form-2

    Uploaded by

    Stefani Tweedy

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    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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