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2012 Membership Form

GARSTANG & DISTRICT HORSE & PONY CLUB MEMBERSHIP APPLICATION 2012 Membership Renewal (per person): Before 1st April: £10.00; After 1st April: £15.00   
Membership Group
: Mini: 9yrs & under, Junior: 10–13yrs, Intermediate: 14-17yrs, Senior: over 18yrs Ages as at 1st Jan in the current year
ADDRESS:  
E-MAIL ADDRESS:TELEPHONE  NO:
NameDOBMembership Group:Membership No:
NameDOBMembership Group:Membership No:
Signature: (Parent/Guardian if under 18years)I agree to comply with Club rules and regulations and sign this form on behalf of all members listed.
ALL CHEQUES MADE PAYABLE TO: GARSTANG & DISTRICT HORSE & PONY CLUBTotal  £