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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: | | Name | DOB | Membership Group: | Membership No: | | Name | DOB | Membership 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 CLUB | Total £ |
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