2012 Membership Application
Type of Membership: Single______ Family______
$15 $25
After February first, there is a late fee of $10.00 for returning members.
Member Names Birthdate* Age in years*
00/00/00 As of January first
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Breakdown of age groups:
PeeWee=10 & under Junior=11-13 Intermediate=14-17 Senior=18-34 Senior+=35 & up
Address: *Required for State Fair &
____________________________________ Champ Show qualifying
City:
____________________________________ Phone:_______________________
State, Zip:
____________________________________ E-mail:_______________________
By signing below, I agree to abide by the rules and bylaws established by Wild River Riders Saddle Club. I also declare that I am over the age of 18 and all members stated above reside at the above address. I am the legal guardian of any minor children listed above. THIS APPLICATION BECOMES VOID IF ANY OF THE ABOVE STATEMENTS ARE NOT TRUE!
Signed:_____________________________ Date:_______________
Mail to: Cassie Rose email to: rsquaredranch@yahoo.com