LLOC & DISTRICT RIDING CLUB

MEMBERSHIP FORM 2010

please print

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TELEPHONE NUMBER......................................................................

ONLY FAMILY MEMBERS LISTED BELOW WILL BE ELIGIBLE FOR PRIVILEGES TO THE CLUB.

NAME.........................RELATIONSHIP..................SENIOR/JUNIOR.......D.O.B........

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 PLEASE CIRCLE  JUNIOR OR SENIOR

MEMBERSHIP APPLICATION FORM 2010
LLOC AND DISTRICT  RIDING CLUB
CHEQUES OR POSTAL ORDERS MADE PAYABLE TO
LLOC AND DISTRICT  RIDING CLUB, AND SEND TO;
RUTH THOMAS, BODERW, RHEWL, MOSTYN, CH8 9HW.

FOR JUNIOR/SENIOR/FAMILY DELETE AS APPROPRIATE
ALL MEMBERS PARTICIPATING IN CLUB EVENTS MUST HAVE ADEQUATE INSURANCE. FAMILY MEMBERSHIP MEANS PARENTS AND CHILDREN OF THE SAME FAMILY. PLEASE SET OUT DETAILS OF FAMILY CONNECTIONS ABOVE

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DECLARATION :- I AGREE TO ABIDE BY ALL THE RULES AND REGULATIONS AS LAID DOWN BY THE CLUB

MEMBERS SIGNITURE.....................................................DATE......................
PLEASE TAKE NOTE
1ST JANUARY 2010 TO 31ST DECEMBER 2010
JUNIOR OR SENIOR MEMBERSHIP £10.00  FAMILY MEMBERSHIP £25.00