COCKINGTON RIDING CLUB

 

MEMBERSHIP FORM 2008

Membership no. assigned

 

Date sub received

 

Mr,Master,Mrs,Miss or other (please state)

Date card sent

 

First Name:

 

o posted

o by hand

Last Name:

 

o Given to a committee member

Address:

o in Caravan on show field

Postcode:

Contact Tel no:

Mobile No:

Email address

Date of Birth: (must be included if under 17)

Adults  please tick one of the following

 

17-24

 

25-34

 

35+

If above member is under 18 please can Parent/Guardian read the following statement:

 

    I (name in CAPS please)…………………………………………………as the parent/guardian

 

    Of (member’s name)……………………………………………………..give permission for

Cockington Riding Club to use any photo taken of the above named member to promote and advertise the club.

 Examples of promotion: website,newsletter,newspaper.

 

Signed parent/guardian………………………………………………………………..Date………………………………….

Horse/pony details

1) Passport name of horse/pony                                                                            Height:……………………… hh

     Passport no:

DOB or age on 1 Jan 08:

     Optional question: The above horse/pony is annually vaccinated against (pleaseό as appropriate

a)Equine Influenza(FLU)

b)Tetanus

2) Passport name of horse/pony                                                                            Height:……………………… hh

     Passport no:

DOB or age on 1 Jan 08:

     Optional question: The above horse/pony is annually vaccinated against (pleaseό as appropriate

a)Equine Influenza(FLU)

b)Tetanus

3) Passport name of horse/pony                                                                            Height:……………………… hh

     Passport no:

DOB or age on 1 Jan 08:

     Optional question: The above horse/pony is annually vaccinated against (pleaseό as appropriate

a)Equine Influenza(FLU)

b)Tetanus

Fees

Junior/Senior  Riding Member                         -                  £12.00

Non-riding/supporter                                        -                        £3.00

More than 3 horses? Please put the horse’s details on the reverse or complete and attach another form.

Please read carefully and tick as appropriate:

CRC will store and use the information above (manually/electronically) in order to send you information relating to Cockington Riding Club events and newsletters only. 

If you do not wish us to keep information above please ό  this box o.

By signing this form you agree to abide by all the Club Rules, which are available from the Membership Secretary and are also published in the schedule.

Signed:

 

Date:

Cheques to be made payable to:Cockington Riding Club.

Please send cheques along with this form to:

Mr.M.Shail, CRC Membership, Brimley, 10 Follaton Bungalows, TOTNES, Devon, TQ9 5LZ

Tel: 01803 864089  email: crc@onetel.com

 


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