Membership Application 2010

Enter N/A for any fields that do not apply
 
First Name:
Last Name:
Address:
City:
Province:
Postal Code:
Telephone:
Fax:
Email:
Single $15.00 Single $15.00
Family $20.00
(please list family below) 		Family $20.00
Late Single $25.00 Late Single $25.00
Family $30.00
(please list family below) 		Late Family $30.00
Family Members and
Birth Dates:
enter n/a for single
New Membership New
Renewal Renewal
Equine Canada Member #:
n/a if not applicable
NBEA Member #:
n/a if not applicable
GMEC Member #:
n/a if not applicable
  
Please indicate how
you would like to
receive club information
and newsletters:		Email Regular Mail Talk Mail
  

SPECIAL NOTES

· Age of each rider will be as of Jan. 1, 2009. · JUNIOR MEMBERSHIP - Available to individuals 17 or under as of January 1, 2010

· Ex:- Birthday is Jan 15, 2009 - riders turns 18, that rider must show as a 17 year old (Junior Rider) for the show season for 2009. (still a Junior - as of Jan 1, 2009).

· Any Junior who has reached age 18 as of Jan 1, 2009, must purchase a single membership and cannot be included under a family membership.

· Memberships are due February 28, 2010

After March 1, 2010, Single $25, Family $30

Please make cheques payable to:

The Greater Moncton Equestrian Club
Mail to: P.O. BOX 7122
Riverview, NB
E1B 4T8