MIDLOTHIAN SADDLE CLUB

Application for Membership

January 1, 200__through December 31, 200__

 
Name:______________________________________Birthday:_____________________

Address:________________________City/State:_________________Zip:____________

Home Phone:__________________Work:__________________Other:______________

E-Mail Address:__________________________

Additional Family Members:

Name:_______________________Birthday:____________Relationship:____________

Name:_______________________Birthday:____________Relationship:____________

Name:_______________________Birthday:____________Relationship:____________

Name:_______________________Birthday:____________Relationship:____________ 

Dues:                                       Single Club Dues:      $15.00__________

                                                Family Club Dues:     $20.00__________

                        (Optional)        NARC & SP DUES:   $35.00__________

                                                Total Amount Due:                $_________

NOTE:  Memberships become effective when dues are received by Midlothian Saddle Club.  NARC & SP memberships become effective when received by Midlothian Saddle Club or January 1, 200__, which ever is later.

We (I) have been advised that the bylaws of Midlothian Saddle Club prohibits the use of alcoholic beverages or illegal controlled substances, profanity and inhumane treatment of animals at any club activity.  We (I) hereby agree, as a condition of membership in the Midlothian Saddle Club, to abide by the bylaws, rules and regulations of the Midlothian Saddle Club.

Signature:__________________________________Date:______________________

Make check payable to:  Midlothian Saddle Club; Mail to: 720 Apple Lane, Midlothian, TX  76065

Referred By:______________________________    NARC&SP website: www.narcsp.org