A Scottish Riding Club affiliated to
British Riding Clubs
Membership Year 1st Nov to 31st Oct
MEMBERSHIP APPLICATION FORM 2014/2015
Name
Address
Tel.
Mobile
Age (if under 21)
Emergency
contact
name
M
Tel.
Postcode
Email
Membership £25
Payment by cheque ☐ Payment by BACS ☐ Date sent:
Please make cheques payable to ‘Polnoon Castle Riders Association’ and send to:
Pat Bell, 4 Borland Crescent, Eaglesham, Glasgow, G76 0JA
BACS payments to: Bank of Scotland A/c 00766321 Sort code 80 06 64 ‘Polnoon Castle Riders Association’
OFFICE USE
Membership No:
Please include reference: ‘MEM (your name)’
Name:
Age:
Winnings/points:
Height:
Up to date flu vac
Yes ☐
Details of horse/horses
Name
Age:
Winnings/points:
No ☐
Up to date flu vac
Please list Riding Club Test/ BHS qualifications or similar:
Please list any First Aid or Health and Safety qualifications:
Please list any allergies or medical conditions:
Please continue overleaf. 
Height:
Yes ☐
No ☐
Interests:
Hacking ☐
Showing ☐
Jumping ☐
Dressage ☐
XC ☐
Trec ☐
Other :
I would like to take part in team competitions:
Dressage ☐
Riders’ Test ☐
Show Jumping ☐
XC/Horse Trials ☐
Assistance to the Club:
The Club is run by members for members. Events and activities can only take place with help from all
members – even just a couple of hours. Assistance can include setting up prior to an event or packing up
afterwards; writing for a dressage judge; picking up poles at a SJ class; help with admin. and many other
jobs. Please indicate with which events/activities you can assist:
SJ Show ☐
Dressage Show ☐
WH/Showing Show ☐
Monthly Club Nights ☐
Social/Fund Raising ☐ Web site/Facebook ☐ Sponsorship ☐
Is there any other assistance you can provide:
Any other comments or suggestions:
Every affiliated riding club is required to forward member details to British Riding Clubs’ Head Office. The
information provided in this form will be held by Polnoon Castle Riders’ Association and British Riding Clubs
on secure databases and used only in accordance with the Data Protection Act 1998.
From time to time photographs may be taken at events for use on the Club website and Facebook page.
Please tick the box if you DO NOT want your photograph to be used. ☐
Signed:
Date: