Membership Fee - $____________ for 2014 year (Jan. – Dec.) ________ PAID
The purpose of the registration form is to collect and create a database of contact information to facilitate good communication of events, etc. to all members. An email listing of complete club contact information will be provided to each member on receipt of renewal and or/new membership.
Your contact information will not be added to the membership database without the required $20 membership fee, payable to ‘Grasswood Fillies’. A receipt will be issued upon request.
Welcome to the Grasswood Fillies!
Name:_________________________________________________________
Address: ______________________________________________________
______________________________________________________________
Phone: ____________________ ____________________ ____________________
Home Cell Work
Email: __________________________________________
Birthdate (for SHF insurance purposes): Day______ Month ______Year ______
May we use photos that may be taken of you/and your horse during Grasswood Filly events for promotional materials, ie for our Facebook page, website, other promotional media: _______Yes _______No
Signature______________________________________________________