No: 2018/
Please complete ONE form per person
and complete all parts to the form clearly
Surname:______(Mr. / Master / Mrs. / Miss / Ms.)
(PLEASE PRINT IN CAPITALS IN ALL CASES) (Please delete as required)
Christian Name(s):______
Age of rider at 1st January 2018:______This is important and must be completed – especially for children
(It is vital you complete this part of the form for the points to be worked out at the end of the season for the overall trophies – Tiny Tots, Juniors, Intermediates and Seniors. If you are 17 years old or over write A in the space provided.) For all other ages, write your age!
Address:______
______
______
Post Code:______
Telephone:______Mobile:______
Email:______
Please include your email clearly as this will be used for all communications from the Club!
Contact details are only retained for the year and will be destroyed at the end of the season – they are used solely to contact you in relation to this year’s shows and presentation night and will not be shared with any third parties.
Please state below the rider and horse/pony nominated for points for 2018
NAME OF RIDER / NAME OF PONY / HORSE / Horse/Pony height (hh)IMPORTANT TO INCLUDE / Horse/Pony age (yrs)
IMPORTANT TO INCLUDE
SUBSCRIPTIONS
Single Membership £10
Family membership £25 (2 Adults & 2 Children – additional children @ £5 each)
Send your membership form and cheque made payable to “Barleyfields Riding Club”to:
- Sally Ashby @ Barleyfields Equestrian Centre, Ash Lane, Etwall, Derby DE65 6HT
- Or mailto: and ask for BACS information
Please enclose a stamped addressed envelope for return of your membership card(s) or alternatively you can collect from the caravan on the first show which is Monday 7th May 2018
Signature of Member:______
(PARENT / GUARDIAN TO SIGN IF MEMBER IS 18YRS OR UNDER 1ST JANUARY OF CURRENT YEAR)
Signature is required for all members and must be made by someone 18 years and over
2018 Mem Form