Buxmont Riding Club’s

Membership Application

 

Name___________________________Date of application___________________

Spouse’s Name _____________________________________________________

Child/Children’s Name(age 17 & under)                             Age               Date of Birth

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

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Address ___________________________________________________________

City _____________________________State ____________Zip______________

Phone Number_____________________ Cell______________________

E-Mail Address (if applicable)_______________________________________

Number of Horses in your family _______________________________________

Type of horses you have: _______________________________________

What is your interest in the Buxmont Riding Club? _________________________

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Do you belong to any other clubs, if so which ones?  ________________________

__________________________________________________________________

Where/How did you hear about the Buxmont Riding Club? __________________

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The Buxmont Riding Club runs on VOLUNTEERISM.  In order to match up your interest and skills with the functions to maintain the club, PLEASE rate the following as to what you can be involved in: 0 for can’t do, a 1 for can try to help out and a 2 for you can help out in that area.

___Food Booth                        ___Judge assistant                    ___Show Booth

___ Banquet                             ___Workshops/Clinics             ___Outside Speakers

___Building                              ___Ribbon Runner                   ___Trail Rides

___Gate help                            ___Ring Master                        ___ Hosted Shows (NBHA, PJHS)

___Western show help        ____English show help             ____ Gymkhana show help

 

Make checks payable to the Buxmont Riding Club, Inc.  Please mail your check and this application to 71 Clump Road P.O. Box 113 Tylersport, Pa 18971-0113 or take this application and your payment to a horse show or meeting. Dues are as follows:  

Single Membership------  $30 (an individual that is 18 yrs or older)

Dual Membership--------   $35, 2 people (at least one of whom is 18 yrs or older & both live under same roof)

Family Membership------  $45, 3 or more people (at least one of whom is 18 yrs or older & all live under same roof)

 

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A Probationary Member on __________________Date Dues Paid __________________

Membership Committee Member______________Cash or Check Number____________

An Active Member on_______________________Treasurer ______________________