7/29/2019 Wcec Membership Form

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Wine Country Equestrian Club(WCEC)

2013 Season Membership Application

Name: _________________________________Age for Junior (as of 12/31/13):

____

Address: _________________________________________________

Telephone: _________________ Email: _________________________

Junior Membership - $20.00 $ ________(Juniors are riders who are 17 years or younger as of Jan. 1, 2013)

Single Membership - $35.00 $ ________

Family Membership - $40.00 $ ________

(Please fill out below for EACH family member who will be participating)

Total Enclosed: $ ________

Family members who will be participating:

Name: __________________________________________ Age: _____

Name: __________________________________________ Age: _____

Name: __________________________________________ Age: _____

Name: __________________________________________ Age: _____

Please indicate what you are interested in:

Dressage Driving Volunteer

Signed: ______________________________________ Date: _______(Parent or guardian must sign if member is under 18)

Release form: Wine Country Equestrian ClubI, the undersigned member and/or parent or guardian of member, realize thatparticipation in equestrian activities is a high risk undertaking. By signing this form formembership in WCEC, I agree to hold harmless WCEC, its board members, officers,members, their estates and heirs, and any representative for any injury, loss, or accident

that may occur to myself, my horse, my equipment or anyone I bring with me whileparticipating in all equine activities sponsored by WCEC.

Signed: ______________________________________ Date: _______(Parent or guardian must sign if member is under 18)

Make checks payable to

Wine Country Equestrian Clubc/0 Anne Buckler11401 Summitview RoadYakima, WA