MEMBERSHIP APPLICATION
IF YOU WOULD LIKE TO BECOME A MEMBER OF MELODY RIDERS SADDLE CLUB OR RENEW YOUR MEMBERSHIP, PLEASE FILL OUT THE FOLLOWING APPLICATION AND RETURN IT TO THE ADDRESS BELOW:
MEMBERSHIP DUES ARE AS F0LLOWS:
______ $ 28.00 PER PERSON (Must be 18 years of age or
older)
______ $ 38.00 PER FAMILY (Must be immediate family group
only)
This includes The Competitor newsletter in which we print our minutes and news articles. Club rules state that if you are a minor, an adult must join with you. A minor is anyone under the age of 18 as of January 1, current year.
FIRST NAME
LAST NAME
BIRTHDATE
AGE
HORSE'S NAME
_____________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
______________________________________________________________________________________
YOUR MAILING ADDRESS _______________________________________Phone
Number ______________
Emergency Contact _________________________ Phone ________________
RESPONSIBILITY RELEASE CLAUSE AGREEMENT
Except in certain circumstances, any rider or participant in a riding activity at the Melody Riders Saddle Club arena or other MRSC event venue, who is injured there, may not hold the Melody Riders Saddle Club or its officers responsible for his or her injuries. According to Washington State RCW 4.24
I have read the above and agree to the above:
Signature ___________________________________________
Date __________________________
Please mail to:
MRSC, P. O. Box 236, Addy, WA 99101
For more information you can contact Oly Burnett evenings
at (509) 935-4006
If you want The Competitor newsletter sent
to a different address than the one listed above, fill out:
Name ___________________________________
Address ______________________________________________________________________
Please check here if you do not want your phone number
printed in directory ___________