AffiliAtes Bay State Trail Riders Association, Inc. Membership Form Memberships are from January 1 through December 31 and include a free subscription to the Horsemen’s Yankee Pedlar and Massachusetts Horse Type of Membership: â?? New
â?? Renewal â?? Single $20 â?? Family $30 â?? Individual Lifetime Membership $350
Name________________________________________________ If you would like to be active in a local
CONNECTICUT MORGAN HORSE ASSOCIATION President: Melissa Curtis, 477 Dowd Ave., Canton, CT 06019; 860-693-2248. Vice President: Will Filosi, 321 Rt. 165, Preston, CT 06365; 860-887-6831. Secretary: Debra Becroft, 67 Hanover St., Yalesville, CT 06492; Treasurer: Lisa Cocco, 71 Old Farms Road, Cheshire, CT 06410; 203-699-8447; Membership: Melissa Curtis, 477 Dowd Ave., Canton, CT 06109; 860-693-2248.
chapter with more programs and events available, please check.
Last Name
â?? HERD South Eastern MA Chapter
Address
Street__________________________________________________
Town__________________________________________________I would like to Help State____________ Zip___________ Phone_________________
Connecticut Morgan Horse Membership Application
â?? by volunteering for trail work days
City
â?? by holding a ride
â?? with other projects that might be needed
â?? I do not want my name released on any mailing lists
â?? with________________________
â?? I do not want to receive the Yankee Pedlar or MA Horse
bstra@charter.net www.bstra.org
Mail this form along with your check made payable to BSTRA to: Rose Zariczny, Secretary, 216 Grand Street, Woonsocket, RI 02895; For more information call 401-762-4805.
State
Youth Membership ($20.00)
Family Membership ($40.00)
Individual Membership ($30.00)
Horse Nominations ($25.00 per horse)
(please list children under 18 with birthdays and name of horse nominated on separate piece of paper.)
Children under 18
DOB
Horse(s) Nominated for Year End Awards Please make check payable to CMHA, Inc. and mail with application to: Melissa Curtis, 477 Dowd Ave., Canton, CT 06019.
Charles River Dressage Association Membership Application
Colonial Carriage and Driving Society Membership Application Form YES, I’d like to be a member for $25
Name _______________________________________________________________________________ Farm Name __________________________________________________________________________
Zip
Telephone
Email ________________________________________________ â?? by helping on a ride
â?? I want to receive the Bugle online
First Name
January 1 through December 31, 2012
CHARLES RIVER DRESSAGE ASSOCIATION, President: Linda Currie, 617-974-4441, l.currie@comcast. net; Vice President: Kate Champa, 401-351-1683, kchampa@earthlink.net; Membership Director: Carol Burkhart, 508-359-9961, carol.burkhart@comcast.net. ____Junior (DOB__/__/__) ____Adult Amateur ____ Professional _____ Vintage (50-59) _____Masters (60+)
Name: Address:
Address _____________________________________________________________________________ City _________________________________________ State ____________________ Zip __________ Telephone ___________________________________________________________________________
Telephone: E-Mail:
We Own ________________________________________________________________Horses/Ponies
I would be interested in helping with (check any that are applicable):
My/our driving interests are: ( ) Pleasure ( ) Educational Seminars ( ) Carriage Horse ( ) Competition ( ) Draft Horse
â?’ Monthly Meetings â?’ Volunteering at shows/clinics
Make check payable to: and mail to:
(
) Pony
Colonial Carriage and Driving Society Kay Konove, P.O. Box 1593, Stockbridge, MA 01262
Connecticut Dressage & Combined Training Association, Inc.
We are a USDF Group Member Organization and a USEA affiliate. Dues: â?’ *OEJWJEVBM ZFBST â?’ $35 Junior VOEFS â?’ $55 Family (includes 2 members) â?’ 64%' GFF GPS FBDI BEEJUJPOBM GBNJMZ NFNCFS .FNCFSTIJQ ZFBS JT %FDFNCFS stm/PWFNCFS th/EARLY BIRD SPECIAL 4JHO VQ CFGPSF +BO HFU B EJTDPVOU
*T UIJT BQQMJDBUJPO GPS â?’ a new membership â?’ a renewal? Name: ______________________________________________ Date: ________________________________
â?’ Public Relations/Advertising â?’ Quarterly Newsletters
â?’ Managing shows/clinics â?’ Fund Raising
â?’ Other (specify)
The Charles River Dressage Association is a GMO (Group Member Organization) of the United States Dressage Federation. Annual Dues: Individual $55, Business $100. Add $12 for each additional family member. Please make your check payable to: Charles River Dressage Association, 4 Jade Walk, Medfield, MA 02052 For more information, call Linda Currie at 617-974-4441.
Connecticut Ranch Horse Association Membership Form Mail form and a check made out to CT Ranch Horse Association to: Andrea Hills, 772 Brooks Rd., Middletown, CT 06457. Name: ____________________________________________________
Membership: $25.00/person; $15.00 for each additional family member
Address: _____________________________________________________________________________
Address: ___________________________________________________________________________________
City: ________________________________ State:____________________ Zip:____________________
City: ______________________________________ State:____________________ Zip:____________________
Phone: ___________________________ Email: ______________________________________________
Day Phone: _________________________________ Evening Phone: __________________________________
Tell us about yourself and your experience: Team Penning and Roping: Prior and/or current rating: Team Penning: _________ Roping: __________
Email: _____________________________________________________________________________________ Family Memberships Only: List the additional names and dates of birth (for Juniors only). To help us to plan activities, please answer the following questions: My primary interest is in: â?’ Dressage Will you volunteer? â?’ yes â?’ no
â?’ Combined Training
â?’ Other________________
visit our website: www.cdctaonline.com email us: cdcta@cdctaonline.com
Please make checks payable to: CDCTA and mail completed application and check to: $%$5" .FNCFSTIJQ D P 4IFMCZ 8BKDT r $IBSMJF $JSDMF 4PVUI 8JOETPS $5
Team Penning or Roping experience: ______________________________________________________ Additional Family Members (please add age for members under 18 yrs): Name: ______________________________________ Experience: _______________________________ Name: ______________________________________ Experience: _______________________________ Signature: ______________________________________________________Date: __________________
Connecticut Trail Rides Association, Inc. Membership Application
Connecticut Horse Shows Association, Inc. 2012 Membership Application â??
â??
New Member â?? Renewal Type of membership desired: Individual/Junior $30.00 (Please attach name and date of birth of each junior member on a separate sheet) â?? *Family $45.00 â?? Corporate, Business or Farm $50.00 â?? Horse/Pony $15.00
Name Address Phone
State
Zip Code Email
Horse/Pony ($15.00 each): (if pony, indicate size-—-S, M ,L)
TOTAL AMOUNT ENCLOSED $________________ INTERESTS: â?? Hunter â?? Jumper â?? Breed â?? Western â?? Pleasure â?? Dressage Do you wish to receive the Pedlar from CHSA? â?? Yes â?? No â?? We agreed to abide by the rules set forth by CHSA, if applicable, I declare that I am an Amateur in accordance with “USEF Article
â?’ Individual Membership (Must be 18 years old) ..................................................................................... $25.00 â?’ Family Membership (Includes children under 18 years old) .............................................................. $30.00 â?’ Lifetime Membership .................................................................................................................................... $255.00 â?’ Lot Dues ................................................................................................................................................................ $45.00 â?’ Stall Dues ($5.00 per stall) ................................................................................................................................ $5.00 â?’ New Members one time charge ................................................................................................................... $10.00 s .EW -EMBERS ONLY "EFORE PAYING FOR A CAMP SITE YOU MUST CONTACT THE CAMP DIRECTOR Ann Dominick at 352-208-1809. s 9OUR NAME WILL BE PUT ON THE LOT LIST IN THE ORDER THEY ARE RECEIVED 9OU CANNOT HOLD A LOT unless you have a horse. Amount Enclosed $ .AME
GR808 Amateur Status.� SIGNATURE ______________________________ (If junior, parent or guardian must sign) DATE ______________ *A Family is a married couple or parent(s) and all children under 18. If showing Walk/Trot or Jog Divisions, please identify (S)addle, (W)estern or (H)unt seat. Show entries must be made using registered name or points will not count.
3TREET
Make checks payable to CHSA and mail to: CHSA Membership, c/o G. Jensen, 195 Wildwood Drive, Cheshire, CT 06410. Points accrue immediately upon receipt of application and dues by Show/Steward at a CHSA Member Show or the postmark date of an application and dues by the Membership Chairman.
-AKE CHECKS PAYABLE TO #42! AND MAIL APPLICATION TO +IM $ORE #42! SECRETARY ,ITCHFIELD 2D -ORRIS #4 06763 s $UES MUST BE PAID BY -ARCH ST IN ORDER TO RECEIVE YOUR YEARLY SUBSCRIPTION of the Horsemen’s Yankee Pedlar and to hold your lots.
#ITY 3TATE
may 2012
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