Membership Application
___ Individual Child or Adult Membership $25.00 If Child, enter Date Of birth: __________________
___ Family Membership $35.00 Includes husband, wife & children under 18 as of January 1.
Name: ______________________
If Family, Spouse name: _________________________
Child Name: ________________________________ Date of birth: __________________
Child Name: ________________________________ Date of birth: __________________
Child Name: ________________________________ Date of birth: __________________
Member Signature:____________________________________ Date:_______________
Parent or Guardian signature if member is a minor: _______________________________ Date: _____________
Printed name of parent or guardian: _______________________________________________________________
Address, City, State and Zip ____________________________________________________________________
Telephone: _________________Cell _______________ E Mail: _______________________________________
I am willing to help at Contest Shows _____ I am willing to help at pleasure shows _____ I I receive the Corral from another source and do not need another copy. _______ Checks Pay to: Wayne County Saddle Club. Mail to P. O. Box 318, Wooster, Ohio 44691
Received by: ________ Amount: _____________Date:__________ Cash ___ Check Number:______