BROOKHEAD WARRINGTON RIDING CLUB  
   
  2008 Membership Application Form  
  Valid until 31st October 2008  
  Senior £20-00    Junior £16-00  
  (Junior Membership - Aged 17 years & under on 1st January 2008 . Application forms MUST be signed by a parent or guardian.)  
                         
   
  NAME :                
   
  ADDRESS:                
                 
  POST CODE      
  DATE OF BIRTH:     AGE:    
  TYPE OF MEMBERSHIP APPLIED FOR : JUNIOR/SENIOR  
  TEL HOME :       MOBILE:          
  E-MAIL ADDRES                    
  NEXT OF KIN   (EMERGENCY USE ONLY) NAME       TEL:        
                         
   
  I agree to be bound by the Rules and Constitution of the Brookhead Warrington Riding Club  
   
  Signed         Date        
   
  Signed         (Parent/Guardian if Junior)  
   
                         
                         
  Details of Horse/Pony to be Used by Member: Office use only  
  Passport Check    
  1: NAME OF THE HORSE/PONY:         Initials:      
  Breed of Horse    
  Height : hh_ Age yrs Date:  
                         
  2: NAME OF THE HORSE/PONY:         Initials:      
  Breed of Horse    
  Height : hh_ Age yrs Date:  
                         
  3: NAME OF THE HORSE/PONY:         Initials:      
  Breed of Horse    
  Height : hh_ Age yrs Date:  
                         
  4: NAME OF THE HORSE/PONY:         Initials:      
  Breed of Horse    
  Height : hh_ Age yrs Date:  
                         
   
  Please return completed form with payment to:  
  (Cheque/PO made payable to "Brookhead Warrington Riding Club")  
   
  BWRC Membership  
  5 Sherwood Crescent  
  Burtonwood  
  Warrington  
  WA5 4PR  
   
          For Office use Only              
  D: /                / P:                          C:   MN:     I: