Surname

Forename:

 

D.O.B

Email address:

 

Home Address:

 

 

 

Post code

MEMBERSHIP NO:

OFFICE USE ONLY

 

 

 

Home Telephone no:

Mobile Number:

Emergency Contact:

Emergency Number:

Membership Fees

Please tick the appropriate Box

Non-Rider £6                      Junior £8                 Senior £12               Family £16

After 31st March £8                   £10                             £14                           £18

(Please note that family membership are for families i.e. Mum/Dad & their children)

Cheques made payable to A.V.R.C

Please forward to (with A5 SAE) Mrs. A. Howell Carman Equestrian Supplies, 593 Thornton Road, Thornton Bradford BD13 3NW Tel: 01274 835308 Call in at the shop

Horse/Pony Details

Please make sure these detail are correctly filled in, as they help us to sort the classes out for the Winter Championships.

H/P Name:

Breed:

Age:

Height:

Passport No:

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Additional Names (For Family membership)

Surname:

Forename:

D.O.B

Membership No

Office use only

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Signature:                                                   Date: