JOIN WRV

Western Riders isn't able to accept membership applications electronically due to parental permission requirements. You may print this membership application. Dues must be paid before using the riding ring.

                           WRV Membership Application

                                         Date: _____________

Single Membership:                                                               Family Membership:

Member Name: ____________________________________                 $60.00 Opt-out fee   YES       NO

Parent (if applicant is under 18):_______________________

Family members

First Name                                         Last Name (if different from above)       Age as of Jan. 1, 2008                   Please Circle

1. _________________________   ___________________________     ____________________  $60.00 Opt-out fee   YES       NO

2  _________________________   ___________________________      ___________________   $60.00 Opt-out fee   YES       NO

3. _________________________    ___________________________     ___________________    $60.00 Opt-out fee   YES       NO

4 ._________________________    ___________________________      ___________________   $60.00 Opt-out fee   YES       NO

5 ._________________________   ____________________________     _ __________________  $60.00 Opt-out fee   YES       NO

6.  _________________________   ___________________________      ___________________   $60.00 Opt-out fee   YES       NO

Address: _________________________________ City/State/Zip: __________________________________

Home Phone: _______________ Work phone: ______________ Cell phone: _______________

E-mail address (print clearly):_____________________________________

For new applicants, or under age 18 membership, Sponsored By: __________________________________

All applicants/members under age 18 must be sponsored by an adult member of The Western Riders of Virginia, Inc.  The adult sponsor takes full responsibility for the minor at all Western Riders of Virginia, Inc., functions.

In order to receive year end awards, the applicant or member of the applicant's family (if a minor) must work one 4 hour work detail  before July 1^st or pay the $60.00 opt-out fee (per rider), and work 2 shows per rider

Signed: ______________________________________ (Sponsor, if a minor)

Individual Membership (5 yrs and older)    @  $25                       ______

Family Membership                                     @  $40                     ______

Work detail opt-out fee at $60 x number of riders _____               ______

                                                  TOTAL DUE                             ______

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