BERMUDA DRESSAGE GROUP
MEMBERSHIP APPLICATION/RENEWAL FORM
P.O. Box HM 2513, Hamilton HM GX, Bermuda
From 01 September 2009 to 31 August 2010
www.bermudadressage.com
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Name of Member(s):
 

Stable (circle):
      Hinson Hall     Spicelands    Inwood     Terceira's     Seaview
  Specify other:

Full Mailing Address:
 

Home
Phone

Work
Phone

Home
Fax

Work
Fax

EMAIL ADDRESS:

Senior/Adult Member

$50.00

Family Member (Please complete Section A below)

$75.00

Junior Competitor (Please complete Section B below)

$30.00

A - FAMILY MEMBER

Name:

Date of Birth
Date/Month/Year

Stable

 A

 A

 A

 B

 B

 B

 C

 C

 C

B - JUNIOR MEMBER

NAME OF PARENTS/GUARDIAN

PLACE OF WORK

PHONE

VOLUNTEER REQUEST

WE ALWAYS NEED VOLUNTEERS - CAN YOU ASSIST IN ANY OF THE FOLLOWING (please circle)

Runner

Scribe

Scorer

Announcer

Steward

Canteen

 Other (please specify):

Would you be able to provide Accommodation, Transportation and/or Entertainment for our visiting Judges and/or Clinician?
Yes                  No
. 

Would you like to make a donation to the BDG?  PLEASE indicate the value of your donation below:

General Donation $_________ FEI Challenge $_________CEA Challenge $_________
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