BERMUDA DRESSAGE GROUP
MEMBERSHIP APPLICATION/RENEWAL FORM
P.O. Box HM 2513, Hamilton HM GX, Bermuda
From 01 September 2011 to 31 August 2012
www.bermudadressage.com
.

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(S)

Name:

Date of Birth
dd/mm/yy

Stable

 A

 A

 A

 B

 B

 B

 C

 C

 C

B - JUNIOR MEMBER

NAME OF PARENT/GUARDIAN

JUNIOR DOB (dd/mm/yy)

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 $_________
.