I hereby make application and enclose $________ for membership during the year____ January1st to December 31st Date:____________
Name:_____________________________________
Address:___________________________________
Zip Code:________________ Tel:_________________E-Mail:_________________
Individual Membership = $5.00
Family Membership =$10.00 (Includes Parent(s) and all children under 18.)
List all persons under 18 that are included in a family Membership and dates of birth.
___________________________________________________________________
___________________________________________________________________
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How did you hear about us? ___________________________________________
Please make checks payable to White Mountain Riding Club, and mail application and checks to:
Marilyn Hannah, 524 Rt 3 North Stratford, NH 03590