Greeley Saddle Club

Membership Application-2020

P.O. Box 1963 Greeley, CO 80631 Date Paid______________________

Membership Type Single $30.00 Family $40.00

Contact Preference (i.e. Newsletters) Email Mail

Permanent entry numbers are assigned to each participant. If you have a number that was assigned in 2016 or

after KEEP that number and record below. New numbers will be assigned in the order in which memberships are

paid. There will be no special requests for numbers.

Last Name First Name Birthdate

(required)

Permanent #

(Assigned by Office)

Street Address ________________________________________________________________________

City_____________________ State_____ Zip__________Phone Number__________________________

Emergency Contact: Name_____________________________ Phone____________________________

Email________________________________________________ Do you have health Insurance? ______

VOLUNTEER SERVICE FOR GREELEY SADDLE CLUB

Members are required to volunteer a minimum of 2 hours (single) or 4 hours (family) each year to qualify

for year-end awards and to help our club run on event days.