Office Use Only: Date App.

Recd: ________ Date Dues Paid: _________

WHISPERING PINES CHAPTER OF THE SOUTH WIND DRESSAGE AND EVENTING ASSOCIATION
Membership Application This Organization is a Chapter of a USDF Group Member Organization. Individual/Primary, Family, and Junior/Secondary members of this organization are automatically USDF Group Members.

This application is: Name:_ Address: City: Cell phone:

New (Initial)

or a

Renewal (USDF Number:

___) ___________

____________________________________ Birth Date: __________________________________ Phone: __________________________ State: ____ Zip:

______________ ___________

_____________________ Email:

_________________________

I apply for membership in the Whispering Pines Chapter and agree to be bound by the Constitution and By-Laws, and rules, regulations, decisions, and motions lawfully adopted under said Constitution and By-Laws of the Association. Date: __________ Signature:____________________________________________ ______________________________________
(If you are under the age of eighteen years, the application must be signed by you and your parent/guardian.)

Printed Name of Parent/Guardian:

(Necessary if Signer less than eighteen years of age)

Signature of Parent/Guardian: __________________________________________________ Membership Type/Dues: (due annually before November 1st) Individual/Primary ($40.00) entitled to full Group Member benefits under USDF, including GMO year-end award eligibility, and USDF Group Member Number, and USDF magazine subscription. Junior/Secondary ($25.00) must be 18 years old or younger. You will not have a USDF member number nor will you receive the magazine. Please note that this is different from previous years. If a junior is planning on showing in recognized shows, he/she will need to sign up as an individual. Family membership ($55) entitled to full group member benefits under USDF, including GMO year-end award eligibility, and USDF Group Member umber, and USDF magazine subscription. Requires at least two family members.
Send To: Nanci Kendall 5203 Phillips Rd Valdosta, GA 31601 Email: nanci_kendall@hotmail.com

Make checks payable to: Whispering Pines

Revised 06/17/12