MEMBERSHIP FORM
SILVER SPUR RIDING CLUB, INC.
WEST RIVER ROAD, SIDNEY, MAINE
ESTABLISHED 1950
2009
The application must be accomplished by the membership fee and have an accurate address for mailings.
Your mailings and/or notices will come by E-mail, so please write your E-mail address clearly below. It is
important that if the application for membership is a minor the parents reads and signs the statement
below which is required for membership.
Membership Fee Family: $25.00______ Individual: $20.00________
New Member: ______ Renewal (was a member in 2008) _______
New Member Sponsored By:
__________________________________________________________
Complete all information (please print clearly)
Name: ____________________________________ Date: __________
Address: _________________________________
_______________________________________
Telephone Number: ____________________________
E-Mail Address: (required for newsletters) __________________________________
If this is a family Membership please list all names below. Also please list the date of birth of each child.
Birth dates are required or the application will be rejected.
Husband: ___________________ Wife: __________________
Children’s Names and DOB:________________ ________________
________________ ________________
________________ ________________
Please be aware that this club HIGHLY RECOMMENDS and ENCOURAGES all members under the age of 18
to wear a safety helmet at all times while mounted on a horse whether it be inside the ring or not.
As parents of a minor child/ren please read the two statements below and after thinking of all the safety
issues and what you feel would be best for you child/ren please sign one of the two statements either
agreeing to wear a helmet or choosing not to. Both parents need to sign please. A signature is required
for membership.
By signing here you are agreeing to have your minor child/ren follow this recommendation to wear the
safety helmet.
_____________________________ ________________________________
By signing here you are agreeing that you have read the recommendation but are choosing not to follow
that recommendation and agree as the parents of the minor to take care of any and all medical cost if your
child should get hurt. You are also agreeing to hold Silver Spur harmless of any liability or lawsuit.
_________________________________ _________________________________
Also if your chid/ren will be coming with someone other than you the parent please put there name here
and make sure they are informed of your decision. _________________
Please make checks payable to Silver Spur Riding Club.
Please mail completed membership form and check to:
Jackie Kulik
140 North Reynolds Road
Winslow, Maine 04901
Thank You! Hope to see you at the Shows!