Western Michigan Miniature Horse Club
Membership Form for 2007
| NAME: | |
| YOUTH NAME | BIRTHDATE |
| YOUTH NAME | BIRTHDATE |
| YOUTH NAME | BIRTHDATE |
| ADDRESS | |
| CITY | STATE/ZIP |
| PHONE | |
|
Adults - $10.00 x ______ = $_______
Youth 13-17 - $5.00 x ______ = $_______ Youth 12 & Under - FREE x ______ Equine Times Subscription - $8.50 = $_______ TOTAL = $________ |
Referred by:_________________________________(for new members only please)
Make checks payable to: WMMHC
| Mail to: | Audra Fitzpatrick-Cook 14578 154th Avenue Grand Haven, MI 49417 |