Membership Application

Published on March 2017 | Categories: Documents | Downloads: 30 | Comments: 0 | Views: 273
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Tri-State Rodeo Association
Membership Application
Send To:

Barb Nissen
3636 Devils Hole Road
Luckey, OH 43443
(419) 833-3636

Circle One: Family $20.00
After May 1st
$25.00

Individual

Name:__________________________________

$15.00
$20.00

Spouse:_____________________________

Address:________________________________________
City:__________________________________

Phone:______________________

State:____________

Zip:______________

E-Mail Address:________________________________________________________________
Please attach copy of Birth Certificate for all youth (18 years or under as of 01/01/current year)
Name/Birth Date
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
To earn points for Year-End Awards:
Attach copies of registration papers or proof of ownership with pictures
Lease horses must have the same
Lease forms may be attained from the Membership Secretary
Transfers are valid for 60 days only, from the date of transfer
Note “call names” (if used) on copies of registration papers
Both OWNER and EXHIBITOR must be Tri-State Rodeo Association members
Rule books may be attained from the Point Secretary or officers at any time
List of Horses:
______________________________________ ______________________________________
______________________________________ ______________________________________
______________________________________ ______________________________________
Signature:____________________________________
Date:_______________________

OFFICE USE ONLY
Date Received _____________
Check #
_____________
Check Date
_____________
Amount
_____________
Treasurer
_____________

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