1. No category

CHISLEHURST AND RUSHMORE EQUESTRIAN CLUB
I wish to join Chislehurst and Rushmore Equestrian Club
Subscription
Full members (17yrs and over)
Standing order
Non-riding
Family membership
£25.00 - if paying by cheque or cash
£22.50 - if setting up mandate for standing order
£12.00
£37.50 - 2 riding members + 2 social members
I enclose a cheque for £______________
OR
I have arranged to pay by attached standing order.
NAME (Miss, Mrs, Ms, Mr., Dr ) ...................................................................................................................................
ADDRESS .....................................................................................................................................................................
...................................................................................................................................... POSTCODE...........................
HOME TELEPHONE (INC. CODE)........................................................................................
MOBILE ………………………………………………………………………………………..
e-mail ……………………………………………………….
USUAL SIGNATURE....................................................................................BHS NUMBER (if any)..........................
PONY CLUB OR RIDING CLUB GRADES (if any)....................................................................................................
ANY OTHER QUALIFICATIONS.......................................................................................................................................
ROAD SAFETY CERTIFICATE..................................................................................................................................
Please make cheques payable to CHISLEHURST & RUSHMORE EQUESTRIAN CLUB
Please return completed form and remittance/Standing Order to the Membership Secretary:MISS SYLVIA SINGLETON
130 Mayeswood Road
Grove Park, London. SE12 9RU.
Telephone Number 020 8857 3548
Would all horse owners please complete this section.
Horse’s Name...................................................................Colour........................................Height...................Sex..............
Age...................Stabled at...............................................................................BHS Points/BSJA Winnings.........................
PLEASE NOTE
TAKING RIDING CLUB TESTS OR REPRESENTING THE CLUB
For both of these your name has to be registered with the British Horse Society, to which we are affiliated. Before
taking a Riding Club Test or Exam or representing the club in an official competition, you must have held membership
for 3 months and your horse must have a valid equine influenza certificate.
The Club members address lists are kept on a database. If you have any query about this, please contact the
Membership Secretary.
The Committee reserves the right to refuse membership.
STANDING ORDER MANDATE
Your Bank Details
To
Name of Account to be Debited
Sort Code
Account Number
Please pay HSBC BANK WOOLWICH SORTING CODE 40 - 07 - 35
Account Number 51266322
THE CHISLEHURST & RUSHMORE EQUESTRIAN CLUB
Quoting as reference your surname and initials …………………………………
THE SUM OF £22.50
TWENTY TWO POUNDS AND FIFTY PENCE
Commencing the Date …………… and thereafter every 15th January
Annually until further notice in writing.
Signature (S) …………………………
Please complete the following:I am interested in competing in the following
Dressage
Show jumping
Eventing
Hunter Trials
Combined training
Quizzes
Clinics
Training sessions
I am interested in representing the club in either individual or team events
I would like to take the Road Safety Test
I would like to take the Senior Equitation Tests
I would like to take the First Aid Course
I would like to take the Senior Horse Welfare Exams
I am willing to help at the following:
Annual Show
Hunter Trials
Dressage
One Day Event
I would like to see the following organised: -____
In-hand show