Chiddingfold branch of The Pony Club
MEMBERSHIP RENEWAL - ADDITIONAL INFORMATION FORM
TO BE COMPLETED BY THE PARENT/GUARDIAN ON RENEWING MEMBERSHIP(one per child please)
MEMBER’S NAME …………………………………………………………………………………………………………………………………………………………………
DATE OF BIRTH …………………………………………………………………………………………………………………AGE ON 1st JAN 2018…………………
PLEASE INDICATE BELOW IF THE MEMBER SUFFERS FROM / HAS SUFFERED FROM ANY CONDITION WHICH MAY AFFECT THEIR RIDING OR BE AFFECTED BY THEIR RIDING (ie diabetes, epilepsy, asthma, hay fever, dyslexia etc). This information is kept strictly confidential and is only made available to the organiser/instructor relevant to your child’s activities on the day
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HORSE/PONY’S STABLE NAME ……………………………………………………………………………..HEIGHT ………………………. AGE ......
HORSE/PONY’S COMPETITION NAME ……………………………………………………………………………………………………………………………………..
NB: Please would you be sure to let us know of any horse or pony change of details for our records
ARE YOU INTERESTED IN BEING ON A TEAM IN 2018 Yes /No
WHICH PONY CLUB LEVEL DO YOU AIM TO COMPETE AT IN 2018: please circle all that apply
Jumping = Tadpoles (up to 60cm) PC70 (70cm) PC80 (80cm) PC90 (90cm) PC100 (1m) PC OPEN (1.10m)
Dressage = Grassroots Novice Intermediate open
WHAT ARE YOU MOST INTERESTED IN: Please circle all that apply
Eventing Show Jumping Dressage Tet/Triathlon Non-Competitive/Fun Badges/Tests Other (please specify)
DO YOU HAVE ANY SUGGESTIONS FOR THE FUTURE OR FEEDBACK FROM 2017?
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WE REALLY APPRECIATE OUR VOLUNTEERS AND ARE GRATEFUL FOR ANY HELP OR SUPPORT YOU CAN OFFER PLEASE TELL US WHAT TIME OR TALENTS YOU CAN OFFER THE BRANCH ON THESE DATES OR GENERALLY?
27th May 2018 – Junior Show at Eashing......
10th June 2018 – Branch One Day Event at Rogate......
13/14thOctober 2018 – Branch Tetrathlon (Churcher’s College……………………………………………………………………………………………...
Camp – w/e 12th August 2018………………………………………………………………………………………………………………………………………………….
OTHER: eg Catering/Social events......
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PLEASE RETURN THIS FORM TO THE BRANCH MEMBERSHIP SECRETARY WITH YOUR MEMBERSHIP RENEWAL
Mrs Belinda Butcher, Woodhill, Hawkley, Liss, Hants GU33 6LX
9th December 2017