MOUNTAIN STREAM SADDLE CLUB
MEMBERSHIP FORM
    
     NAME  ____________________________________________________________
     ADDRESS  __________________________________________________________
     __________________________________________________________________
     PHONE  ____________________________________________________________
     
     EMAIL ADDRESS:____________________________________________________
 
     MEMBERSHIP:  SINGLE $20.00   o  FAMILY $30.00   o
     NAMES OF ADDITIONAL FAMILY MEMBERS:
     ___________________________________________________________________
     ___________________________________________________________________
     ___________________________________________________________________
     ___________________________________________________________________
     I undersigned, do hereby agree to comply with the rules of the Mountain Stream
     Saddle Club.  I will not hold Mountain Stream Saddle Club, it's officers or members
     liable for any theft or injury obtained while at a Mountain Stream Saddle Club show
     or event and releases Mountain Stream Saddle Club from all responsibility.
     SIGNED________________________________________DATE_______________

     SIGNED________________________________________DATE_______________

     Parent or Guardian if under 18:

     _______________________________________________DATE______________
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