Membership Application

To join TVDCTA or renew your membership, please print this page, complete the requested information, and mail it (along with your dues) as directed:

Tennessee Valley Dressage and Combined Training Association Membership Application

Primary Member Name: _________________________________ Birth Date (for Juniors): _____________

Address: ______________________________________________________________________________

______________________________________________________________________________

Phone: (_____) __________________ E-Mail Address: ________________________________________

Membership Type: Please select either Individual Adult, Individual Junior, or Family Membership and

enter appropriate fee.

____ Individual Adult Membership ($40) (USDF Dues $20, Club Dues $20)

____ Individual Junior (under 21) Membership ($30) (USDF Dues $20, Club Dues $10)

____ Family Membership ($50; covers two riders) (USDF Dues $30, Club Dues $20)

Secondary Family Member Name: _________________________________

Birth Date (for Juniors): _____________

Additional Family Membership Riders ($12 each) (USDF Dues $10, Club Dues $2)

____ Additional Family Rider 1 Name: ___________________________________

Birth Date (for Juniors): _____________

____ Additional Family Rider 3 Name: ___________________________________

Birth Date (for Juniors): _____________

____ Additional Family Rider 4 Name: ___________________________________

Birth Date (for Juniors): _____________

____ Total Membership Fee - A portion of your dues will be sent to USDF

If a new member, how did you find out about TVDCTA? (Which TVDCTA member should get the credit?)

___________________________________________________________________________________________

Are you interested in helping out with:

Awards - Budgets - Clinics - Shows - Combined Training - Librarian

Meetings/Programs - Membership - Newsletter - Nominating - Publicity - Volunteers ?

Please make checks payable to TVDCTA. - Please submit renewals prior to November 30th.

Mail to: TVDCTA Membership, c/o Penny Lee, 104 Stilwell Drive, Toney, AL 35773

For more information, contact Penny at (256) 348-4960

To pay using PayPay, select the appropriate category below and click on Add To Cart. (Note, this option is

currently being tested, so it is not currently available)

This organization is a USDF Group Member Organization and members are automatically USDF Group Members.

Tennessee Valley Dressage and Combined Training Association

Last Updated 12/30/2011