FWDCMembership

Fort Worth Dressage Club Membership Application

Name *

First Name Last Name

USDF #

Address: *

Street Address 1

Street Address 2

City State

Zip

Phone Number *

Email Address *

Birthdate

mm/dd/yyyy

A $7.00 credit will be applied for each renewal membership and will be reflected in your "Total Due".

I Want to

Membership Type

ST1

Member renew #2

I Want to

Membership Type

ST2

Member renew #3

I Want to

Membership Type

ST3

Total Due

Family Member

Name

USDF #

Birthdate Phone

PAYMENT OPTIONS

		Mail to:
PAYPAL.ME/FWDC		Donna Claunch
		1308 Marydale Dr.
		Arlington, TX 76013

Credit

By clicking on the "Submit" button you are agreeing to the following:

I hereby release the Fort Worth Dressage Club, its officers, members, employees and agents from any liabilities and all claims of every kind including costs, expenses, or attorney fees that might result from
damages, injuries, or losses resulting directly or indirectly from the negligent act or omissions of the officers, members, employees or agents of the Fort Worth Dressage Club.