FALL 2017 Registration Form

Please Print and fill out the following application to join us on the next trail ride.

Name ________________________________________________________________

Address _______________________________________________________________

______________________________________________________________________

Phone (_______) _________________ - ___________________________

E-Mail _______________________________________________________

Adult (18 and over) _________________ x $65.00 each

Youth (11 through 17) ________________ x $35.00 each

Age 10 & Under ______________ No Charge

Late Registration __________________ x $5.00 each Adult (Registrations not post-marked WITH payment enclosed by September 5, 2017)

Total Amount Enclosed $ ___________ . 00

Help us plan meals !!!!!
How many are attending ?

Fri. _________ Sat. ___________ Sun. _____________

Vegetarian __________________

Make check payable to: Amelia Springs Trail Ride

Mail to: Jennifer Vaughan
P.O. Box 70
Crozier, VA 23039
Phone: 757-635-4300

E-Mail: ameliatrailride@gmail.com.com

Click HERE for the Waiver form that must be signed and mailed in as well.

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