WASHINGTON BARREL RACING ASSOCIATION

2008 MEMBERSHIP APPLICATION

 

NAME:___________________________________________________________________________

ADDRESS:________________________________________________________________________

CITY:___________________________________________ STATE:___________ZIP:____________

PHONE NUMBER:____________________________E-MAIL:_________________________________

CELL PHONE #:_____________________________SOCIAL SECURITY #_______________________

HAS BEEN A WBRA MEMBER IN PAST?___________HOW LONG AGO?_________________________ 

REFERRED BY:_____________________________________________________________________                                                                                                                                     

                                                                                                                         AMOUNT

MEMBERSHIP FEE                    $55.00 BY NOVEMBER 1st............................      _______________

                                            $60.OO BY JAN 1st.....................................      _______________

                                            $65.00 after 1/1/08...................................       _______________

                                            ROOKIE MEMBERSHIP $55.00 (1st year member)

CURRENT OFFICER? _______________

GOLD CARD MEMBER?  ____________ If yes, do you need a subscription to Competitor News? _______

OPEN AWARDS FEE                   $10.00...................................................        _______________

2000 NOVICE NOMINATION        $10.00..................................................         _______________

Horse Name    ______________________________________________

Horse’s lifetime winnings as of date nominated    ___________________

500 NOVICE NOMINATION          $10.00 .................................................          _______________

Horse Name    ______________________________________________

Horse’s lifetime winnings as of date nominated    ___________________

Futurity horse? ______________

                                                                                                   TOTAL FEES _______________

   

As a condition of membership all members will be required to hold an office or participate on a committee. They will designate their committee choice at the time of membership and the chair will be responsible for tracking participation. Committees will consist of: Spring Fling, Futurity, Last Chance and Finals.

Please check one:

___ Spring Fling  ____ Futurity ____ WBRA Races @ Futurity  ____ Last Chance ____ Finals

                                                                                                                    Make checks payable to WBRA

MEMBER SIGNATURE ____________________________________________________ DATE __________

                                            Member agrees to abide by ALL WBRA rules

Payment received by _____________________________ Check # _______________ DATE ___________

 

YOUTH/JUNIOR MEMBERSHIP

 

NAME _________________________________________________  AGE AS OF 10/1/07__________________________

YOUTH/JUNIOR MEMBERSHIP FEE $35.00 ...............................................                 _______________

       *Please send copy of birth certificate

AGE 12 & UNDER JUNIOR DIVISION AWARDS FEE   $5.00 ........................                  _______________

AGE 13 TO 18 YOUTH DIVISION AWARDS FEE   $5.00 ...........................                   _______________

 

                                                                                                                       TOTAL FEES      _______________

PARENT/GUARDIAN SIGNATURE _________________________________________ DATE _____________

Mail form and fees to:

WBRA Secretary / Treasurer    

Shawnee Lanphear  201509 Terrill Rd   Kennewick, WA 99337