ACTRA's Membership Form
Just
Print Page and Mail to:
Gwenn Dexter
RR # 5
Canning, NS
B0P 1H0
NAME.......................................................................................................................................
ADDRESS.................................................................................................................................
PROVINCE.............................POSTAL CODE.............................TELEPHONE............................
E-MAIL.......................................................................................................
Junior riders in family
Name.................................................................
Age...................
Name.................................................................
Age...................
Name.................................................................
Age...................
Senior riders in family
Name................................................................
Name................................................................
Name................................................................
I wish to register the following mount(s) with ACTRA
Send copy of Registry Certificate
NAME................................................................................................SEX...............................
BREED................................................................................................AGE.............................
REGISTRY INFO. ASSOCIATION...................................................NUMBER....................
COLOR....................................................................................................................................
MARKINGS............................................................................................................................
Membership: Individuals $17.50, Family $22.50, Mount Registration $25.00
Total Submitted...............................
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