|
John Wayne Pioneer Wagons & Riders 28th Annual Cross State Ride 2009 Information & Registration |
|
Circle days you will attend: May 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 31 June 1, 2, 3, 4, 5, 6, 7 |
|
FEES: |
EACH: |
X # People |
X # Days |
= Total Cost |
| Horse Rider or Participant, Full Trip, per person |
$ |
|
|
|
|
Teamster and one Helper, Full Trip |
$ |
|
|
|
| Non Rider/Helper, Full Trip when accompanied by a Full Trip paid rider or participant. |
$ |
|
|
|
|
Children 11 through 17, Full trip (per person) |
$ |
|
|
|
|
Children under 10 Per Day or Full Trip (see note below) |
None |
|
|
|
|
Per Day: Rider, Teamster /Helper (UP to Full Trip Fee) |
$ |
|
|
|
| Annual Membership (If not a member) |
$25.00 |
|
|
|
|
Total Amount Paid |
Note: Children under 10 are free when accompanied by a Paid Member parent/guardian.
| Name of Member:________________________________ | Home Phone:________________________________ |
| Address:_______________________________________ | Cell Phone:_________________________________ |
| City:__________________________________________ | State:___________Zip:________________________ |
REGISTRATION CLOSES MAY 15 TH. RIDE IS LIMITED .
|
Ride Horse [ ] Drive Wagon [ ] Walk [ ] Bike [ ] Other _____________________ |
|
**All participants of JWPW&R’S events must be a JWPW&R member and sign this waiver. |
| I do hereby waive any and all liability against persons organizing any rides sponsored by the John Wayne Pioneer Wagons and Riders or owners of real property upon which rides are held. |
|
Signed:______________________________________Signed:_____________________________________ Signed:______________________________________Signed:______________________________________ All Riders/participants must be JWPWR Members and pay the above ride fees whether they ride or or not. |
|
[ ] Please check if you would like to help with Camp or Trail Activities. [ ] Please check here if you are a new member. MAIL FORM TO: JWPWR P.O. BOX 191 Graham, WA 98338 |