2025 WSDAC Membership Form

2025 Membership Form

Fill out the form carefully for registration
Rider Name

First NameMiddle NameLast Name
Birth Date

MonthDayYear
Gender
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Rider E-mail
example@example.com
Mobile Number
Phone Number
Work Number
WSDAC # (if applicable)
Horse Name & WSDAC Horse # (s) (if applicable)
TO REGISTER A HORSE FOR THE NATIONAL HORSE REGISTRY PLEASE COMPLETE BELOW.
Name of Horse
Birthdate of Horse
Breed of Horse
Sex of Horse

MareGeldingStallion
Canadian Born Horse
Division of Rider
Friends of WSDAC Membership Fee
etransfer payment to wsdacpayments@gmail.com
Show Membership Fee
etransfer payment to wsdacpayments@gmail.com
Judge Membership Fee
etransfer payment to wsdacpayments@gmail.com
Rider Signature

Clear
Parent/Guardian Signature

Clear
etransfer payment to

wsdacpayments@gmail.com
Should be Empty: