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)
Division
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: