Application for Century Club Membership
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Email
example@example.com
Address
Street Address
Street Address Line 2
City
Province
Postal Code
Phone Number
Please enter a valid phone number.
Is this your first or subsequent Century Club Ride?
First
Second
Other
Which organization did you do your Century Ride with?
Century Club of Canada
Dressage Foundation- USA
Other
Horses Name
Horses Birth Year
Proof of Horses Age (Registration, Passport, Purchase document etc.)
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of
Rider's Age
Riders Birthdate (Birth certificate, Passport, Driver's licence etc)
Preferred Name of Horse and Rider (for publications)
Do you belong to a Dressage Club or Organization? Please list
Proof of Riders Birthdate ((Birth certificate, Passport, Driver's licence etc)
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Current Membership in CADORA INC
Number
Proposed Date of Ride
Date
Proposed Test
Level and test
Location of Ride
Event and Address
Event Contact
Name
Event Contact
E mail
Submit
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