Velvet Court Society USDF GMO Membership Application

Velvet Court Society USDF GMO Membership Application

Online membership application .
Member and Contact Information
Member Type
Full Legal Name

First NameMiddle NameLast Name
Preferred Name
Farm/Stable Name
USDF Member Number
Mailing Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
City
State
ZIP Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
Date of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit year Birthdate determines USDF rider awards designations
Membership Details and Volunteer Preferences

Please share with us your interests.
Membership Category
Volunteer Participation Areas

Other
Volunteer - Other
Membership Directory Consent
You agree to let us share your information with other members and only when appropriate .
Agreement, Signature, and Payment

The Velvet Court Society is a USDF Group Memebrship Organization and by signing this form you agree to abide by the bylaws set forth by the USDF and accept revocation of memebership as a result of violating said bylaws. Membership is voluntary and you agree to hold harmless the Velvet Court Society for any injury resulting to your person or persons you represent.
Agreement & Liability Waiver Signature
Agreement & Liability Waiver Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Parent/Guardian Signature (if Junior/Young Rider)
Payment Method
Total Amount Enclosed
All memberships are $25.00 per person.
PayPal handle: @velvetcourtsociety Contact: Jill Ekis 3811 New Texas Rd Pittsburgh, PA 15239
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Velvet Court Society USDF GMO Membership Application

Member and Contact Information

Membership Details and Volunteer Preferences

Agreement, Signature, and Payment