Registration Form

Please Print and fill out the following application to join us on the next trail ride.

Name ________________________________________________________________

Address _______________________________________________________________

______________________________________________________________________

Phone (_______) _________________ - ___________________________

E-Mail _______________________________________________________

Adult (17 and over) _________________ x $50.00 each

Youth (11 through 16) ________________ x $30.00 each

Age 10 & Under ______________ No Charge

Friday Dinner __________________ x $8.00 each

Total Amount Enclosed $ ___________ . 00

Help us plan meals !!!!!
How many are attending ?

Fri. _________ Sat. ___________ Sun. _____________

Vegetarian __________________

Make check payable to: Amelia Springs Trail Ride

Mail to: Wanda Walker
14340 Bent Creek Rd
Amelia VA, 23002
Phone: 804-561-6633 or 804-513-1319

E-Mail Wanda at saddleupbilly@yahoo.com

Click HERE for the Waiver form that must be signed and mailed in as well.

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