Name ________________________________________________________________
Address _______________________________________________________________
______________________________________________________________________
Phone (_______) _________________ - ___________________________
E-Mail _______________________________________________________
Adult (17 and over) _________________ x $60.00 each
Youth (11 through 16) ________________ x $30.00 each
Age 10 & Under ______________ No Charge
Saturday (ride, lunch and dinner only) __________________$40
Sunday (ride only) ___________________$25
Total Amount Enclosed $ ___________ . 00
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.