The Dyfnant and Vyrnwy Horse Riders and Carriage Drivers Association

I wish to apply for membership of the above association:
Title Mr. / Mrs. / Miss / Ms.
Name
Address
Post Code
Telephone Email
INSURANCE:
Are you insured while riding?
Yes No (Please tick)
If so, with whom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I enclose my membership fee of £10.00 (please make cheques payable to D.V.H.R.C.D.A.)

Signed . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . . . . . . . . . .
Please send this form, together with your payment, to:
Sue Davidson
Membership Secretary DVHRCDA
Ty Brith
Cwmnant y Meichiaid
LLANFYLLIN
POWYS SY22 5NB





Sue’s email is kitd@madasafish.com
or phone: 01691 648299