Maine Appaloosa Youth Club Membership Application

Any person under the age of 18 as of  January 1 of the calendar year is eligible for membership in the Maine  Appaloosa Youth Club. The only requirement is the applicant must belong to the Maine Appaloosa  Horse Club.

Name of Youth: _____________________________________ Date of Birth:   _________________

Mailing Address: ____________________________________ Telephone #:   __________________

City, State, Zip:   __________________________________________________________________

Email Address:   ___________________________________________________________________

Parents Name:   _________________________________________________________________    Do you have brothers and/or sisters:   _________________________________________________    Do you have other pets:   __________________________________________________________

Would your parents be willing to volunteer to help with: (please check)

Fundraising events?   _______ Special Events? _______ Group transportation? _______

What are your horses names:   _____________________________________________________    _____________________________________________________________________________    _____________________________________________________________________________

Do you plan to show for In-state Points ________ or Regional Points ________ AYA #:   ___________________

List other horse organizations you are a member of (ex. AJQHA):   ______________________________________________________________________________

What grade/school are you in? What are your other hobbies and interests, sports, etc.?   ______________________________________________________________________________    ______________________________________________________________________________    ______________________________________________________________________________

Would you like to run for a Youth Club office in the future?   _______________________________    Would you like to run for Appaloosa Royalty?   __________________________________________

Do you have any concerns or requests for the coming year? We really do  want input from all members: (please use additional paper if needed)   ________________________________________________________________________________    ________________________________________________________________________________

The annual membership dues are $5.00 payable to: MAINE APPALOOSA YOUTH CLUB

Mail this application and a check for $5.00 for each youth to:

Maine Appaloosa Youth Club Lisa Blanchette 84 Harbor View Drive Sullivan, ME. 04664

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