CAN CHASER RASING

MEMBERSHIP APPLICATION / RENEWAL

MARCH 29^th, 2009 TO DECEMBER 31^st, 2009.

Subscription: Regular member (13 and up) $15 

Junior (9-12 years) $15 

Mini under 9 $10 

Mr/Mrs/Miss/Ms Name: ________________ Last Name: ________________

Address: _________________________________________________________

___________________________________________________________ Tel: __________________________

E-Mail Address: _____________________________________________

(PLEASE WRITE CLEARLY)

New Member Renewal

Name of Horse ___________________

Please indicate a category for which your horse will be competing in. The categories below indicate how much money your horse has won from barrel racing

Horse under 500.00, Horse under 1500.00

Horse under 3000.00 Horse over 3000.00

6 and under lead line 8 and under Junior 9-12 yrs Youth 13-17 Adult 18 and over

Please return this form, together with your check payable to C.C.R to

KATY GORHAM, DEBBEN BEESLEY, JOHN BURT,

OR MAIL TO

CCR

P.O. BOX 635

MARIPOSA CA 95338

www.canchaserracing.com