Please print all information below clearly. Your Name and Spouse’s Name (if family or joint membership) ________________________________________________________________________________________________________________________ Children’s names & ages - (17 yrs and under if family membership) ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ Mailing Address ____________________________________________________________________________________________ Town ___________________________________________________________ State __________ Zip code __________________ Contact phone # (______) ______-__________ Cell phone # (______) ______-________ PLEASE PROVIDE IF AVAILABLE E-MAIL_______________________________________________________________ FOR RENEWALS ONLY --- LOT #__________ & STALLS #__________ Do you wish to (continue to) receive The CT Horse Magazine Y/N (circle)

Do you own a horse(s)__________Do you lease (written lease) a horse(s)__________________ How did you hear of CTRA (new members) Member_____ Facebook______ Website_____ Other (explain)______________________? Initiation Fee (New memberships or see *NOTE) ……….… $10.00 Family Membership….……………………………………………………………… . $35.00 Single Membership…(18 yrs and Over) ……………………………… $30.00 Joint Membership (married with no dependents) ……………… $40.00 (*) Camp Lot Fee…………………………………………………………………………. $ 150.00 (*) Stall Fee (each stall) …….……………………………………………………….. $ 25.00 NOTE FOR RENEWALS: You MUST pay your membership dues and lot fees by MARCH 1ST in order to hold your camp lot and to continue to receive your subscription to Equine Journal. In order to keep your lot you must have stayed on your lot for two 24 consecutive hours one must be on one of the 6 camp function weekends, which are: Camp opening, Memorial Day weekend, Forth of July weekend, Auction/BBQ weekend, Labor Day weekend and CTRA Boardman Memorial Trail Ride Weekend. (*NOTE) Memberships allowed to lapse more than 90 days of the due date Jan 1, are considered past due and subject to the initiation fee for reinstatement Per Article IV - Dues (**NOTE) Camp lot fees and stall fees are only payable once a member has been assigned a lot or stall. New members must request their name be added to the lot/stall (waiting) list to be considered for a lot/stall when they become available. The Camp Director is in charge of the lot/stall list and assigning lots/stalls to members. $_________________ INITIATION FEE (New memberships or see *NOTE) $_________________ FAMILY MEMBERSHIP $_________________ SINGLE MEMBERSHIP $_________________ JOINT MEMBERSHIP $_________________ CAMP LOT FEE * (renewal only) $_________________ STALL FEE *(renewal only) $_________________TOTAL AMOUNT DUE CHECK # ___________ DATE SUBMITTED___________________ I acknowledge that I am riding at my own risk and shall assume the risk and legal responsibility as such and agree to make no claim against the Connecticut Trail Rides Association, Inc. any member, officer nor against any owner of land which members are permitted to pass for any damage, or injury, or loss which may occur to myself, my horse, any vehicle or other article which I may send with my horse. In addition, I acknowledge that I am responsible for all actions by myself and my horse. I (we) assume and accept full responsibility for damages done by me (us) or my (our) guests, or horses while on CTRA’s land or any and all land on which I (we) ride. Signature: _____________________________________________________________ Date: ____________________ Spouse’s Signature___________________________________________________ Date: ____________________ PLEASE MAKE CHECKS PAYABLE TO C.T.R.A. AND MAIL TO: CTRA Treasurer, Ruth Strontzer, 117 Filley Road, Haddam, CT 06438 For questions concerning Memberships Contact: CTRA Treasurer, Ruth Strontzer (860) 345-2954 For questions concerning CTRA Club activities, Camp Boardman events, and Trail Rides Contact CTRA President Peggy Robinson 860-309-0673

Membership