Century Club Application : The Century Club : Grants and Programs : The Dressage Foundation

We look forward to having you as a Century Club member! Fill out this form and we will be in touch.

Please return completed applications at least two weeks prior to the date of the scheduled ride to ensure your ribbon arrives in time.

Please note your first Century Club ride membership is provided free of charge. If you wish to do additional Century Club rides, a donation of at least $100 per ride is suggested to help cover costs.

Name

Mailing Address (address must be in the United States)

Country

Address Line 1 *

City *

State/Province *

Postal Code *

Please select if this is your first Century Club ride or an additional ride.

First Ride
Additional Ride

Please note your first Century Club ride is provided free of charge. If you wish to do additional Century Club rides, a donation of at least $100 per ride is suggested to help cover costs.

Phone Number

Alternate Phone Number

Email Address

Your Date of Birth

Age at time of ride

Horse's Name

Preferred Name:

Do you have a preferred name for yourself and/or your horse for the publications? (newpaper, magazine, etc.)

Plaque Name:

Do you have a preferred name for yourself and/or your horse for the plaque?

(If unanswered the name on the plaque will match the horse’s registered name)

Horse's Date of Birth

Age of Horse

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Horse's Breed

Are you a member of a dressage club? If so, please list the organization name(s).

What is the anticipated date of your Century Club Ride?

Where do you plan to ride for your Century Club membership? (Show name and location)

Show Manager's Name

Show Manager's Email

Do you have a primary contact person other than yourself? If so, list his/her name and email address.

How did you hear about the Century Club?

Proof of your age (can also be mailed to the Foundation separately)

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Proof of horse's age (can also be mailed to the Foundation separately)

No file selected

Click or drag here to add files

Please check this box if you would like to help promote TDF and the Century Club! We will send you flyers to pass out at your show along with your ribbon!

Century Club Membership Application

Century Club Application

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