New Member Registration

Title

Surname

Forename(s)

Date of Birth (DD/MM/YYYY)

Address 1

Address 2

Address 3

Town

County

Postcode

Daytime Telephone

Evening Telephone

Mobile

Email Address

Confirm Email

Do you want to compete in:

• Dressage -- Please Select -- No Yes
• Showjumping -- Please Select -- No Yes
• Showing -- Please Select -- No Yes
• All three

Are you a member of:

• BHS -- Please Select -- No Yes
• BSJA -- Please Select -- No Yes
• BD -- Please Select -- No Yes
• PC -- Please Select -- No Yes
• B.E. -- Please Select -- No Yes
• Aff.R.C. -- Please Select -- No Yes

Do you own a horsebox ?
-- Please Select -- No Yes

Do you own a trailer ?
-- Please Select -- No Yes

Do you keep horses at home ?
-- Please Select -- No Yes

How many horses do you own ?

Is your horse insured ?
-- Please Select -- No Yes

What is your insurance renewal month of:

Your horse insurance

Your horsebox/trailer insurance

By submitting this form you acknowledge that you have read and agreed to abide by the rules of Trailblazers.

The above information may be used by the organisers of Trailblazers and other selected companies to contact you with details of other events, products or services. Please tick box if you do not want your information to be passed on.