Jr. membership form

Junior members name ____________________________  Date ____/_____/_____

Jr. member's age__________  Birthdate______/___________/_______

Address______________________ City___________________ State______

Zip code____________

Home phone(_____)___________________

Do you have an e-mail address? If so list it here ______________________________

Parents signature____________________________________

Do you own any animals? __________ If so, how many__________ What kind of animal(s) _______________________________

Will you be able to volenteer some time to help the rescue? ______________

If yes on what days? ________________________________

Can you participate in events that our rescue has a booth at? yes or no. If yes in what ways__________________________________

Please make your $5.00 check made payable to Angels Haven Horse Rescue and send it to:

Angels Haven Horse Rescue / Junior Membership

Mindy Kazaroff

21140 Robinhood Avenue

Fairveiw Park, OH 44126

Print this out and send it to Mindy at the address at the bottom of the page