Team Information:

Team Name:                                                                                                                                                                         

Address:                                                                                                                                                                               

City:                                                        State:                      Zip:                         County:_____________________

Telephone:                                                                                  Fax:  ___________________________________

Type of team:                   High School (grades 9-12)                                Middle School (grades 6-8)

       In  Public School            Private School           Home school          Barn team            Other

If recognized by a school, please indicate whether team will be recognized as a  Club or a  Team Sport

Will School allow members to “letter” as a school club or sport?   Yes*             No

                *If yes, please attach lettering requirements to Team Membership Application

Team Advisor:

(Each team must have a Team Advisor, who is  at least 21 years of age.  The advisor can be the Team’s RIFNA  coach, a parent, or other person(s) chosen by the Team, a teacher or school administrator.) 

Team Advisor Name:                                                                              Work Telephone:                                             

Home Phone:  ______________________________________      Cell Phone:  _______________________

Date of Birth:  __________________      Preferred title:   Mr.        Mrs.          Ms.

If affiliated with school, please complete the following:

School Athletic Director Name:  ______________________________Telephone: __________________

School Principal Name:______________________ ______________ Telephone: __________________

Student Participant Requirements:

Will the school require up-to-date physicals for its equestrian student-athletes?    Yes                 No

GPA requirements of student athletes:  __________________________________

List any other requirements for student-athlete participation in the equestrian program:  ______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

By signing this application, I, on behalf of the above-named equestrian team/club, make application for membership in RIFNA and verify that, to the best of my knowledge, the above information is true. 

Advisor Signature:                                                                                              Date: