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Century Club Membership Application

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.

Country
Address Line 1 *
City *
State/Province *
Postal Code *
Please select if this is your first Century Club ride or an 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.
Do you have a preferred name for yourself and/or your horse for the publications? (newpaper, magazine, etc.)
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)
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