“THE CHARLESTON EQUESTRIAN” 2012 Supporting
REIN and SHINE
REGISTRATION FORM Parent’s Names: _____________________ (Or Rider if Adult) Family Name
_______________________ and/or _____________________________ Parent’s First (w/Title) Spouse’s First (w/Title) (if applicable)
Home Address: ______________________________________City/State/Zip____________________________ Please Circle Primary Contact Number and Contact Person Home Phone:_________________ Her Work Phone:______________ Her Cell:_________________ Other Phone:_________________ His Work Phone:_______________ His Cell:_________________ Email Addresses: Hers:___________________________________His:__________________________________
Barn Association: ____________________ Trainer _________________________ Please list days and times that the rider is normally at the stables and available for pictures. We will contact you to schedule your photo shoot._________________________________________________________________________ ___________________________________________________________________________________________
Please Enroll Me or My Child Listed Below in the 2012 “THE CHARLESTON EQUESTRIAN” Program Rider’s Name:_____________________________Age:______ DOB: Month_____Day_____Year______ Rider’s Email:_____________________________ Cell:_____________________ Is It OK to Contact ______ My donation for $95.00 for __________________________to participate in the “THE CHARLESTON EQUESTRIAN” PHOTO BOOK PROJECT benefiting the REIN and SHINE Charity is enclosed. I understand that I will be called by Signature Photography to set up the Pre-Consultation and the Photo Session appointments and understand the terms stated in the “TCE Just the Facts” document published on the “THE CHARLESTON EQUESTRIAN” Website. ____________________________________________ ____________________ Parent’s Signature (or Rider, if Adult) Date 0
Please make your donation payable to REIN and SHINE and send it with this signed form to “THE CHARLESTON EQUESTRIAN”, c/o Signature Photography, 320 East Bay Street, Suite C, Charleston, SC 29401. You may pay by check or by credit card using the form below. Credit Card Information Type: ____________ Card Number: ______________________________ Security Code: _____ EXP:____/____ Name on Card: _____________________ Billing Address of Card: ______________________________________ Questions? Please call the studio: 843-300-3333
Website Information: http://EOC.SignaturePhotography.Biz