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YOUTH'S NAME:______________________________________________________________________________ ADDRESS:___________________________________________________________________________________
TOWN:_____________________________________         STATE:____________    ZIP:_____________________
PHONE:____________________________________    CELL PHONE:_____________________________________
EMAIL ADDRESS (please print clearly) :  ____________________________________________________________

Please circle your desired membership level:  Youth members get a free tee shirt.  Please indicate appropriate youth or adult size for the youth member.

Youth - $10 (under 18)            


Youth Tee Shirt Size (check off one):  ___  Small (6-8)          ___Medium (10-12)                        __ Large (14-16)        ___ XL (18-20)

Adult Sizes:  ___ Small            ___ Medium            ___ Large           ___ XL 



Please check here if you are interested in volunteering your time at any of the NEECA fundraising and social
events we sponsor throughout the year.  The success of our organization greatly depends upon the willingness
of our members to donate their time/talents to ensure our events are successful and your involvement
would be greatly appreciated! We may call you before an event that you are interested in to sign you up for some volunteer hours.

What are your preferences for volunteering?  Please check all that apply.

___ Gymkhana                                               ___ Youth Fun Day                 ___ NEECA Show in Barre

___ Clean-Up Day at Park                                 ___ Equestrian Showcase        

___ One or more of NEECA Clinics                       ___ Fall Social   

Parent's Name:__________________________________________________________________________
Phone Number:___________________________     Email:________________________________________

Please make $10 checks payable to "NEELMCC".  Yearly membership effective January 1st through December 31st of each calendar year.  Mail to our Membership Coordinator:


                      Debbie Martin  - 26 Hinckley Street, Florence, MA   01062                 Email:


Please feel free to contact the Youth Coordinator, Pam DeGregorio, with any questions or suggestions for increasing youth participation and/or youth activities:     (978) 544-6457

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