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The Heritage Ride


Online Pledge Form:


Qty Amt Title
The Heritage Ride Pledge Form
Select a Pledge Amount:
$15.00 Pledge (incl. CHOICE of T-shirt or Waist Belt. Specify selection in Comments below. If t-shirt, indicate SIZE.)
$35.00 Pledge (incl. T-shirt and Waist Belt. Specify t-shirt SIZE in Comments below.)
$75.00 Pledge (includes T-shirt, Waist Belt and Mid-Year Insured Individual Membership OR 1-year CHC Affiliate Membership. Specify in Comments below which type desired. Indicate SIZE of t-shirt.)
$100.00 Pledge (includes T-shirt, Waist Belt and Mid-Year Insured Family Membership. Specify t-shirt SIZE in Comments below.)
$150.00 Pledge (includes T-shirt, Waist Belt and 1-year Non-Profit/Club/Organization/Ranch/Horse Business/Corporate Membership. Indicate SIZE of t-shirt.)
$1.00 Other Pledge Amount
$0.00 Opt-out of receiving pledge gifts listed above. Give pledge only.

 Total Amount Due

Comments:


First Name:
 Required Field
Last Name:
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Company Name:
Address:
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City:
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State:
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Postal Code:
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Country:
Telephone:
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Email:
 Required Field

PAYMENT DETAILS
Please select your method of payment and provide billing information if paying by credit card. Fields marked with Required Field are only required for that specific payment type.

I prefer to pay by Credit Card
Card Type:
       
Name on Card:
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Card Number:
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Card Code
(what is this?):
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Billing Zip:
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Expiration Date:
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I prefer to mail a check

A printable confirmation will be displayed upon completion. Please print and mail it with your check to:

Colorado Horse Council
22 S. 4th Ave.  #106
Brighton, CO  80601


Thank you for you Pledge to further the work of the Colorado Horse Council.

I understand that by submitting this form, I am agreeing that Colorado Horse Council, Inc. will charge my credit card.


  I have read and agree to these terms.

REVIEW AND SUBMIT
Please review your information above and click "submit" below to securely process your payment