First Name

Last Name

Your Email

Full Address

Your Phone Number

Membership Options:
Adult – 18 yrs and over – 1 CCHAO vote – $50.00Youth – 17 yrs and under – 1 CCHAO vote – $25.00Couple – 2 adults – 2 CCHAO votes – $80Family – 2 adults & related youth – 2 CCHAO votes – $100Associate/Supporting Member – non-voting – $25Voluntary Donation – Please indicate amount belowDonation to Upper Canada Village Canadian Horse Project – $20

Payment Method:
Pay by E-TransferPay by Cheque
Online Banking Set-Up: Payee: CCHAO Email: CCHAOtreas@gmail.com
Make cheque payable to: CCHAO – Send To: Sandra Addison, CCHAO Treasurer, 32 Kitchen Road, Vittoria, ON N0E 1W0

Photo/Video Release Authorization:
By checking this box I, give permission to CCHAO and to its designated agents, to photograph/video me at CCHAO activities and to use such photographs/videos in all forms of media, for any and all promotional purposes. I further consent to the use of my name in connection with the photographs/videos. I understand that I will not receive any payment for my time or expenses or any royalty for the use of the photo/video, and I hereby release CCHAO from any such claims.
Photo/Video Release Authorization

Website Authorization:
To help members contact each other we list members’ names and email addresses on our website About Us page.
Yes, I am OK to have my name and email on the CCHAO websiteNo, please do not put my name and email on the website

Your message (optional)