Family Membership Form

If you have more than one rider in your home, you may do a family membership.

Rider #1 First Name *

Rider #1 Last Name *

USHJA #

Rider #2 First Name *

Rider #2 Last Name *

USHJA #

Rider #3 First Name

Rider #3 First Name

USHJA #

Email Address *

Barn Affiliation *

Street Address

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Phone

Additional Rider information

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