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Membership Form - 2023
Membership forms will be accepted. Payments need to be made by check payable to PBHA mailed to PBHA PO Box 932 Rochester, WA. 98579 or submitted on the 1st day of race.
Note we have changed membership to per person to make easier to track. Membership fee is $40 that includes awards for 1st horse, additional horses $20 each. Buckaroo membership $20 that includes awards.
Thank You! NO PAYPAL OR VENMO!!
Name
*
First
Last
Fill out this field for the 1st rider
Address
Street Address
City
State / Province / Region
Postal / Zip Code
Phone
*
###
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###
-
####
Home Phone
Cell Phone
###
-
###
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####
Cell Phone if available
Email
*
Confirm
Choose your Membership
Membership is not complete till paid in full.
*
Membership $40
Buckaroo Membership $20
Additional Horse $20
Additional Horse $20
Additional Horse $20
Rider and Horse Combination:
Enter the Rider and Horse's Registered Name:
Rider and Horse Combination:
Enter the Rider and Horse's Registered Name:
Rider and Horse Combination:
Enter the Rider and Horse's Registered Name:
Rider and Horse Combination:
Enter the Rider and Horse's Registered Name:
please add your social security number here or be prepared to have it at the 1st race.
Additional instructions or comments:
Additional instructions or comments:
ie: If a minor please include parent name and contact in this box
Name
First
Last
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