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Membership Form - 2022
Membership forms will be accepted. Payments need to be made by check payable to PBHA mailed to PBHA PO Box 939 Rochester, WA. 98579 or submitted on the 1st day of race. sorry due to the new rules on paypal and venmo we are not accepting those forms of payments at this time.
Name
*
First
Last
Fill out this field for the 1st rider
Additional Family Member
Fill out this field when signing up for a family Membership
Additional Family Member
Fill out this field when signing up for a family Membership
Additional Family Member
Fill out this field when signing up for a family Membership
Address
Street Address
City
State / Province / Region
Postal / Zip Code
Phone
*
###
-
###
-
####
Home Phone
Cell Phone
###
-
###
-
####
Cell Phone if available
Email
*
Confirm
Choose your Membership
Membership is not complete till paid in full.
*
Individual Membership $20
Family Membership $30
Buckaroo Membership Only $10
Choose your Award Fee Options, Awards based on Horse Rider Combination.
*
1st Horse Award Fee $20
2nd Horse Award Fee $20
3rd Horse Award Fee $20
Buckaroo Award Fee $10
No Awards
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:
ie: No Awards fee on Tiny!
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