Hudson Valley Arabian Horse Association

Membership Application

Application Type - Renewal ______ New______

Name________________________________________________________________________________________

Farm Name ___________________________________________________________________________________

Address ______________________________________________________________________________________

City __________________________________ State _________________ Zip ____________________________

Phone____________________________________________________

E-mail_____________________________________________ Birth date _____/____ /_______ (required for Youth)

AHA membership #__________________________

*** Information Release Please check below if you do NOT want the above information printed in the Region 16 Directory or online on the Members Only web site.

Name/ address ______ Phone ______ Email address ________

Signature of Applicant __________________________________________________________________________

Signature of parent or guardian if under 18 __________________________________________________________

Membership Categories (Check one) _______$55.00 One Yr Adult ______ $150.00 3 Yr Adult AHA Membership, AHA Voting privileges and AHA Competitions Card and AHA Excess Personal Liability Insurance _______$40.00 One Yr Adult _______ $105.00 3 Yr Adult AHA Membership and AHA Voting privileges _______$20.00 One Year Club Associate No AHA Voting privileges and No AHA membership _______$30.00 One Yr Youth AHA Membership & Competitions Card No AHA Voting privileges or insurance _______$20.00 One Year Youth AHA membership, No AHA Voting privileges Get a full 12 months of benefits! A late fee of $10 will be applied when a membership is renewed after the last day of the month in which it expires. We encourage everyone to JOIN ON LINE at www.arabianhorses.org/membership.asp It saves time and you can use your credit card and print your membership card right away. Many online options will be available for joining, renewing and acquiring your Competition Card. You can even join AHA first and get your Competition Card later when you're ready to compete. Competition Cards can be ordered online or purchased at AHA recognized events.

Would you be interested in helping at club activities? Yes _____ No _____ Maybe _____ In what areas of activity participation are you interested? Check all that apply. ______ Breeding ______ Recreational Riding ______ Showing at AHA, USEF rated shows ______ Showing at open/fun shows (not rated) ______ Distance/Competitive riding ______ Working Hunter ______ Working Western ______ Professional Trainer/Exhibitor ______ Dressage ______ Sport Horse ______ Other____________________________ Make Checks Payable to: HVAHA Mail to: Elizabeth Redkey 9 Appletree Lane Latham, NY 12110 Email: membership@hvaha.org