Page 11 - HBHA 2021 Directory Book
P. 11

I.B.H.A. - P.O. BOX 268 - SHELBY, IN 46377

                    PHONE AND FAX (219) 552-1013          E- MAIL IBHAINC@SBCGLOBAL.NET          www.ibha.net


                                    MEMBERSHIP APPLICATION

        ______ANNUAL       $30.00   Must be a current member to apply for amateur or walk trot status.
        ______ADULT WALK TROT        $15.00
        ______AMATEUR    $15.00           _____AMATEUR   SELECT $15.00 ADDITIONAL

        ______YOUTH        $15.00
        ______LIFETIME      $300.00


        PRINT NAME _______________________________________________________________I.D. *_________________

        PLEASE PRINT
        ADDRESS______________________________________________________________________________

        CITY________________________________________STATE______________ZIP___________________________

        PHONE _________________________________________________

        * COMPLETE FOR YOUTH ACTIVITY APPLICANT or AMATEUR APPLICANT:

        NAME & NUMBER OF IBHA HORSE______________________________________________________________________

        DATE OF BIRTH OF APPLICANT_________________ RELATIONSHIP TO EXHIBITOR________________________________

        SIGNATURE OF PARENT OR GUARDIAN FOR YOUTH________________________________________________________

        * AMATEUR MEMBERSHIP AGREEMENT ONLY FOR AMATEUR APPLICANTS

        To be an amateur member you must abide by the IBHA rules contained in the IBHA Official Handbook.  Before
        submitting application carefully read rules to ensure you meet the amateur eligibility.

        I have not within the past three years of submitting this application:

        Shown, judged, trained or assisted in training a horse for remuneration.

        Instructed another person in riding, driving, training or showing a horse for remuneration.

        Held the credentials of a horse show judge for any organization.



        Held membership with the Professional Rodeo Cowboys Association or Womens Professional Rodeo Association,  for
        those events or classes which are the same events or classes in which the individual competes, or desires to compete in
        IBHA amateur competition.

        Signed_________________________________________________________________Date_______________________

        VISA

        CARD____________________________________exp._______________code_________
   6   7   8   9   10   11   12   13   14   15   16