Rider’s Name___________________________________________ PHBA ID#______________________
Address_______________________________ City ____________ State _______ Zip Code __________
Phone #________________________________________ Are you a current PHBA member YES NO
Registered Name of Horse___________________________________ Registration#______________
If applying for membership please fill out the enclosed membership form.
If your membership is allowed to expire, then a new Golden Trails Horseback Riding application must be submitted with the enrollment fee. All PHBA memberships expire December 31st of the current year.
Is this your first year of enrollment in the PHBA Golden Trails Horseback Riding Program- YES NO
If No, when was your last year of participation? _____________.
All participants in the PHBA Golden Trails Horseback Riding Program must pay a one-time enrollment fee of $25.00, provided that your membership remains current.
Payment is enclosed- YES NO
In the form of- CHECK MONEY ORDER CREDIT CARD
If paying by credit card please complete the information below: There will be a $5.00 administration fee for this transaction.
Visa OR Mastercard
Card #_____________________________________________Exp. Date________________
Last 3 Numbers on Back of Card____________________________
Cardholder’s Signature _________________________________________________________
Upon acceptance of this application, an Official PHBA Golden Trails Horseback Riding log sheet will be mailed to you. All hours must be kept in 50-hour increments on the official log sheet to get credit. Only one log sheet per horse and rider. If you have more than one registered Palomino please log on a separate log sheet. Have fun and enjoy riding your registered PHBA horse!
Please return application to:
Palomino Horse Breeders of America
15253 E Skelly Drive
Tulsa, OK 74116-2637
(918) 438-1234 Ext 15 FAX (918) 438-1232