Last name - _____________________________
First name - _____________________________
Additional Family Members/ Relationship/Age (for youth members only)
1_________________________ Spouse / Child _____
2_________________________ Spouse / Child _____
3_________________________ Spouse / Child _____
Birthdays of each member_______________________________
Address - _________________________________________________
City - ____________________ State - ______ Zip - ____________
Email Address ______________________________________________
Phone - _________________ Alt. Phone - ______________________
Drivers License #__________________
Are you a member of MFTHBA Y / N if yes please provide # - _______
Do you own a Registered Foxtrotter Yes / No?
Horse Name - ___________________ S M G Reg # - __________
Horse Name - ___________________ S M G Reg # - __________
What are your interests / how may we assist you as a member: (circle all that apply)
Trail riding Shows Parades Clinics Breeding Training
Versatility Performance Driving Modeling English
Western Education Youth Programs Horsemanship
Costs
Family - $25(includes Husband/Spouse/and all dependent children under age 18)
Single - $15 Youth - $5
Is this a NEW ____ membership or a RENEWAL ____?
Add $5.00 late fee for renewals if paid after February 1
Please mail a check/money order payable to SWC-MFTHBA send:
DeAnn St. Claire
477 CR 4877
Pittsburg, TX 75686