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Rider Information

First Name:

Last Name:

Birth Date:

Email:

Alternate Email:

Phone:

Billing Information

Address:

City:

State:
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Zip:

HHSA Member Information

Areas of Interest:
English
Western
Both

Horse Registration

If Transfer, Name of Previous Owner:

Horse’s HHSA Number:

Horse’s Name:

Breed:

Year of Birth:

Sex:
GeldingMare

Color:

Markings

Owner/Lessee Information

Owner:

Lessee:

(If lessee, please submit a copy of the written lease agreement for this horse. If no written agreement is available, the horse’s owner must be a member of HHSA)

Recorded Owner of Horse:

Owner’s Address

Owner’s Email

Owner’s Phone

Owner’s birth date, if under 18 years old