Membership Application Form

Membership Application Form

Select your membership type and provide your details to join.
Membership Type
Applicant's Full Name

First NameLast Name
ABHA Membership Number
Date of Birth (for Junior Riders)

MonthDayYear
Date
Parent/Guardian Name (for Junior Riders)

First NameLast Name
Email Address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Home Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip Code
Emergency Contact Name

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Family Members (for Family Membership)
Image Use Consent

I understand that, as per ABHA membership rules, images of members may be used on the Gold Rush Barrel Racing Club Inc website and social media.

Agreement to Rules

I agree to abide by the constitution, rules, and regulations of the Australian Barrel Horse Association and Gold Rush Barrel Racing Club Inc, and accept full responsibility for my actions.

Riding Member Acknowledgement

I acknowledge that I am only considered a riding member if I am a financial member of the Australian Barrel Horse Association.
Signature

Open membership

Open Membership

$30.00 Quantity

Junior Membership

$30.00 Quantity

Family Membership

$70.00 Quantity

Non-Riding

$10.00 Quantity

Total