Date________________________Phone#____________________
Name_____________________________ApHC#_______________
Address_______________________________________________
E-mail___________________________________________
_______________________________________________
IF JUNIOR MEMBERSHIP, PLEASE LIST EACH JUNIOR'S NAME &
ApHC#
Junior____________________________ ApHC#_____________
Junior____________________________ ApHC#_____________
Junior____________________________ ApHC#_____________
Junior____________________________ ApHC#_____________
Single Adult Membership $15.00
Family Membership $25.00
Youth Membership $10.00
REGISTERED POINTS ENROLLMENT:
Horse___________________ __________________$10.00ea.
___________________
__________________
N/P ___________________ __________________$10.00ea.
___________________ __________________
Youth___________________ ________________ $10.00ea.
___________________ __________________
Challenged Rider_______________________________
EASTERN SHORE HORSE - POINT FORM
Horse___________________ __________________$10.00
___________________
__________________
N/P ___________________ __________________$10.00
___________________ __________________
Youth___________________ _________________$10.00
___________________
__________________
Challenged Rider_______________________________
PLEASE INCLUDE A COPY OF YOUR HORSES REGISTRATION PAPERS!!!!!
Complete application and return with appropriate fees to:
Joanna
Haddock
24880 Riverton Cut Off
Mardela,
MD 21837
