Membership Application

2008

Type in your information, then print:

Name Date
Address
City State Zip
Phone Cell
Email Web Site
# Horses Breed
Would like newsletter sent to my: home address
email
ApHC member? No
Yes #
NCAApHC Membership Level Single - $15.00
Family - $25.00 (includes all children under 18 living in same household)
Family Members: Name
Name
Name
Name
Name
Name
Make checks payable to NCAApHC and mail to:

Pauline Smith
529 Weldon Lane
Edgemont, AR 72044

Note: Membership term is January to December and good for current year. Under Arkansas Law an equine activity sponsor is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risk of equine activities.---- Arkansas Code 16-120-201 and 16-120-202