Humboldt Bay Horse Club

Membership Form

Date:________________
Primary Name: ________________________________________________
Phone Number: ________________________________________________
Additional Family Members included In Membership:
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________________________________________________
________________________________________________
________________________________________________
Address:
________________________________________________
________________________________________________
________________________________________________
________________________________________________
E-Mail Address: ________________________________________________
Please check one type of membership
Family Membership ___________$30.00
Individual Membership ________$20.00
Youth Membership ___________$10.00
Business Membership _________$25.00
Please make checks out to: Humboldt Bay Horse Club
Mail to:
HBHC Membership
56197 Highway 101
Fortuna, CA 95540

For Office Use:

Date Received: ___________________
Amt. Received: ___________________
Check # _____________
Cash
Received by:______________________