MHAO HIGH POINT REGISTRATION FORM

2012 Show Year

OWNER INFORMATION:   NAME:_________________________________________________________________ ADDRESS:______________________________________________________________                      ______________________________________________________________                               ______________________________________________________________ PHONE:___________________________    FAX:_______________________________ E-MAIL:________________________________________________________________ AMHA MEMBER#:_______________________________________________________ Dues Pd:  Yes    No

JUNIOR EXHIBITOR INFORMATION:   NAME:_________________________________________    D.O.B.:________________ ADDRESS:______________________________________________________________                    ______________________________________________________________                    ______________________________________________________________ PHONE:______________________________  FAX:_____________________________ E-MAIL:________________________________________________________________ AMHA MEMBER #: ______________________________________________________ Dues pd:    Yes    No

HORSE INFORMATION:   NAME OF HORSE:_______________________________________________________ D.O.B.:___________________ AMHA REGISTRATION #:_______________________ SIRE:___________________________________________________________________ DAM:__________________________________________________________________                            Stallion        Mare      Gelding

Link to Declaration