Membership Line It Up Show Series Membership Line It Up Show Series Membership Member Information In order to receive points towards end of year awards, you must have a completed membership form on file. Members will only accrue points after they have paid their dues and the rider is registered. Payment is collected via Cash, Check or Venmo only. Venmo Link below after submission. Rider Name * Rider Name First First Last Last Birthday * Age as of January 1, 2023 * Parent/Guardian Name * Parent/Guardian Name First First Last Last Email * Mobile Number * Address Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Trainer Name * Farm Name * Horse Name (most often ridden if multiples) * TIP (type NA if not TIP registered) * PSHA Identification (type NA if not registered with PSHA) Signature * Clear Date * Apply for Membership Start Over
