This on-line membership form may also be used for more than one entry.  Just follow the directions below, then select the submit button below.  On the confirmation page, you may click "Return to the form" to return to this page to enter another membership.  Points will not begin to accumulate until membership has been paid in full.

Enter the information in the appropriate box or select from the drop down list.  To select more than one choice, click on first selection, then hold down the "Ctrl" button and click on the next selection. When you have finished your selections, let go of the "Ctrl" button and go to the next box.

Please select type of membership

Individual Membership - $20.00 Farm Membership - $20.00 Equine Membership - $15.00 Lifetime Membership - $200.00

Name

Address                                                          City                                          State     Zip

Email *(Required)                                                     Phone

Please indicate the following for proper point recording:  Adult (18 and over) Junior/Child (under 18)

Under 18, please provide Birth date  

Not Member VHSA Membership Pending Associate Member Regular Member             Membership #

If you are a VHSA member or have membership pending, please indicate type and number

Equine Show Name

Breed                                                                              Foal Date (mm/dd/yyyy)

Color

Height              If pony, please indicate size     

            Not Applicable Small Pony - 12.2 and under Medium Pony - Over 12.2 and not exceeding 13.2 Large Pony - Over 13.2 and not exceeding 14.2  

Sex

Gelding Mare Stallion

Owner/Lessee Name

Is Equine member of VHSA?           Yes   No VHSA #

Are you leasing this equine?           Yes   No

If yes, then you must also be a member to accumulate points

Are you the owner of this equine?   Yes   No

If yes, then you must also be a member to accumulate points

Are you the rider of this equine?     Yes   No

If yes, then you and the owner or lessee must also be a member to accumulate points

Please indicate payment method      Cash Check MasterCard Visa

If paying by Credit Card, please call Sharon Golesh directly at 757-270-5228

Payment may be made at show or by mail to the following address:

Do NOT send cash through the mail.

ECHSA

2508 West Landing Rd

Virginia Beach, VA 23456

757-270-5228

ECHSA is not responsible for payments not received via mail.  Membership, benefits and points will accumulate once payment is received. If received between show dates, then points from most recent show will be included.

Submission of this form indicates you understand and will comply with ECHSA Rules and Conditions.