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Kansas Saddle Horse Association

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KSHA Online Membership Application

and Horse Nomination

First name*

Last name*

Email

Phone*

Multi-line address

Country/Region*

Address*

Address - line 2

City*

Zip / Postal code*

Birthday if Youth only membership

Month

Day

Year

List Spouse and Children and childrens date of birth

Check if this is a renewal

Product

Single membership$20

Family membership$30

Youth membership$15

Product

Horse Nominations$20

List each horses registered name, registration number and breed

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