PCQHA Membership Application Form

All annual Adult & Youth memberships expire November 30th. Membership shall become effective the day the membership application is received in the PCQHA Office.

ALL REGISTERED OWNERS & EXHIBITORS of a competing horse IN ALL DIVISIONS must be members of PCQHA at the time of showing to be eligible for any PCQHA sponsored awards program. Youth exhibitors must be members of PCQHYA to qualify to participate in PCQHA youth team competition and/or to be eligible for any PCQHA sponsored awards. Amateur exhibitors must be members of PCQHA to qualify for PCQHA sponsored awards in the amateur division. A current PCQHA membership is required of any exhibitor competing for an All-Around Award, Circuit Award, or any PCQHA special award, including, but not limited to, jackpot or added money at PCQHA
sponsored horse shows, special events, etc.

PCQHA RULES REQUIRE THE OWNER OF THE HORSE (AS LISTED ON THE HORSE’S REGISTRATION PAPERS) AS WELL AS THE EXHIBITOR TO BE A CURRENT PCQHA MEMBER. IN SOME CASES THIS WILL REQUIRE MULTIPLE AQHA AND PCQHA MEMBERSHIPS.

Your AQHA Number*

Your Name (*must be same as AQHA)

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

New Membership or Renewal*

New MemberRenewal

Year of Membership

Category

E-mail*

Phone Number*

Area CodePhone Number

Date of Birth*

Date

AQHA Membership Expiration Date

Date

Horse Name*

Horse Owner Name (*must be same as AQHA)

Horse AQHA Number*

Year Foaled

Submission of this form is evidence of my agreement to abide by and be bound by the rules and regulations of PCQHA and/or PCQHYA.

Note: Contributions or gifts to the Pacific Coast Quarter Horse Association are not tax deductible as charitable contributions for federal income tax purposes; however, dues payments and contributions may be deductible as ordinary and necessary business expense.

PCQHA MEMBERSHIP OPTIONS:

1 Year Adult$40.00

Lifetime Adult$400.00

1 Year Youth$30.00

* BUCKLE BONANZA$30.00

 Annual PCQHA Buckle Bonanza Shows: Back 2 Basics, Show Me The Money, Mother’s DayCircuit and Brookside Bonanza PCQHA Champion Buckles present as Circuit awards to highest placing member or horseat each show $30 nomination fee by the exhibitor for L1 Youth and Amateur Divisions $30 nomination fee by the horse for the L1 Open Division Questions? Call Deb at 916.768.6837

Pacific Coast Journal Magazine Subscription$25.00

I am enclosing an additional $25.00 to my membership fee for a mailed subscription to the official publication of PCQHA, the monthly Pacific Coast Journal. We do not sell our membership list to any other organization. You will receive show notifications from approved PCQHA shows and we may send e-mail notifications of new shows, products, services and topic-based news alerts. Members may choose to opt-out of receiving information by email at any time.

Total $0.00

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Card Expiration

Security Code

Please click one of the PayPal options to complete payment and submit the form.