VRHA MEMBERSHIP APPLICATION 2025
1st January - 31st December
Name
*
First Name
Last Name
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Afghanistan
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Algeria
American Samoa
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Martinique
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Mauritius
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Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
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New Caledonia
New Zealand
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Niger
Nigeria
Niue
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Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
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Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
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Slovenia
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South Ossetia
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eSwatini
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Tajikistan
Tanzania
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Zimbabwe
Other
Country
Phone Number
*
Are you a current NRHA (National Reining Horse Association) Member
*
Please Select
General NRHA Member
General Non Pro NRHA Member
Youth NRHA Member
Youth Non Pro NRHA Member
Professional NRHA Member
Associate NRHA Member
Not an NRHA Member
Youth DOB
/
Day
/
Month
Year
Date Picker Icon
Parent/Guardian Name - Youth membership application
First Name
Last Name
Parent/Guardian Phone Number - Youth membership application
Please volunteer to your club, support from the membership makes a difference to the future of your club. Without voluntary help the club has to pay workers, our preference is not to increase the membership levy to cover these costs.
I am available to help the club with:
Show Arena Set Up
Show Arena Pack Up
Gate Marshall
Event Tractor /Drag
Show Announcer
Scribe
Fundraising
Sponsorship
Administration Support
Presentations
Other
Membership Select New or Renewing
*
New
Renew
Select from the list below
*
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( X )
Helpers Donation - Yes In addition to my membership I would like to assist the club pay for workers when needed
$
100.00
AUD
Friend of the Derby - Yes In addition to my membership I would like to sponsor the 2025 VRHA State Championship Derby Show
$
50.00
AUD
3 Year Adult Membership (3 x $60 Membership 3 x $15 Insurance)
$
225.00
AUD
Adult Membership ($60 VRHA Levy $15 Insurance) 2
$
75.00
AUD
3 Year Youth Membership 18 Years & Under (3 x $25 Membership 3 x $15 Insurance)
$
120.00
AUD
Youth Membership 18 Years & Under ($25 VRHA Levy $15 Insurance) 2
$
40.00
AUD
Additional Youth Membership 18 Years & Under ($0 where Youth sibling has full Youth membership)
$
Free
AUD
Clinic Membership ($25 Insurance Clinic / Try out attendance
$
25.00
AUD
Non Rider Member ($15 VRHA Levy + $15 Insurance)
$
30.00
AUD
NRHA Member Event Levy ($15 Insurance)
$
15.00
AUD
NRHA approved shows only and does not entitle to VRHA Hi-Point or Award programs
Total
$
0.00
AUD
Submit
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