NYRA STAR Registration
If you are registering multiple members for NYRA STAR, please complete this form once for each child. Thank you!
Child's Name
*
First Name
Last Name
Child's Date of Birth
*
-
Month
-
Day
Year
Must be 12 & under
Gender
*
Male
Female
Other
Parent's Email
*
Class
Please Select
Adult
Child
Parent's Phone Number
*
Parent's Name
*
Home Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
User Photo
Browse Image Files
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Submit photo of face from neck up. No headwear or other people in it. Must be 1 MB or less.
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of
Schedule your free Paddock & Winner's Circle Experience
By completing this form, I confirm that my child is 12 years old or under at the time of submission.
*
I agree
Document
Browse PDF File
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of
Signature
*
Type a question
Connection String
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