2024-2025 NSBRA Membership Form

Members Name*

First NameLast Name

Parent/Guardian Name - If member is a minor. Leave blank if not applicable.

First NameLast Name

E-mail*

Phone Number*

Area CodePhone Number

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Members Date of Birth*

MonthDayYear

Members Shirt Size - Unisex*

This is for general polling.

Horses Blanket Size*

This is for general polling.

Horses Registered Name

As listed with registration association such as AQHA. Leave blank if not applicable.

Horses Barn Name *

If horse is not registered or you may provide a short hand/barn/nick name for your horse at jackpots. If you prefer to only list horse with registered name please put it in this box too.

Horses Registration Paper or Pictures

If not included with application please email to NSBRAPoints@gmail.com within 10 days of application.

Under $1000 - Horse has not wont more than $999, in it's lifetime, as combined total with any Owner.
Under $10,000 - Horse has not wont more than $9999, in it's lifetime, as combined total with any Owner.
Senior - Ages 50 and over.
Junion - 17 years and under.
Open - Any age rider and any demonination of money won for horse.
FBR - 10 years of age and younger.
Associate

I, the undersigned, agree to abide by all the North State Barrel Racing Association rules and in no way will hold the association or any of its members, arena operators or officers liable. I participate at all North State Barrel Racing Association approved functions at my own risk. The North State Barrel Racing Association and its Arena Operators reserves the right to accept or reject any membership or entries.

My Products*

Under $1,000 Memberships

H-294Membership Under $1000

$50.00

H-295Membership Under $1000

$50.00

H-296Membership Under $1000

$50.00

H-297Membership Under $1000

$50.00

H-298Membership Under $1000

$50.00

H-299Membership Under $1000

$50.00

Under $10,000 Memberships

M-276Membership Under $10,000

$50.00

M-278Membership Under $10,000

$50.00

M-279Membership Under $10,000

$50.00

Open Memberships

O-271Membership Open

$50.00

O-272Membership Open

$50.00

O-273Membership Open

$50.00

O-274Membership Open

$50.00

O-275Membership Open

$50.00

Senior Membership

S-266Membership Senior

$50.00

S-267Membership Senior

$50.00

S-268Membership Senior

$50.00

S-269Membership Senior

$50.00

S-271Membership Senior

$50.00

S-272Membership Senior

$50.00

Junior Memberships - Ages 17 & Under

J-278Membership Junior

$50.00

J-279Membership Junior

$50.00

J-280Membership Junior

$50.00

J-281Membership Junior

$50.00

FBR - Ages 10 & Under

FBR MembershipThere is no membership number needed for FBR members but those with active memberships will be reflected alphabetically on an updated membership list.

$25.00

Associate Memberships

Associate MembershipMembership for producers who are not an active member on a horse.

$30.00

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Total

$0.00

Payment Methods

Credit Card

Apple Pay

Google Pay

ACH Bank Transfer

Once you submit your application, you will receive an email confirmation of this transaction. That is your confimation of membership and memeber number to be used for this season. Multiple horses will take multiple transactions via this process.

Thank you!

NSBRA Membership Form

Membership Category Details

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