Family Membership – Walking Horse Owners Association

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Family Membership Registration- For 2 adults and up to 6 children 17 & under

Gift, Coupon, or Redemption Code?

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First Name *

Last Name *

Email Address *

Username (lowercase alphanumeric) *

Password (type this twice please) *

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Additional Info

Birth Date *

Address *

City *

State *

Zip Code *

Phone Number *

Additional Members of Household

Adult Two Name

Adult Two Date of Birth *

Child One Name

Child One Date of Birth

Child Two Name

Child Two Date of Birth

Child Three Name

Child Three Date of Birth

Child Four Name

Child Four Date of Birth

Child Five Name

Child Five Date of Birth

Child Six Name

Child Six Date of Birth

Confirm Membership Type *

Billing Method

Card Number (no dashes or spaces) *

Card Expiration Date (mm/yyyy) *

Card Verification Code * need help?

Card Start Date (mm/yyyy), or Issue Number *

Billing Address

Street Address *

City / Town *

State / Province *

Postal / Zip Code *

Country *

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