New York State Horse Council ...NYSCH
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2018 MEMBERSHIP FORM

New York State Horse Council, Inc
Memberships are for the calendar year Jan. 1-Dec. 31

Please complete all fields which apply.
New Membership
Renewal -- ID#
I wish to receive the NYSHC Newsletter via: E-Mail Postal Mail
Email (Required): Address:
City: State: Zip Code: County: Phone:

Individual / Family / Lifetime Membership / Youth Membership

Family Membership: “Family Member” includes you, your resident spouse and your children up to age 18 residing at the address provided.
Name of Member # 1 ..First Last
Name of Member # 2 ..First Last
Name of Children & Age

Age Group Primary Member:
Number of Equine You Own?


Business/Club/Organization Membership:
Business Name:
Contact Name ..First Last
Website:
Category:
Options: Horse & Rider Services - Adoption / Boarding / Breeders / Camps / Carriage / Clinics / Clinicians / Dentistry / Education / Farrier / Horsemanship / Humane Welfares / Lessons / Rescue / Showing / Training / Transportation / Therapeutic / Veterinarian. Organizations & Clubs - Driving / Horse Organization / Horse Club / Social / Trail / Youth (4H, Pony Club, College teams, etc.). Trail Services - Lodging / Camping. Business Services - Insurance / Legal / Marketing / Promotional / Publications. Sales & Products - Barns/Buildings / Feed/Supplements / Tack / Trailer/Truck / Shop & Apparel

Please check the NYSHC Chapter you wish to join.

Membership Type
Individual with Insurance (one adult 18+) ...$55.00
Family with Insurance (two adults with children up to age 18) ... $75.00
Lifetime with Insurance 1st year (one adult 18+) ...$500.00
Lifetime with Insurance - subsequent year renewal (one adult 18+) ...$20.00
Individual without insurance (one adult 18+) ...$35.00
Family without Insurance (two adults with children up to age 18) ...$55.00
Youth without Insurance (Not associated w/Family Membership. One child up to age 18) ...$10.00
Parent Signature Required here: __________________ Youth Date of Birth: _______
*Youth membership form must be sent via postal mail with signature
Organization/Club/Business/Farm without Insurance ...$75.00
Includes your Website or Facebook link listed on our WWW.NYSHC.ORG Website; Business Directory by Category & Name, NYSHC Trails Guide and in the NYSHC Quarterly Newsletter

Method of Payment:

If you are not comfortable with Paypal or run into issues, please write a check and send with this printed Membership Form.

Please make check payable to New York State Horse Council.
Please write 2018 Membership on the check.
There will be a $25 charge for returned check.
Send this form along with check to:
Paula Pratt
NYSHC Membership Chair
3555 Stetson Road
Bloomfield, NY 14469
Questions: Call Paula Pratt @ (585) 657-4550 or membership@nyshc.org

*For inquiries regarding Insurance through Equisure/Association Resource Group, please contact Missy Whittington at (716) 655-2045 or via e-mail Missy.Whittington@NYSHC.org.

*For inquiries or advertisement regarding the NYSHC Quarterly Newsletter, please contact Mary Szarek at (716) 837-3761 or Email: info@wnyHorse.info.

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