Application for Fox Trot America Award Program

Please fill out a separate form for each horse enrolled.

Date Date * / MM / DD YYYY
Name: *
Member Number: *
Address Address *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Name of Horse: *
MFTHBA Registration # *
Recorded Owner of Horse: *
Owner's Membership Number: *
Owner's Address: Owner's Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone: Phone: * - ### - ### ####
Email *
Fox Trot America Enrollment Fee:
$40.00 per each horse/participate combination.

I understand and agree to the rules of the MFTHBA Fox Trot America Awards Program as defined by the program's description sheet available for viewing on the web site or a copy which is available from the MFTHBA Headquarters. I understand that I must have read the Fox Trot American Application from the office prior to logging time.
Do you agree that you have read the Fox Trot American rules *

Do you agree that you have read the Fox Trot American rules Yes No
$0

Total

+Processing Fee 4%