Medal Program Enrollment Form

The MFTHBA Medal Program provides an opportunity to recognize the achievements of MFTHBA and MFTPR registered horses.

1. Name of Horse *
Registration Number (Horse #1) *
2. Name of Horse
Registration Number (Horse #2)
3. Name of Horse
Registration Number (Horse #3)
4. Name of Horse
Registration Number (Horse #4)
Owner Information
Owner of Horse: *
Member Number: *
Address: Address: *
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone: *
Email *
Lifetime Nomination Fee: $50.00 each

NOTE: Horses may be enrolled at the time of initial registration (if 18 months or under) for $15. This form is not required to nominate a horse under that situation.
Choose number of horses entered: *

Choose number of horses entered: 1 horse 2 horses 3 horses 4 horses
I understand and agree to the rules of the MFTHBA Medal Program as defined on the MFTHBA website. *

I understand and agree to the rules of the MFTHBA Medal Program as defined on the MFTHBA website. Yes No
$0

Total

+Processing Fee 4%