BLACK HILLS EQUESTRIAN ASSOCIATION
Membership Form

Individual: FREE    Family: FREE
Family defined as persons living at the same address

NAME:________________________________________________________________________

ADDRESS:_____________________________________________________________________

CITY:_________________________________STATE:________________ZIP:_______________

TELEPHONE (H):__________________________WORK:_______________________________

EMAIL:________________________________________________FAX:___________________

DOB:____________________   MEMBERSHIP YEAR: _____________________

Tell us a little about yourself and your primary interest:____________________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

Print and mail to:
Linda Rabe - 5900 Long View Road, Rapid City, SD 57703