2017 – 2018
STATE MEMBERSHIP FORM FOR OFFICE USE ONLY
NHSRA: ______
Rookie: ______Prev: ______
BC: ______
TR: ______
Name:______Preferred Name:______
Mailing Address: ______City, State, Zip:______
Phone: (______) ______Cell Phone: (______)______
Email Address ______
Date of Birth: ______Social Security:______Sex: M F Grade: 9 10 11 12
Name of High School: ______
School Address, City, and Zip: ______
Parents or Guardian Names: ______
Were you a member in Arizona last year? YES NO If yes, what was your membership number? ______
Is this your first year to be a member of High School Rodeo in any State? YES NO
If you were a member in a state other than Arizona, what state? ______
Did you compete at the State Finals Rodeo in June? YES NO
I hereby certify that I am enrolled in ______High School and will graduate in
______(year). If any information is found to be false on this application or entry form, your membership is automatically terminated and your dues, points, and point standings are forfeited. The burden of proof lies with the member in case of any question.
Date: ______Signature of Member______
PLEASE READ CAREFULLY - IMPORTANT:
AHSRA Membership Dues MUST be paid with a Cashier’s Check or Money Order made payable to AHSRA.
To be a member of the Arizona High School Rodeo, it is your responsibility to complete this application AND the National High School Rodeo Association Membership Form and National High School Rodeo Minor’s release form. ALL THREE FORMS and the fees listed on the National High School Membership Application must be returned to the Rodeo Secretary, Marsha Collier, before your entry form can be accepted.
NEW MEMBERS: You must submit a copy of your BIRTH CERTIFICATE and the most recent GRADE REPORT from your school. Last Year’s Members who did not compete in the State Finals Rodeo must also submit a most recent grade report.