Application To
Join EPHPA & NHPA
National Horseshoe Pitcher
Association
• $15.00 Regular Yearly
Dues (including insurance)
• $ 8.00 Junior Yearly
Dues (under 18 years of age)
Name
___________________________________________
Street
Address ___________________________________
City/State/Zip
____________________________________
Age ______ DOB
_________ ^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^ Please circle one of the Categories / Divisions which include:
Telephone _________________ County** _________________
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Make check payable to: Send to:
Butch
W. Young
122 Frosty Hollow
Road
Phone (570) 925-5060