2024 MEMBERSHIP APPLICATION

NATIONAL HORSESHOE PITCHER’S ASSOCIATION - INDIANA CHARTER

NAME Card#

STREET ADDRESS

CITY ZIP CODE:

PHONE #: DATE OF BIRTH:

EMAIL: YEARS OF MEMBERSHIP:

Adult Membership is $40, Junior are $5, Lifetime members are $15

MEN ELDER WOMEN JUNIOR MEDICAL EXEMPTION

Make a check or money order payable to the “INHPA” Mail to:

Sharon Chiddister

1008 College Ave.

Goshen, IN 46526