MEMBERSHIP APPLICATION

Please fill out the following form to join the LPA.

First Name

Email Address

Last Name

Date of Birth

Address

City

State

Postal Code

Cell Phone

Sign-up for text updates

Yes

No

Do you have your own polo horse?

Yes

No

Select your level of polo experience

None

Some stick-n-ball experience

Amatuer player

Rated Player

Player Rating

What type of Membership are you interested in?

Player Membership

Captain Membership

MVP Membership

Youth Membership

Social Membership

Work-to-Ride Membership

Riding Level of Experience

Please include any questions or comments here that would help us to better understand your desired level of involvement with LPA.

Tax ID/EIN: 85-1558158

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