525 Old Waterford Road NW, Leesburg, VA 20176 Phone (703) 779-0440 Fax (703) 779-0550 E-mail Infouse-2025

1. Click ‘Get Form’ to open it in the editor.
2. Begin by indicating if you are renewing your membership. If yes, provide your USEA member number.
3. Fill in your personal details including your name, gender, date of birth, and contact information such as address and phone number.
4. Select your membership category from the options provided and indicate any additional items for purchase.
5. For young riders under 21, complete the emergency contact section with the legal guardian's information.
6. Sign the document to confirm your payment method and total amount enclosed.
7. Review all entries for accuracy before submitting via fax or mail to ensure a smooth processing experience.

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