Dutch Harness Horse Registry of North America, Inc.

Registration Application

Color

Sex

Bay

Chestnut

Mare

Stallion

Black

Roan

Gelding

Grey

First Name

Second Name

Date Foaled

Name of owner

Address:

City:

State/Prov:

Country

Zip/Post. code:

Phone:

E-mail:

Markings

Sire of Foal

Reg. No.

Dam of Foal

Reg. No.

Breed of Sire

Breed of Dam

Color of Sire

Color of Dam

Visa

Mastercard

Discover

Ameerican Express

Card Number

Click here for Credit Card Acceptance

Name on Card

Exp. date

After you have completed the form above and have clicked on the submit button below, please 
Click here to fill out Pedigree information
If you don't have a Credit Card you may fill out this form and it will be processed, but no
Certificate will be sent to you until payment has been received or If you wish to submit your
Application through the mail go back to Forms and download an Application form and follow the instructions  on the Form.  Mailing address:
The Dutch Harness Horse Registry of North America, Inc..
1004 Gulf Rd
Elyria, Ohio 44035