Riders Interscholastic Federation of North America, Inc.

RIFNA Farm Application

Name:                                                                                                                                                                                    

Address:                                                                                                                                                                               

City:                                                        State:                      Zip:                                         Email:                                     

Telephone:                                                  Fax:___________________________

Farm Contact:                                                                       Telephone:                                                                          

This application is an:       Initial Application ___            Annual Renewal___             Recertification ___

Current RIFNA farm (Y/N):                            Years with RIFNA:                                                    

Coaches Names & Date of Birth (Must be 21 or Older):

                                                                                Date of Birth (Must be 21 or Older)_____________________

_                                                                              Date of Birth (Must be 21 or Older)_____________________

                                                                                Date of Birth (Must be 21 or Older)_____________________

Disciplines Taught:  Hunter                     Dressage                     Western

Have you been a certified RIFNA farm in the past?   Yes (indicate date:  __________________)

                                                                                          No 

Will your farm be able to host RIFNA Shows or Meets?  Yes             No         Yes, offsite*

*Please explain:  ______________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________       

 (Please understand RIFNA requires every team to host a show or a meet at least once a year and, if your facility cannot then you will need to team up with other farms or rent a show facility.)

Have you hosted shows in the past?   Yes                       No

Number of Horses Available to use for teaching:                         

Type of Barn (i.e.: lesson, private, sales, school, etc.):                                                 

Insurance Information (fax proof):                                                                                                                                

Fee Paid:  $500.00*                                                

Payment type:   Check     Money Order   Online through paypal

*Initial certification is $500 with an annual renewal is $50.  Facility members must be re-certified every five years. 

By signing this document, I verify that, to the best of my knowledge, the above information is true. 

Signature:                                                                                Date:                                                                                    

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