Video Order Form Name* First Last Email* Phone*AddressRequired if you are ordering a video that will require shipping. Street Address Address Line 2 City State AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific ZIP Code Association*NSBA (National Snaffle Bit Associaton)Buckeye Reining SeriesSFRHA (South Florida Reining Horse Association)GCRCHA (Gulf Coast Reined Cow Horse Association)FRHA (Florida Reining Horse Association)HDRHA (Heart of Dixie Reining Horse Association)TNRHA (Tennessee Reining Horse Association)KRHA (Kentucky Reining Horse Association)SERHA (Southeast Reining Horse Association)EPRHA (Eastern Pennsylvania Reining Horse Association)VRHA (Virginia Reining Horse Association)Balcony SportsPAC (Performing Arts Conservatory)MESD (Mary Ellen School Of Dance)Honey's School of DanceDance Alive National BalletEquestrian Video*This is total number of rides you are requesting a video for. Price: $25.00 Quantity: Delivery Method*Online (YouTube)USB Thumb DrivePayment Method*If your video order requires payment please indicate your preferred payment method. Please mail check made payable to National Sports Broadcasting, 4530 SW 52 Circle #110, Ocala, FL 34474CheckCredit CardMessage*If ordering videos please be as specific as possible. Indicate what day you rode and what class you were in and if you recall please indicate a draw or back number of your horse. This will help us locate your video quicker.Shipping Price: $5.00 Total $0.00 CAPTCHA This iframe contains the logic required to handle Ajax powered Gravity Forms.