Horsin' Around Club 2021
MEMBERSHIP FORM/LIABILTY WAIVER

Enclosed is my check for $_______________ for:
$15 _______ Youth membership only.
$20 _______ Individual membership only.
$25 _______ Family membership only.
$50 _______ Individual membership with sponsorship.
$55 _______ Family membership with sponsorship.
___________ (Initialed) Non member / Show participant only
Note: Non-members are NOT eligible for high point awards.


PLEASE COMPLETE PERSONAL INFORMATION BELOW AND ALL INFORMATION ON SECOND PAGE REGARDLESS OF STATUS
(MEMBERS AND NONMEMBERS).

I do hereby make application for membership to the Horsin' Around Club. I agree to comply with all rules and regulations for all activities and understand that I am fully responsible for my actions. I understand that my membership will be valid for current year's show season and is renewable each season. Memberships must be current to earn high point awards each show season.

Date: ________________________________________________________________________________________

Name(s): (Please Print) ________________________________________________________________________________________

________________________________________________________________________________________

________________________________________________________________________________________

Address: ________________________________________________________________________________________

City, State, Zip: ________________________________________________________________________________________

Email: ________________________________________________________________________________________

Phone(s): ________________________________________________________________________________________

Date of Birth and Age (If Minor): ________________________________________________________________________________________


APPLICANT MUST READ ENTIRE APPLICATION AND SIGN THIS FORM FRONT AND BACK WITH NO EXCEPTIONS. ALL MINORS MUST HAVE A SIGNATURE FROM A PARENT OR GUARDIAN. (SEE BACK OF PAGE)


RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT ('AGREEMENT')

In consideration of participating in the Horsin' Around Club sponsored activities, I represent that I understand the nature of this Activity and that I am qualified, in good health, and in proper physical condition to participate in such Activity. I acknowledge that if I believe event conditions are unsafe, I will immediately discontinue participation in the Activity.

I fully understand that this Activity involves risks of serious bodily injury, including permanent disability, paralysis and death, which may be caused by my own actions, or inactions, those of others participating in the event, the conditions in which the event takes place, or the negligence of the 'releasees' named below; and that there may be other risks either not known to me or not readily foreseeable at this time; and I fully accept and assume all such risks and all responsibility for losses, costs, and damages I incur as a result of my participation in the Activity. I hereby release, discharge, and covenant not to sue Horsin' Around Club, its respective administrators, directors, agents, officers, volunteers, and employees, other participants, any sponsors, advertisers, and, if applicable, owners and lessors of premises on which the Activity takes place, (each considered one of the 'RELEASEES' herein) from all liability, claims, demands, losses, or damages on my account caused or alleged to be caused in whole or in part by the negligence of the 'releasees' or otherwise, including negligent rescue operations; and I further agree that if, despite this release, waiver of liability, and assumption of risk I, or anyone on my behalf, makes a claim against any of the Releasees, I will indemnify, save, and hold harmless each of the releasees from any loss, liability, damage, or cost which any may incur as the result of such claim.

I have read this RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT, understand that I have given up substantial rights by signing it and have signed it freely and without any inducement or assurance of any nature and intend it be a complete and unconditional release of all liability to the greatest extend allowed by law and agree that if any portion of this agreement is held to be invalid the balance, notwithstanding, shall continue in full force and effect.

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Printed name of participant

______________________________

Date

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Signature of participant

______________________________

Date

PARENTAL CONSENT: AND I, the minor's parent and/or legal guardian, understand the nature of the above referenced activities and the minor's experience and capabilities and believe the minor to be qualified to participate in such activity. I hereby release, discharge, covenant not to sue and AGREE TO INDEMNIFY AND SAVE AND HOLD HARMLESS each of the Releasees from all liability, claims, demands, losses, or damages on the minor's account caused or alleged to have been caused in whole or in part by the negligence of the Releasees or otherwise, including negligent rescue operations, and further agree that if, despite this release, I, the minor, or anyone on the minor's behalf makes a claim against any of the above Releasees, I WILL INDEMNIFY, SAVE AND HOLD HARMLESS each of the Releasees from any litigation expenses, attorney fees, loss liability, damage, or cost any Releasee may incur as the result of any such claim.

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Printed name of Parent/Guardian

______________________________

Date

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Signature of Parent/Guardian

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Date

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