Vous êtes sur la page 1sur 2

Office Use

St. Vrain Roundup Club Membership Application and Renewal 2013

Date Paid: ____________ Cash Check Waivers Signed: SVRC BCF

Please complete the information below and submit the form along with dues to: SVRC Secretary Welcome! Membership dues are as follows: Primary Member Name: Street Address: City/State/Zip: Email: Home Number: Work Number: Check here if address has changed. Family $25 Individual $15

Cell Number:

Please list all family members who will show and their age group: First Name Last Name Relationship to Member -

Age Group

Age Groups (as of January 1): Pee Wee (10 and under), Intermediate (11-13), Junior (14-19), Senior (20-49), Masters (50 and over), Novice (limited show experience 20 and over)

Our club relies solely on the participation of the membership to make things work. We encourage each member to volunteer in at least three areas to help out with shows and social events/meetings. Remember, to qualify for year end awards, each member must volunteer in at least one show or committee, participate in at least one business meeting during a single show year (not including awards night) and dues must be paid in full before points begin to accumulate. Please check the areas you and/or your family are willing to volunteer in: Flagger Gates Timer Recorder Ribbons Office Wrangler Roundup (open gymkhana during Fair) Show Box Show Manager: Inventory/Order Ribbons May 5 June 2 June 15 February Announcer Ring Steward Cleanup Grounds Steak Fry (social event, cook out during Fair) Awards Committee July 21 March April Judges Sept 22 December

August 25 November

Potluck Host (set-up, decorate, clean-up):

Please complete the liability waiver on the back side as well. St. Vrain Roundup Club is a non-profit, for fun, volunteer club, and is not responsible for accidents or injuries.

Waiver, Release, Covenant Not to Sue and Indemnity Agreement (Adult and/or Minor Children) (All Applicants over the age of 18 required to sign below) Each of the undersigned, for himself, his heirs, representatives, and successors, does hereby and forever absolutely waive and release any claim for damage or injury to the undersigned or their minor children which hereafter may arise or result from participation by the undersigned or the undersigneds minor children in any activity of the St. Vrain Roundup Club, (an informal and unincorporated association), and does hereby covenant and agree not to sue the St. Vrain Roundup Club, or any of its members or agents, or any other person on whose premises the activities of the St. Vrain Roundup Club may be conducted, or any other person acting under the direction or control of such named parties, for any such claim. The consideration for this waiver, release and covenant not to sue and indemnity agreement is the acceptance of the undersigned and their minor children for participation in the activities of the St. Vrain Roundup Club. It is acknowledged and agreed that such participation in any activities of the St. Vrain Roundup Club would be strictly forbidden absent the execution of this document by the undersigned. The undersigned acknowledges the inherent risk of damage or injury in the activities of the St. Vrain Roundup Club, and that all such activities cannot be fully supervised at all times, and that each participant assumes all risk of harm or injury resulting from participation in such activities. The undersigned represents that he/she has full authority to execute this document, and has fully read it. In consideration of acceptance of the undersigned is such activities he/she will fully indemnify and hold harmless the named parties from any claim, loss or damage, including reasonable attorneys fees incurred by the named parties in connection with any claim made by or on behalf of, or arising out of, any injury to the undersigned or their minor children, of any type or nature, including claims by or on behalf of the undersigned, and any person with a right to represent any claim of the undersigned, absent willful wrongdoing by any of the named parties. Date Signed: ________________________________________________________________________ All Applicants over 18 Signatures: _______________________________________________________ Names of Minor Children: _____________________________________________________________ Signature: __________________________________________________________________________ Father, Legal Guardian) ( Mother, Names of Minor Children (not part of family as son or daughter): ______________________________ Signature: __________________________________________________________________________ ( Mother, Father, Legal Guardian) WARNING Under Colorado Law, an equine professional is not liable for any injury to or the death of a participant in equine activities resulting from inherent risks of equine activities, pursuant to section 13-21-119, Colorado Revised Statutes.

St. Vrain Roundup Club

Vous aimerez peut-être aussi