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Membership
RCHA Ranch Cutting Horse Association 560 Wilson Ranch Rd – Holliday, Texas 76366 Office: 940-586-1839 - Cell: 940-631-4490 - Fax: 940-586-0189 www.ranchcutters.com --- rcha.association@yahoo.com
2012 MEMBERSHIP APPLICATION
2012 MEMBERSHIP APPLICATION
__________ Active Membership $100 – plan on participating at cuttings.
__________ Associate Membership $50 – do not plan on participating but would like to remain on mailing list.
__________ Youth Membership $25
Name: _____________________________________________________
Address: ___________________________________________________
City – State – Zip Code_______________________________________
Home Phone #: ______________________________________________
Cell Phone #: _______________________________________________
Due to the number of mailouts and to cut costs we would like to email as many mailouts as we can in 2011. If you would be willing to receive you mailouts via email please give your email address below.
Email address _______________________________________________
Name of Ranch: _____________________________________________
Phone #: ___________________________________________________
Length of Employment: _______________________________________
If Contract Labor, Ranch Reference: _____________________________________
Phone #: _______________________________
Please send appropriate membership fee along with copy of the registration papers of any horses that might be shown during the current points year at least two weeks prior to an event. No application will be considered until all requirements are met.
RCHA 560 Wilson Ranch Rd Holliday, Texas 76366
______________________________________________________Signature Required
By signing, I agree that I have read and understand all rules; and that I qualify and have answered all questions truthfully.
Waiver of Liability and Release
In consideration of being allowed to participate in any way in the RCHA events and related activities, the undersigned acknowledges, appreciates, and agrees that: 1. There is a risk of injury from the activities involved in these events, including the potential for permanent paralysis and death; 2. I KNOWINGLY AND FREELY ASSUME ALL SUCH RISKS, both known and unknown, EVEN IF ARISING FROM THE NEGLIGENCE OF THE RCHA or others, and assume full responsibility for my participation; and 3. I willingly agree to comply with the stated RCHA rules and conditions for participation and the decisions of the RCHA Managing Committee; and,4. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kind, HEREBY RELEASE AND HOLD HARMLESS RCHA, their officers, officials, members, agents, and/or employees, other participants, sponsoring agencies, sponsors, advertisers, and if applicable, owners and lessors of premises used to conduct the event ("RELEASEES"), WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER ARISING FROM THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE. 5. I HAVE READ THIS DOCUMENT IN ITS ENTIRETY AND FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITHOUT ANY INDUCEMENT.
Date Signed: ______________________ Signature: ___________________________________________________________ Participant Name in Print ___________________________________ SS# ___________________________________________________ D.O.B. _________________________________________________ Phone No. ______________________________________________ Emergency Contact _______________________________________
FOR PARTICIPANTS OF MINORITY AGE (UNDER AGE 18 AT THE TIME OF REGISTRATION)
This is to certify that I, as parent/guardian with legal responsibility for this participant, do consent and agree to his/her release as provided above of all the Releasees, and for myself, my heirs, assigns, and next of kind, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities incident to my minor child’s involvement or participation in these programs as provided above, EVEN IF ARRISING FROM THEIR NEGLIGENCE.
Date Signed __________________ Parent/ Guardian Signature ___________________________________ Emergency Phone No. ______________________________________
Email: rcha.association@yahoo.com
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