MEMBERSHIP APPLICATION FOR YEAR 2017 Date of Application ______
SILVER SPUR CLUB www.silverspurclub.org
Name of Applicant : ______
RELEASE, ASSUMPTION of RISK, WAIVER and INDEMNIFICATION
This document waives important legal rights. READ IT CAREFULLY BEFORE SIGNING.
I AGREE in consideration of my membership at the SILVER SPUR CLUB, to the following:
I AGREE that I choose to participate voluntarily in all Silver Spur activities and competitions attended with or without my horse, as an observer, rider, driver, handler, lessee, owner, agent, coach, trainer, or as parent or guardian of a junior member or exhibitor. This would also include my general use or riding on the grounds when there is no organized or sanctioned events. I am fully aware and acknowledge that horse sports and the competition involve inherent dangerous risks of accident, loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death (“Harm”).
I AGREE to release The Silver Spur Club and their Competitions and members from all claims for money damages or otherwise for any harm to me or my horse and for any Harm caused by me or my horse, to others, even if the Harm resulted, directly or indirectly, from the negligence of the Silver Spur Club or the Competition.
I AGREE to expressly assume all risks of Harm to me, or my horse, including Harm resulting from the negligence of The Silver Spur Club or any of their Competitions.
I AGREE to indemnify (that is to pay losses, damages, or costs incurred by) The Silver Spur Club and any of their Competitions and to hold them harmless with respect to claims for Harm to me or my horse, and for claims made by others for any Harm caused by me or my horse at any of their Competitions or gatherings.
I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that The Silver Spur Club encourages me to do so while WARNING that no protective equipment can guard against all injuries.
If I am a parent or guardian of a junior member or exhibitor, I consent to the child’s participation in any and all competitions or activities held by The Silver Spur Club and AGREE to all of the above provisions and AGREE to assume all of the obligations of this Release on the child’s behalf.
I AGREE that The Silver Spur Club and “their Competitions” as used above includes all of their officials, officers, directors, employees, agents, personnel, volunteers, and affiliated organizations.
I have read this agreement before signing it and agree to abide by the by the standing rules, bylaws and regulations of The Silver Spur Club and their competitions.
If applying for " FAMILY" membership, please remember that this includes only children that are under the age of 18 and your dependant or over the age of 18 and enrolled in school or other legal dependant.
Parent or Guardian must sign this release form for Jr. membership
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Applicant Signature or Parent/Guardian Signature Printed name and date
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Spouse/Significant Other Signature Printed name and date
PARTICIPATION INTERESTS: Please circle those areas of interest to you and your family.
GAMES PERFORMANCE FAIR PARKING TRAIL RIDING DRESSAGE
RODEO PENNING/ROPING CROSS COUNTRY HALTER BARREL CLUB
COMMITTIES
FINANCE/WAYS & MEANS: SHOW: SCHEDULING: PUBLICITY/MARKETING: BLDG & GROUNDS: SOCIAL: YOUTH
What other things would you be able to help with? (ie: phone calls, food preparation, etc.) ______
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Failure to fill out both sides of this form and sign may constitute a $50.00 fine.
SILVER SPUR CLUB www.silverspurclub.org
P.O. BOX 272
Silverdale, WA 98383
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NAME OF APPLICANT Sponsor (New applicants only)
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MAILING ADDRESS PHONE NUMBER
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CITY STATE ZIP Email Address
_____ FAMILY $100.00 PLEASE CHECK ONE:
_____ SINGLE $75.00 _____ WORK 16 HOURS - Tracking Log
_____ JUNIOR $55.00 OR _____ NON - WORK FEE of $75
Non Work Fee must be paid at time of
Membership Application submission
IF APPLYING FOR “FAMILY” MEMBERSHIP LIST FAMILY MEMBERS BELOW, PLEASE REMEMBER THAT THIS INCLUDES ONLY CHILDREN THAT ARE UNDER THE AGE OF 18 AND YOUR DEPENDANT OR OVER THE AGE OF 18, ENROLLED IN SCHOOL AND YOUR DEPENDENT OR OTHER LEGAL DEPENDENT
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Applicant Date of Birth
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Spouse/significant other Date of Birth
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child Date of Birth Relationship to applicant
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child Date of Birth Relationship to applicant
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child Date of Birth Relationship to applicant
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child Date of Birth Relationship to applicant
A COPY OF THE SILVER SPUR CLUB BY LAWS AND STANDING RULES HAS BEEN MADE AVAILABLE TO ME. I HEREBY AGREE TO ABIDE BY THE RULES & REGULATIONS STATED IN THOSE DOCUMENTS AS A CONDITION OF MEMBERSHIP IN SILVER SPUR CLUB.
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Signature of Applicant or Parent/Guardian
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FOR OFFICE USE ONLY:
Amount received $______Check #______Cash ______Date received ______
The above named applicant was accepted for membership in Silver Spur Club on ______
Signed: ______(President) ______(Treasurer)
Failure to fill out both sides of this form and sign may constitute a $50.00 fine.
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