Hamilton County Riding Club, Inc.

Family Membership - $50

IF UNDER 18 YEARS OF AGE THIS APPLICATION MUST BE SIGNED BY A PARENT AND/OR GUARDIAN AND CAN NOT BE IN THE CHILD’S NAME

If member is 18 years of age or older and is not a full-time student (12 college hrs.+), they must have their own membership.

Age of as January 1st

Applicant's Name:

Date of Birth

Class Division

Preferred Contact #

Spouse's Name:

Date of Birth

Class Division

Spouse Email

Spouse Preferred Contact #

Address, City, State, Zip

Child's Name-1

Date of Birth

Class Division

Child's Name-2

Date of Birth

Class Division

Child's Name-3

Date of Birth

Class Division

Child's Name-4

Date of Birth

Class Division

Child's Name-5

Date of Birth

Class Division

PLEASE READ ALL RULES BELOW:

Check, Individually and as Guardian on behalf of my family members.

It is my/our understanding that for the continued progress of the Hamilton County Riding Club, Inc., I am/we are required to assist in such work necessary to operate and maintain the Club and its grounds/facility. (15 work hours per year/attend 50% or more of club activities per year)

Yes

If I/we do not work, I/we understand that I/we will forfeit my/our points/participation for the year and any awards that I/we may have received.

Yes

I/we certify that all horses I/we bring onto the premises will have a current negative Equine Infectious Anemia (EIA/Coggins) test. EIA/Coggins certificate is subject to inspection upon request. If you are unable to provide adequate proof any rider (member or non-member) will be subject to the penalties and laws of the State of Florida.

Yes

I/we certify that any children listed above that are the age of 16 & under have a signed Helmet Release form on file.

Yes

It is my/our understanding that I am/we are not promised/guaranteed a certain award for a certain place in a class, and that all awards are based on the funds of the club for the year.

Yes

HOLD HARMLESS AND EXCLUSION OF LIABILITY/RIDER’S RELEASE

I/we acknowledge that all horseback-riding events that I/we participate in are considered contact sports for which I/we assume all liability for personal injuries, death and property damage that arises there from. Further I am/we are aware of the Equine Liability Law under Florida Statute 773.01: Florida – Warning – Under Florida law, an equine sponsor or equine professional is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities. and agree not to hold the Hamilton County Riding Club, Inc. and its owners, operators, members, officers, directors, and agents liable for any injury, death to my myself, others, or to my animals arising from either their negligence, my negligence or the negligent conduct of anyone causing me, my family members and/or my animals any injury, death or damages.

By signing below, you have read and understand the Hold Harmless/Exclusion of Liability/Rider’s Release above, and you have received a copy of the current Club's by-laws, and you have read and understand the conduct and obligation of being a member in good standing with the Club.

Applicant's Printed Name Signing Membership form

Applicant's Signature

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