2016 Membership Form & Waiver

February 4, 2014 at 10:44am

QUESNEL & DISTRICT RIDINGCLUB

( quesneldistrictridingclub@gmail.com and Facebook )

2016 MEMBERSHIP APPLICATION FORM

NAME(S):
_____________________________________________________

_____________________________________________________

_____________________________________________________

ADDRESS:
_____________________________________________________

_____________________________________________________

PHONE:
_____________________________________________________

EMAIL ADDRESS:_____________________________________________________

YOUR MAIN EQUINE INTERESTS - PLEASE TICK.

*ENGLISH *JUMPING *CROSS COUNTRY *DRESSAGE *DRILL TEAM

*WESTERN *MOUNTED GAMES/GYMKHANA *OBSTACLE/TRAIL CHALLENGE
*CLINICS *PLEASURE/TRAIL RIDING *HORSEMANSHIP *SHOWING
*COMPETITION *PENNING/SORTING *OTHER

PLEASE TELL US A BIT ABOUT YOURSELF... AND ANY SKILLS / EXPERTISE YOU
HAVE THAT YOU ARE ABLE TO SHARE WITH THE CLUB -

Membership Of Horse Council BC is required to become a member of the QDRC

http://www.hcbc.ca/

HCBC #:______________________ ( please include acopyof your HCBC card )

Circle one of the following:

SENIOR: $20.00

JUNIOR:(18yrs or younger as of January 1 ) $10.00

FAMILY:2 parents/guardians and up to 5 children. $50.00

**Please include all names on lines above.

Nameof a parent, if junior:________________________________

Signatureof parent: _________________________________

Payment:
Cheques made payable toQuesnel & District Riding Club.
Cheque # ______________________
Cash (mark with a tick if paid cash)


WAIVER Of Liability For QDRC Members

I_______________________________________am aware that there are risks, dangers and

hazards in my preparation for, travel to or from and participating in any event which is
organized, operated or sanctioned by the Quesnel & District Riding Club.

Some of these risks, dangers and hazards are foreseeable, and others are not.
These risks, dangers and hazards include the possible risk of severe or fatal injury to myself or
others, and more specifically include, but are not limited to:

-Injuries to my person resulting from falls from my horse, or caused in any other
manner by my horse or by any other horse.

-Extremes of weather and temperature which may result in heatstroke, sunstroke

or any other health ailments.

-Injuries from failing to ride safely or within my abilities.

-Spinal cord injuries which may render me permanently paralyzed.

-The risk of my horse causing damage to my own property or property of others, or

causing injury to other persons or animals.

-The risk or injury failing to wear protective equipment, from wearing defective
equipment or from wearing such equipment improperly.

-Risks of injury or property damage associated with travel to or from ride locations,
including the transport of my horse(s).

-Additional risks associated with non-competitive activities and non-sports

activities, which are often an integral part of events, and Club activities.

I have read and I understand this waiver.

I release the organizers of responsibility, where organizers are defined as the clubs executive,
directors, volunteers, committees, officials and other members, whether negligent or not.

___________________________________ ______________________________
Riders signature Date

_____________________________
Parents signature (if under 18 years)

___________________________________ ______________________________
Witness signature (not related) Position/occupation