the 2015 membership form - Brazos Association for Classical

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BACH 2015 Membership Form
Membership Year November 1 to October 31
 Individual $35 
Family $35 + $15 for each additional family member 
New

Renewal
Note: $20 of your membership fee ($10 for each additional family member) goes directly to USDF for Group Membership
_______________________________________________________________________________________________________
Name (Please Print)
Date of Birth (or USDF Member #)
_______________________________________________________________________________________________________
Address
City
State
Zip
____________________________________________________________________________________________________
Phone
E-Mail
Family Member Names (List primary family member on the first line above. Please list each additional family member below with
name and USDF# or date of birth.) Indicate Junior members.
BACH Release, Assumption of Risk, Waiver and Indemnification
This document waives important rights. Read it carefully before signing.
I am fully aware and acknowledge that equine sports and activities involve inherent dangerous risks of accident and serious bodily
injury including broken bones, head injuries, trauma, pain, suffering, or death.
WARNING: Under Texas Law (Chapter 87, Civil Practice and Remedies Code), an 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.
I hereby acknowledge that I have reviewed the Texas Equine Activity Liability Act Warning, which is set forth above.
In consideration for my participation in the Brazos Association for Classical Horsemanship (“BACH”):
A. I hereby agree for myself and for any spectator accompanying me to an Activity (as hereinafter defined), my family members, my heirs,
administrators, personal representative and assigns (individually and collectively referred to as “My Associates”) to re- lease, discharge and
agree to hold harmless (i) BACH, its officers, directors, members, employees, assigns and agents (hereinafter “BACH”) and (ii) any facility, its
owners, agents, and employees (“Facility”) at which an Activity is held of all claims, demands, causes of action and legal liability for any
accident, damage, injury or illness to me or My Associates or to any horse owned or ridden by me in connection with any show, clinic, event or
function sponsored in whole or in part by BACH (“an Activity”).
B. I do further agree that I and My Associates will indemnify BACH and any Facility for any claims, demands, causes of action and legal liability
brought against BACH for injuries or losses caused directly or indirectly by me or My Associates or by any horse owned or ridden by me in
connection with an Activity and for any costs associated with any claim which may be brought by me or on my behalf or by or on behalf of My
Associates notwithstanding the release set forth in paragraph A whether or not such release is found to be invalid.
C. I hereby acknowledge that this release releases BACH from its/their own negligence including its/their own gross negligence.
D. If I am a parent or guardian of a minor child, I consent to the child’s participation in an Activity and agree to all of the above provisions and
agree to assume all of the obligations in this Release individually and on behalf of such minor child.
_______________________________________ ___________________
Signature
Date
___________________________________________________
Signature
Date
_____________________________________________________________
Signature of Parent or Guardian
Date
.
MAKE CHECKS PAYABLE TO BACH & MAIL TO:
Anne Boyle, 3309 Belmont Circle, College Station, TX 77845
BACH Year End Award Sign Up 2015
For October 13, 2014–October 12, 2015 * One horse/rider combo per form please
Rider
Category (circle)
Horse
Jr/YR
Level (circle all that apply) Dressage:
Adult Amateur
GAG/Intro
Eventing: GAG
Date submitted
Training
Beg Novice
Open
1st
Novice
2nd
3rd
Training
Fee(s): $5.00 for each level/category circled Total:
4th–FEI
Preliminary
Check#
Questions about Year End Awards?
ginni@flash.net; phone days 979-690-6788, eves 979-696-5328
Mail scores to Ginni Cifelli, 6809 Stousland Rd., CS, TX 77845
BACH Year End Award Sign Up Award Sign Up 2015
For October 13, 2014–October 12, 2015 * One horse/rider combo per form please
Rider
Category (circle)
Horse
Jr/YR
Level (circle all that apply) Dressage:
Adult Amateur
GAG/Intro
Eventing: GAG
Date submitted
Training
Beg Novice
Open
1st
Novice
2nd
3rd
Training
Fee(s): $5.00 for each level/category circled Total:
Check#
Questions about Year End Awards?
ginni@flash.net; phone days 979-690-6788, eves 979-696-5328
Mail scores to Ginni Cifelli, 6809 Stousland Rd., CS, TX 77845
4th–FEI
Preliminary
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