February 4, 2014 at 10:44am: 2016 Membership Form & Waiver
February 4, 2014 at 10:44am: 2016 Membership Form & Waiver
NAME(S):
_____________________________________________________
_____________________________________________________
_____________________________________________________
ADDRESS:
_____________________________________________________
_____________________________________________________
PHONE:
_____________________________________________________
EMAIL ADDRESS:_____________________________________________________
PLEASE TELL US A BIT ABOUT YOURSELF... AND ANY SKILLS / EXPERTISE YOU
HAVE THAT YOU ARE ABLE TO SHARE WITH THE CLUB -
SENIOR: $20.00
Payment:
Cheques made payable toQuesnel & District Riding Club.
Cheque # ______________________
Cash (mark with a tick if paid cash)
WAIVER Of Liability For QDRC Members
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.
-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).
___________________________________ ______________________________
Riders signature Date
_____________________________
Parents signature (if under 18 years)
___________________________________ ______________________________
Witness signature (not related) Position/occupation