KCRC Membership Form

Select Your Membership*

Family Membership - NewIndividual Membership - New

Total

Total Price

USDDescription

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Your Name*

First NameMiddle NameLast Name

Your Phone Number*

Please enter a valid phone number.

Your Email*

example@example.com

Spouse/Partner Name*

First NameMiddle NameLast Name

Spouse/Partner Phone Number*

Please enter a valid phone number.

Spouse/Partner Email*

example@example.com

Your Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

List names, age (at time of application) and birth date of all members. Every space must be filled. Use N/A for any blank spaces.:*

	Full Name	Age	Birthdate
1
2
3
4
5
6

Occupation Details*

	Husband	Wife
Occupation:
Employed by:

List three reasons for wanting to join the Kit Carson Riding Club*

Sponsoring Member's/Family's Name*

Sponsoring Member's Phone Number*

Please enter a valid phone number.

Emergency Contacts*

	Name	Relationship	Phone Number
Contact 1
Contact 2

Check each committee the applicant(s) are willing to volunteer. You will be called into service on each committee you select! (Must select at least three committees)*

For membership to the Kit Carson Riding Club, Inc. I/We agree to the following conditions (INDIVIDUALS use an X in each cell of the second column):*

	1st Person Initial	2nd Person Initial
I/We understand that the Kit Carson Riding Club, Inc is a private club to be used by and for the members of the Kit Carson Riding Club, Inc.
I/We agree not to abuse the gate privilege by: a. Allowing non-members to use the club grounds outside of club sponsored public activities.
b. Disabling the gate in any way to keep it open

Committee Name*

How many times did you volunteer and what were your responsibilities?*

Participation: What activities did you participate in during this last membership year?*

KCRC HOLD HARMLESS AGREEMENT
The insurance company holding coverage for Kit Carson Riding Club, Inc. has required
any person(s) participating in any and all activities supervised and/or sponsored by
Kit Carson Riding Club, Inc. to sign a “Hold Harmless Agreement”. Toi simplify paper
work for all facets of the club, the board is requesting a one-time signature of club
members to cover the entire family for participation in horse shows, gymkhanas,
polo, roping, trail rides, and any other activities of the club during the year. Please
list full names and birthdates of ALL family members who MIGHT POSSIBLY participate in club activities. We ask that anyone 18 and over sign for themselves.

****WARNING****
Under Colorado Law, an equine professional is not liable for the injury to or the death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to section 13-21-119, Colorado Revised Statutes.
For more information: http://www.americanequestrian.com/legal/CO.htm

HOLD HARMLESS AGREEMENT
I HEREBY RELEASE Kit Carson Riding Club, Inc., its Officers, Board of Directors and members from any claim or right for damages which may occur to me, my minor children, or equine family (i.e. horses, mules, donkey, etc.) I also assume and accept full responsibility for any damages done by us or our equine family at any Kit carson Riding Club, Inc. sponsored or supervised activity during this membership year.

I hereby release and hold harmless Kit Carson Riding Club, Inc. from any reasonable expectation of privacy or confidentiality for myself and for the minor child and children listed below associated with images taken at KCRC sponsored events. Futher, I attest that I am the parent or legal guardian of the child or children listed below and that I have full authority to consent and authorize Kit Carson Riding Club, Inc. to use their likenesses and names.

I Further acknowledge that participation is voluntary and that neither I, the minor child, or minor children will receive financial compensation of any type associated with the taking or publication of any photographs or participation in club marketing
materials or other club publications and forms of communication. I acknowledge and agree that publication of said photos confers no rights of ownership or royalties whatsoever.

I hereby release Kit Carson Riding Club, Inc., its members, its volunteers and any third parties involved in the creation or publication of club publications, from liability for any claims by me or any party in connection with my participation or the participation of the minor children listed below.

Release of Liability (signature required from each person listed). List names, age (at time of application) and birth date of all members. Every space must be filled. Use N/A for any blank spaces.:*

	Person's Name	Birthdate	Signature (Parents sign for children under 18)
1
2
3
4
5
6

Parent Name

Parent Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent Phone Number

Please enter a valid phone number.

Today's Date*

I have read and agree to the KCRC By-Laws and Code of Conduct

*

I agree

Signature*

Clear

KCRC Membership Form

Member Involvement