Membership Application
❏ 1st-time Individual membership $35
❏ 1st-time members, please tell how you learned about the club?
❏ ___________________________________________________
❏ Individual renewal membership if paid by Feb. 1 $30
❏ Individual renewal membership if paid after Feb. 1 $40
❏ Family membership includes all dependents as defined by IRS
❏ 1st-time Family membership $40
❏ Family renewal membership if paid by Feb. 1 $35
❏ Family renewal membership if paid after Feb. 1 $45
❏ Out of state membership $20
Member Information (Head of Household):
Last name: ______________________ First name: _____________________
Street: ________________________________________________________
City: ___________________________ State: ___________Zip: ___________
Home Phone: ____________________Cell Phone: _____________________
Email address: __________________________________________________
Member Information (Partner):
Last name: ______________________ First name: _____________________
Street: ________________________________________________________
City: ___________________________ State: ___________Zip: ___________
Home Phone: ____________________Cell Phone: _____________________
Email address: __________________________________________________
Children’s name(s) and age(s):
Last name: ______________________ First name: __________________ Age: _____ Last name: ______________________ First name: __________________ Age: _____ Last name: ______________________ First name: __________________ Age: _____ Last name: _______________________ First name: ___________________ Age: _____
Signature: _______________________________________ Date: _____/_____/_____ Signature: _______________________________________ Date: _____/_____/_____
Please mail application, liability release forms, with a check made payable to S.R.H.A. to: Jill Cole, 1110 Marty Road, Los Gatos, CA 95033. Payment may also be made via Zell: summitriders23@gmail.com
SUMMIT RIDERS HORSEMAN’S ASSOCIATION, INC.
Participant’s Release and Hold Harmless Agreement
( This Agreement contains important limitations of legal liability. Please read carefully before signing. )
I, _________________________________________, desire to attend or participate in one or more events (each one a “Horse Event”) sponsored or facilitated by Summit Riders Horseman’s Association, Inc., a California nonprofit corporation (“SRHA”). A Horse Event may include activities such as horse riding, training, taking lessons, attending clinics and seminars, or caring for horses.
I acknowledge (a) any Horse Event and all horse-related activities are dangerous and contains inherent risks such as bodily injury, physical harm, and damage to me, my horse(s), my property, and spectators; (b) horses have unpredictable temperaments which can cause behavior leading to injury or damage; (c) even an experienced horse owner cannot predict how each horse will react in a variety of situations and cannot guarantee my safety; and (d) an inherent risk of riding is falling off the horse.
By signing below, I knowingly assume for myself and my spouse (if applicable) all inherent Horse Event risks, known or unknown:
1. I hereby release SRHA and its members, Board of Directors, officers, employees, independent contractors, agents, and volunteers; Ron Parker; Randy Parker; Sandi Parker; all other persons and organizations involved with facilitating the Horse Event; and all their representatives, heirs, administrators, successors and assigns (each a “Released Party”) from any acons, claims, demands, damages, attorneys' fees or costs of any kind (the “Claims”) related to my participation or attendance at a Horse Event. This release applies to and includes all known and unknown and unexpected claims referred to in Section 1. I have read California Civil Code Section 1542, which provides: “A general release does not extend to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the release, which if known by him or her must have materially affected his or her settlement with the debtor.” I waive all rights otherwise available under Section 1542, having had full opportunity to consult with counsel.
2. I will defend, indemnify, and hold harmless any Released Party against any Claims related to any (a) act or omission by me, my horse(s) or my guests, or (b) proceeding brought for my benefit arising from my participation or attendance at any Horse Event.
3. I acknowledge that at any Horse Event, photos or other digital recordings are usually taken by SRHA in the spirit of having a recorded memory of a great me. I hereby grant full permission to SRHA and/or its authorized agents to use my full name, image, likeness, and/or voice in any photograph, video, audio, or any other recording in whatever form (the “Recording”) and to use it for any legitimate purpose related to SRHA. Any Recording will be exclusively owned by SRHA.
4. This Agreement is governed by California law and is binding on my administrators, executors, heirs, successors, and assigns. It contains the entire agreement among the pares. If any portion is deemed by a court of competent jurisdiction to be unenforceable, that portion shall be severed from the remaining portions, which shall remain in full force.
I have read this Agreement carefully and understand it. It is effective when signed and continues until revoked in writing by me.
Date: ____________________ Signature:_________________________________________________ (If under 18) Date of Birth: _____________________ Parent or Guardian ________________________
Emergency phone # _________________________ Email address ______________________________
MINORS MUST HAVE THE FOLLOWING LIABILITY WAIVER SIGNED BY THEIR PARENT OR LEGAL GUARDIAN
We, the undersigned parents of_________________, for and in consideration of my child’s participation in one or more SRHA Horse Events, state that we have read the above Agreement and expressly agree that the terms and conditions of this Agreement apply to and are binding on us and my minor child in as so far as it pertains to his or her participation in a Horse Event, a Recording, and to any injury or damage said minor child or his/her horse may sustain or cause as a result of said participation. We further warrant we have health and accident insurance on said minor. I declare under penalty of perjury that the foregoing is true and correct.
Executed this ______ day of __________, 20___ at _______________________ California.
Mother: Phone: __________
Father:Phone: __________________
I acknowledge that I have read the foregoing paragraphs and understand the content thereof.
Signature: _________________________________________________
Date: __________________________
Signature: _________________________________________________
Date: __________________________
Updated January 2024
