MEMBERSHIP APPLICATION
P.O. BOX 2102
Evanston, WY 82931
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(307) 677-4490
bearriverriders@yahoo.com
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www.bearriverriders.com
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MEMBERSHIP APPLICATION P.O. BOX 2102 |
___ Individual Membership: $20.00 *****MUST be 18 years or older!
___ Family Membership: $30.00
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Adult member names (Ages 18+):
________________________ (Birthday __________) ________________________ (Birthday __________) ________________________ (Birthday __________) ________________________ (Birthday __________)
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Child member names (under 18 years):
________________________ (Birthday __________) ________________________ (Birthday __________) ________________________ (Birthday __________) ________________________ (Birthday __________)
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Mailing Address: ________________________________________________________
City: _________________________________________ State: ______ Zip: ____________
Phone: (H) _____________________ (C) ______________________ (W) ______________________
E-Mail: _______________________________ OK to share info. with other members? ___YES___NO
I / my family interests are: (please mark all that apply)
___ Gymkhanas / ___ Horse Shows / ___ Trail Rides / ___Clinics / ___Communications
___Other Interests ____________________
I do hereby give consent to the persons named on this membership application to participate in the Bear River Riders (B.R.R.) activities and release the B.R.R., its officers, agents, Uinta County, and all affiliated organizations of any responsibility for injury or damage done to myself, my family, my livestock, or equipment resulting from participation in or association with B.R.R. activities.
Signature: _________________________________________ Date: ___________