PBEA Membership Form

Powder Basin 2026 Membership, Non-Member Schooling, Donations or Fee for Overnight Pen

CREDIT CARD Payment Option ONLY - 2.9% + 30 cents
Rider Information
Rider's Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Rider Email
example@example.com
Phone Number
Other Family Members Names
Youth (under 18) - $35Individual Membership - $50Family Membership (same address) - $75Trainer Membership - $100Overnight pen (one horse one night) - $15Overnight Pen (2 horses one night or 1 horse two nights) - $30Day Use Per Rider - for non-members- $50
Donation (** helps with park updates)
Calculation of Selection/s Plus Donation (if, any) - Do NOT Edit*
2026 RELEASE OF LIABILITY FOR PBEA Facility and Riding PARK
PLEASE READ BEFORE SIGNING!

By signing this form, I state that I understand that equine activities are inherently risky and potentially dangerous. I understand that riding is a potentially risky and potentially dangerous sport. I herby declare that I am participating in thisactivity entirely at my own risk I herby assume this risk and further do herby release and hold harmless Powder Basin Equestrian Association and my fellow riders, from all liability , including any negligence, resulting in accidents, damage, injury, illness and /or death, to myself and to my property , including the horse or horses which I will ride at the PBEA Facility and Riding Park.

This release will be considered valid any time I ride at PBEA Facility and Riding Park. I further understand and accept the limitations applied by Wyoming State Law, specifically the “Recreation Safety Act” (WS. 1-1-121 through 1-1-123) that participants in recreation activities, particularly including equine activities, accept full responsibility for the inherent risk, dangers and conditions which are characteristic of, intrinsic to, or an integral part of any sport or recreational opportunity.

I acknowledge that I am participating entirely at my own risk. RIDE AT YOUR OWN RISK!! Please use your own good judgment and ride safely!
2026 POWDER BASIN EQUESTRIAN ASSOCIATION

MEMBERS CODE OF CONDUCT

READ BEFORE Signing

Membership Dues:

Individual - $50 Family - $75 Junior $35 Trainer: $150

Trainers are required to provide proof of insurance.

Members and Trainers Rights & Responsibilities:
- Wear appropriate safety gear. Minors are highly encouraged to wear ASTM/SEI approved safety headgear at all times when mounted unless a waiver signed by a guardian is on file with PBEA office. Anyone participating in jumping activities is REQUIRED to wear safety headgear and heeled boots.
  - Minors are highly encouraged to ride with adult(s) present.
- Make decisions in training and competition with the welfare of the horse first and foremost in your mind.
- If dangerous or inappropriate behavior on or off the horse by a member is reported in writing to the Board, the member will be subject to Board review and possible loss of membership.
- Unsafe or illegal behaviors may result in consequences from the PBEA Board.
- Support others, encourage those new to the club and the Equestrian Park.
- Be respectful and support the PBEA Board and its decisions. Be courteous when presenting different ideas or when disagreeing with other club members.
- Be considerate of those contributing their time to put on Events and maintain the Park.
- Be courteous to Officials, Organizers and Volunteers.
- Volunteer when you are able by donating your time at Events and in the upkeep and maintenance of the Park.
- To ensure the longevity of PBEA, please consider taking a turn on the board of directors and planning and hosting events.
- If posting on Social Media, keep your comments respectful, professional and helpful.
Parent or Guardian Release Waiving a Minor’s Need for Headgear - jump to confirmation if no need to complete this section.
I, First Name Last Name , parent/guardian hereby waive the requirement that my child/children named Child/Children's Names wear headgear during non-jumping mounted activities at the PBEA riding facility.
**Note this is a waiver of headgear for general riding at the park - headgear is still required for all jumping activities.
Confirmation

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Signature*

Clear
Total from Sum of Fees plus fees (2.9% + 30 cents)

Amount to be charged (includes 2.9% + $.30 processing fee)*

USDAuto populates DO NOT EDIT. Charged amount

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

Should be Empty:

Powder Basin 2026 Membership, Non-Member Schooling, Donations or Fee for Overnight Pen

Parent or Guardian Release Waiving a Minor’s Need for Headgear - jump to confirmation if no need to complete this section.