CCBA Membership Form

Membership*

Membership Type*

All Youth Memberships must be accompanied by an adult membership

Primary Adult on Membership

Full Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

E-mail*

example@example.com

Joint membership is for 2 adults in the same household. Please fill out the below information for the additional adult.

Full Name

First NameLast Name

Phone Number

E-mail

example@example.com

Will you be additionally getting youth memberships?*

YesNo

Youth #1 Name

First NameLast Name

Youth #1 Birthday

Date

Youth #2 Name

First NameLast Name

Youth #2 Birthday

Date

Youth #3 Name

First NameLast Name

Youth #3 Birthday

Date

Are you interested in Sponsoring a Class at a CCBA show in 2023?

Yes $25 one time ClassYes $125 one Class all year at all your showsMaybe, please contact me for more informationNoYes, I’d to sponsor something bigger or division at the Championship show, please contact me.

Your membership will become valid once we have received both your Membership form and payment. No points will accrue until membership is active.

If you are not paying by Paypal, Venmo, or Credit Card, Please mail in your membership.

Mail PDF forms & checks to

Vicki Tolhurst

16 Virginia Rail Dr

Marlborough, CT 06447

Make All Checks Payable to Connecticut Color

Waiver of Liability

Each person engaged in recreational equestrian activities shall assume the risk and legal responsibility for any injury to his person or property arising out of the hazards inherent in equestrian sports, unless the injury was proximately caused by the negligence of the person providing the horse or horses to the individual engaged in recreational equestrian activities or the failure to guard or warn against a dangerous condition, use, structure or activity by the person providing the horse or horses or his agents or employees. CT Law (1997, Rev. Sec. 52-557p; 1993, P.A. 93-286, § 1.)

Liability Release:

I agree that I am personally responsible for my safety and actions and for the safety and actions of any minors under my care while competing with CCBA and/or at the Glastonbury Hunt Club or Falls Creek Farm. I agree to comply with all policies and rules set forth by the state of Connecticut.

The undersigned agrees to release, indemnify, and hold CCBA, Glastonbury Hunt Club, Sterling Stables, its officials, board of directors, employees, volunteers, or additional locations where CCBA sanctions events may occur, harmless to any claims. Applying for Membership of CCBA constitutes agreement herein.

I agree to the above Waiver of Liability*

Yes

Member or Guardian Signature*

My Products*

Individual Membership

$25.00

Joint Membership - 2 adults in same household

$40.00

Youth - Accompanying Adult Membership Required

$10.00 Number

Single Class SponsorshipSponsor one class for our day show or Championship Show. Pricing includes mention in our banquet book, on our website & Facebook.

$25.00

Year Class SponsorshipSponsor one class for all shows. Sponsored by: your name on all classlists. Provided Business card ad in banquet book, printed on banner made and displayed Championship Show, Name announcement at the Championship show. Plus, linked Logo/Name on Website, and mention on our Facebook. A board member will reach out and ask what class you'd like to sponsor.

$125.00

Enter coupon

Total

$0.00

Payment Methods

Debit or Credit Card

First Name

Last Name

Credit Card Number

Security Code

Card Expiration

Please click one of the PayPal options to complete payment and submit the form.

2023-24 CCBA Membership