Membership Form
2025 Show Year
Rider Name
First Name
Last Name
Date of Birth (Youth Riders Only)
Additional Riders and Dates of Birth (Family Membership Only)
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Phone Number
Please enter a valid phone number.
Choose One
New Member
Renewal
Liability Release
By checking the “I agree” box below and typing your name, you are electronically signing this liability release form. You affirm that an electronic signature has the same effect as a written signature. You also confirm you are 18 years or older.ACKNOWLEDGEMENT OF RISK: The undersigned acknowledges that the participation in horse events as a contestant, an employee or a volunteer exposes the participant to a substantial and serious risk of property damage, personal injury or death. The undersigned expressly acknowledges that his/her participation in the event will involve such a hazard. RELEASE OF SPONSORS: The undersigned hereby releases all sponsors from liability and all property damage, personal injuries or other claims arising from the undersigned’s participation in the event, including those known and unknown, unforeseen and future contingent. COVENANT NOT TO SUE: The undersigned covenants that the undersigned shall not now, at any time in the future, directly or indirectly, commence, or prosecute any action, suit or other proceeding against Western States Versatility Ranch Horse Association, its affiliates, Officers, Board of Directors, Volunteers, or any other sponsors. ASSURANCES: The undersigned has full power, authority, capacity and right without limitation to execute, deliver and perform this release. BINDING EFFECT: The release shall be binding upon the undersigned and the undersigned’s spouse, legal representatives, heirs, successors and assigns. This release has been fully and carefully read by the undersigned and the undersigned fully understands its terms and conditions and has voluntarily executed and delivered the Release as of the date signed below.*ACKNOWLEDGEMENT OF RISK: The undersigned acknowledges that the participation in horse events as a contestant, an employee or a volunteer exposes the participant to a substantial and serious risk of property damage, personal injury or death. The undersigned expressly acknowledges that his/her participation in the event will involve such a hazard. RELEASE OF SPONSORS: The undersigned hereby releases all sponsors from liability and all property damage, personal injuries or other claims arising from the undersigned’s participation in the event, including those known and unknown, unforeseen and future contingent. COVENANT NOT TO SUE: The undersigned covenants that the undersigned shall not now, at any time in the future, directly or indirectly, commence, or prosecute any action, suit or other proceeding against Western States Versatility Ranch Horse Association, its affiliates, Officers, Board of Directors, Volunteers, or any other sponsors. ASSURANCES: The undersigned has full power, authority, capacity and right without limitation to execute, deliver and perform this release. BINDING EFFECT: The release shall be binding upon the undersigned and the undersigned’s spouse, legal representatives, heirs, successors and assigns. This release has been fully and carefully read by the undersigned and the undersigned fully understands its terms and conditions and has voluntarily executed and delivered the Release as of the date signed below.
Signature
Date
Membership Dues
UVRHA Single $45.00
UVRHA Family $65.00
UVRHA Youth $15.00
Method of Payment (Your reservation will not be complete until payment is received)
VENMO @maegan-davis-4
Paypal paypal.me/utahversatility
Check Make checks payable to the UVRHA Mailing address: 1692 N Main St Genola UT 84655
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