Membership Form

Member Details:

Full Name (as it should appear in the membership directory)*

First NameLast Name

If you wish for a different name on any event name badges, please list here:

First NameLast Name

Farm Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Preferred Phone Number*

E-mail*

example@example.com

Participation Survey - please let us know your interests so club activities can be offered to fit the needs of our members:

Any other activities of interest? Can you host a show? A Pleasure drive? Offer a tour of your farm? Please let us know and a board member can reach out to discuss.

Are you an experienced driver? Would you be interested in mentoring a new driver/member?

YesNo

If you are an active driver please tell us about your driving activities, your equines and what you do with them:

If you are not actively driving; we would love to have you become involved in club activities. Please check which might be of interest to you:

Hosting a drive or eventTaking photos at eventsWelcoming new membersGathering info on club activities for reporting to Corral

Or do you have another talent or skill you would like to share?

WRCA often receives inquiries from those interested in professional services. If you provide any of the following, please check here and we can pass along any inquiries the club receives.

Train driving horses and ponies for private ownersOffer driving lessons with your horses/school horsesBreed or sell driving horsesOffer commercial carriage rides

PHOTO RELEASE (Please select one option):*

I grant to Western Reserve Carriage Association, the right to take photographs of my family and myself in connection with events sponsored by Western Reserve Carriage Association. I authorize Western Reserve Carriage Association, its assigns and transferees to copyright, use, and publish the same in print and/or electronically without compensation. I further agree that Western Reserve Carriage Association may use such photographs of me with or without my name and for any lawful purpose, including for example, such purposes as publicity, illustration, advertising, and web content.I do NOT grant Western Reserve Carriage Association the right to take photographs of my family and myself in connection with events sponsored by Western Reserve Carriage Association and am providing a photo of those who should not be photographed to facilitate identification and exclusion of same from club photographs.

Please list any minors (under age 18) for which you grant the above stated permission (photo release)

LIABILITY DISCLAIMER

I understand that neither the Western Reserve Carriage Association ("Club"), its officials, directors, officials, organizers, members, volunteers, trainers, helpers, employees, servants, workers and/or agents, nor the property owners, accept any responsibility for accidents, damage, injury or illness to me or any other persons or property in connection with any event, competition, show, schooling show, pleasure drive, clinic, horse riding activity, carriage riding activity or any other participation in any event and/or activity by me while on any premises used by the Club, or on the premises of a Club member holding a club-related event.

I hereby expressly agree for myself and my principals, representatives, employees, and agents that horse sports, including spectators, drivers and/or riders, involves inherent dangerous risk of serious injury or death. "Inherent risk of an equine activity" means a danger or condition that is an integral part of an equine activity, including, but not limited to, any of the following: (a) The propensity of an equine to behave in ways that may result in injury, death, or loss to persons on or around the equine; (b) The unpredictability of an equine's reaction to sounds, sudden movement, unfamiliar objects, persons, or other animals; (c) Hazards, including, but not limited to, surface or subsurface conditions; (d) A collision with another equine, another animal, a person, or an object. By participating, I do so voluntarily and expressly assume any and all risks of injury or loss and I agree to indemnify and hold the Club, its officers, directors, members, volunteers, employees and agents harmless for and against all claims including any injury or loss suffered during or in conjunction with any activity on these premises, any premises used by the Club, or any member's premises for a Club-related event, whether or not such claim, injury, or loss resulted either directly or indirectly, from the negligent acts or omissions of the Club, its officers, directors, members, volunteers, trainers, helpers, employees, servants, workers, agents, officials, and/or organizing committee. I further agree not to commence an action or suit in this or any other jurisdiction for any such injuries or losses.

Driver's Name*

First NameLast Name

Date*

Date

Signature*

Parent's Name (if driver is under age 18)

First NameLast Name

Parent's Signature (if driver is under age 18)

Please note that all Grooms, Navigators, Passengers, and Attendants must sign a WRCA Liability Release. Paper copies are available at all events.