Yucaipa Barrel Racers Membership Application

Yucaipa Barrel Racers Membership Application
We are excited to welcome you to the Yucaipa Barrel Racers. We are a passionate group of individuals who share a love for barrel racing, horsemanship, and the camaraderie of the rodeo community. Your membership reflects your dedication to the sport and your commitment to being part of a supportive and competitive environment.

YBR club membership allows you access to all events hosted by us at a discounted rate, as well as an invitation to the year-end awards banquet. We have both individual and family plans.

If you have any questions, don't hesitate to contact us at yucaipabarrelracers7@gmail.com
Name*

First NameLast Name
Date

MonthDayYear
Date
Date of Birth *

MonthDayYear
**If under the age of 18 at the time of the application, A parent or guardian will need to provide their information.
Age
Parent or Legal Guardian Name

First NameLast Name
Parent or Legal Guardian DOB

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Preferred Contact Method

TextEmail
Membership Type*

Individual ($30)Family ($60)
***Family membership is defined as immediate members of a family living at a home, i.e., father, mother and dependent children under 18 years of age at the same address, up to a maximum of 5 people

First Name   Last Name    DOB

First Name   Last Name   DOB

First Name   Last Name   DOB

First Name   Last Name   DOB

First Name   Last Name   DOB
Photo and Media Authorization

Do you allow Yucaipa Barrel Racers to take photographs or videos of you, and/or your child (and/or horse, if applicable) during events, and do you understand that these images may be used for promotional purposes, including being posted on Yucaipa Barrel Racers' social media accounts and website. Do you also acknowledge and agree that you or your family will not receive any compensation for the use of these images and that they will be used solely for promoting the organization and its events.
Photo and Media Authorization*

YesNo
Payment Options:
Signature:

I, the undersigned, understand that participating in Yucaipa Barrel Racers events involves risks of injury, death, and property damage. I voluntarily assume all such risks and agree to release and hold harmless Yucaipa Barrel Racers, its organizers, officers, volunteers, and sponsors from any and all claims, liabilities, or damages that may arise from my participation in these events, including those caused by negligence.

I further agree to indemnify Yucaipa Barrel Racers and its representatives from any claims made as a result of my actions during the event. I acknowledge that I am responsible for my own safety and actions while participating and agree to follow all event rules and instructions.

By signing below, I confirm that I have read and fully understand this Release of Liability, and I agree to its terms.

**Effective March 1, 2003; all riders under 18 are REQUIRED to wear a helmet when riding at all sanctioned shows.

YBR DOES NOT PROVIDE MEDICAL INSURANCE FOR ITS MEMBERS
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