CSRHC Membership Application Form

CSRHC Membership Application Form

Annual Fee from January 1st - December 31st
Select Membership*
CSRHC Membership #
Name*

First NameLast Name
Type of Membership

$55.00 Adult Membership$25.00 Youth Membership$25.00 Social Membership$30.00 Event Membership$25.00 Special Event Membership Upgrade (If you have paid an Event Membership in the past 7 days you are eligible to pay just $25 to update to a Full Adult Membership)
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Email*
example@example.com
Date of Birth
NRHA Member #
Emergency Contact Details*

First NameLast Name
Emergency Contact Phone Number*
Parent/Guardian if 18 Years or Under

First NameLast Name
Parent/Guardian Phone Number
Terms and Conditions:

I hereby apply to become a member of the Calliope Sliders Reining Horse Club Inc. In the event of my admission as a member, I agree to abide by the rules and regulations of the Calliope Sliders Reining Horse Club Inc and the NRHA.

I indemnify all members whether it be committee and ordinary members of this club from and against all actions, liabilities, costs and charges received by me during competitions and events held by the Calliope Sliders Reining Horse Club Inc.

I acknowledge that the activity being undertaken is for the purposes of recreation, enjoyment or leisure which involves a significant degree of physical risk. The Provider acknowledges that they are providing Recreational Services, providing facilities for participation in a recreational activity of training, and/or participation in a recreational activity, or supervising, adjudicating, guiding or otherwise assisting a person’s participation in a recreational activity.

Declaration

By selecting the checkbox of Terms and Conditions of this agreement I understand that the Recreational Services about to be sold to me as set out in this form may cause me or my dependents personal injury or death. I understand that I and my dependents waive our rights to sue the Provider for losses relating to me or my dependents personal injury or death that result from any negligence caused by the provider.
Terms and Conditions*

Check Box when Terms and Conditions are read and fully understood
Signature of Participant or Legal Guardian if Participant is under 18 yrs old

Clear
To compete in NRHA sanctioned classes you must have full NRHA Membership.

NRHA membership will need to be applied for direct via the link.

NRHA: www.nrha.com
We will confirm your application as soon as payment is received. Please note that all competitors must hold current membership or Event Membership in order to ride.

Thank you
My Products
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Adult Membership$55.00AUD

Youth Membership$25.00AUD

Social Membership$25.00AUD

Event Membership$30.00AUD
Required for non members at any Calliope Show, Clinic or Fun Day

Special Event Membership Upgrade (for those who have paid an Event Membership in the past 7 days)$25.00AUD

Total $0.00AUD
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Please click one of the PayPal options to complete payment and submit the form.
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