Office Use

Date Paid: ____________

St. Vrain Roundup Club
Cash
Check
Waivers Signed:
Membership Application and Renewal – 2011
SVRC
BCF

Please complete the information below and submit the form along with dues to:
Ann Aschbacher – SVRC Secretary – 303-246-2070
3395 E. Aurora Ave, Boulder, CO 80303

Welcome! Membership dues are as follows: Family $25 Individual $15

Primary Member Name:

Street Address:
City/State/Zip:
Email:
Home Number: Work Number: Cell Number:
Check here if address has changed.
Please list all family members who will show and their age group:
First Name Last Name Relationship to Member Age Group
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-
-
-
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Age Groups (as of January 1): Pee Wee (10 and under), Intermediate (11-13), Junior (14-19), Senior (20-49), Masters (50 and over),
Novice (limited show experience 20 and over)

Our club relies solely on the participation of the membership to make things work. We encourage each
member to volunteer in at least three areas to help out with shows and social events/meetings.
Remember, to qualify for year end awards, each member must volunteer in at least one show or committee,
participate in at least one business meeting during a single show year (not including awards night) and dues
must be paid in full before points begin to accumulate.
Please check the areas you and/or your family are willing to volunteer in:
Flagger Gates Timer Announcer Ring Steward
Recorder Ribbons Office Cleanup Grounds
Wrangler Roundup (open gymkhana during Fair) Steak Fry (social event, cook out during Fair)
Show Box Inventory/Order Ribbons Awards Committee Judges
Show Manager: May 8 June 5 June 18 July 17 August 28 September 18
Potluck Host (set-up, decorate, clean-up): February March April November December

Please complete the liability waiver on the back side as well. St. Vrain Roundup Club is a non-profit, for
fun, volunteer club, and is not responsible for accidents or injuries.
 Waiver, Release, Covenant Not to Sue and Indemnity Agreement
(Adult and/or Minor Children)

Each of the undersigned, for himself, his heirs, representatives, and successors, does hereby and forever
absolutely waive and release any claim for damage or injury to the undersigned or their minor children which
hereafter may arise or result from participation by the undersigned or the undersigned’s minor children in
any activity of the St. Vrain Roundup Club, (an informal and unincorporated association), and does hereby
covenant and agree not to sue the St. Vrain Roundup Club, or any of it’s members or agents, or any other
person on whose premises the activities of the St. Vrain Roundup Club may be conducted, or any other
person acting under the direction or control of such named parties, for any such claim.

The consideration for this waiver, release and covenant not to sue and indemnity agreement is the acceptance
of the undersigned and their minor children for participation in the activities of the St. Vrain Roundup Club.
It is acknowledged and agreed that such participation in any activities of the St. Vrain Roundup Club would
be strictly forbidden absent the execution of this document by the undersigned.

The undersigned acknowledges the inherent risk of damage or injury in the activities of the St. Vrain
Roundup Club, and that all such activities cannot be fully supervised at all times, and that each participant
assumes all risk of harm or injury resulting from participation in such activities.

The undersigned represents that he/she has full authority to execute this document, and has fully read it. In
consideration of acceptance of the undersigned is such activities he/she will fully indemnify and hold
harmless the named parties from any claim, loss or damage, including reasonable attorney’s fees incurred by
the named parties in connection with any claim made by or on behalf of, or arising out of, any injury to the
undersigned or their minor children, of any type or nature, including claims by or on behalf of the
undersigned, and any person with a right to represent any claim of the undersigned, absent willful
wrongdoing by any of the named parties.

Date Signed: ________________________________________________________________________

Applicant Signature: __________________________________________________________________

Names of Minor Children: _____________________________________________________________

Signature: __________________________________________________________________________
( Mother, Father, Legal Guardian)

Names of Minor Children (not part of family as son or daughter): ______________________________

Signature: __________________________________________________________________________
( Mother, Father, Legal Guardian)

WARNING
Under Colorado Law, an equine professional is not liable for any injury to or the death of a
participant in equine activities resulting from inherent risks of equine activities, pursuant to section
13-21-119, Colorado Revised Statutes.

St. Vrain Roundup Club