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Timberline Riders Gymkhana Club
Online Timberline Riders Gymkhana Club Membership Application 19 Years & Older

AGE GROUPS

(LL) Lead Line unable to ride alone

(N) Novice- no experience

(LB) Little Britch - p to 9 years

(PW) Pee Wee 10-13 years

(J) Junior 14-18 years(S) Senior 19-39 years

(JB) Jack Benny 40 years and older

First Name (Rider) Birthdate (Y-M-D) Gender HCBC # Age Group Horse’s Name Gymkhana  Before

Volunteer hours or a flat donation fee is required to be eligible for year end points.  Any family member can contribute to the volunteer hours.  Please indicate to the right drop down your preference.

Choose from the  following

Waiver:Due to circumstances which can arise from people participating in high risk sport events, it is imperative that Timberline riders Gymkhana club and Pineview Recreation commission be relieved of any and all responsibility of injuries, damage and or death during any equine related events in or around this arena. The parent, guardian or adult person over the age of 19 years signing this waiver for the above named rider, relieves the parties in this waiver of any and all responsibility of all damage, injury and or death while on our grounds. A paid and current membership number with HCBC is provided above.

Parent or Guardian

Responsible for information on this form

Item:                                              Price                 Individual Membership																	$20  Family Membership                     $50  Non riding associate	                   $15

Please email Michelle Prince an e- transfer payment to:


mlprince@telus.net



Thank you.

Date: