Butler County Saddle Club - Kansas

Butler County Saddle Club - Kansas

Butler County Saddle Club 2016

Member Application

 

P.O. Box 145

Leon, KS 67074

www.bucosaddleclub.com

 

Last Name_________________ First Name______________________ DOB­­­­­­_____________

 

Family Member ________________________  DOB_____________________

                             ________________________  DOB_____________________

                             _________________________DOB_____________________

                             _________________________DOB_____________________

 

Address________________________________________________________________

 

Email__________________________________________________________________

 

Telephone_________________________Cell__________________________________

 

Emergency Contact:

Name_____________________________Phone________________________________

 

I AGREE_____ DISAGREE______ TO HAVE MY NAME, ADDRESS AND PHONE NUMBER LISTED IN A MEMBER DIRECTORY.

 

PLEASE LIST ANY OTHER FAMILY MEMBERS ON BACK. ELIGIBLE FAMILY MEMBERS ARE: SPONSE/PARTNER AND CHILDREN UNDER 21 SINGLE AND STILL LIVING IN YOUR HOME. GROWN CHILDREN, GRANDCHILDREN (UNLESS UNDER YOUR CARE) SISTERS, BROTHERS, PARENTS OUTSIDE THE HOME, AUNTS AND UNCLES MUST HAVE THEIR OWN MEMBERSHIPS.

 

RELEASE FORM:

I HAVE READ AND WILL ABIDE BY THE “BYLAWS AND RULES” OF THE BUTLER CO. SADDLE CLUB, INC. I ALSO ACKNOWLEDGE THAT THE PARTICIPATION IN THE EVENTS SPONSORED BY THE BUTLER CO. SADDLE CLUB COULD RESULT IN INJURES TO MYSELF, MY HORSES AND MY PERSONAL PROPERTY. I HEREBY RELEASE THE BUTLER CO. SADDLE CLUB, ITS OFFICERS AND MEMBERS OF ANY AND ALL RESPONSIBILITY FOR INJURES AND/OR DAMAGES TO MYSELF, MY HORSE, AND/OR MY PERSONAL PROPERTY FROM ACCIDENT, THEFT AND/OR VANDALISM. I ALSO UNDERSTAND THAT IN ORDER TO QUALIFY FOR ANY HIGH POINT AWARDS I MUST BE A MEMBER IN GOOD STANDING WITH THE BUTLER CO. SADDLE CLUB.

 

 

 

 

 

 

 

I ALSO MUST VOLUNTEER FOUR (4) HOURS OF DOCUMENTED TIME FOR A SINGLE MEMBERSHIP OR EIGHT (8) HOURS OF DOCUMENTED TIME FOR A FAMILY MEMBERSHIP, UNLESS CHOOSING THE ‘OPT OUT’ OPTION LISTED BELOW.

 

 

_____________________________________________SIGNATURE

 

 

_____________________________________________PRINT NAME

 

 

STARTING WITH 2016, BUTLER CO. SADDLE CLUB IS OFFERING AN OPT-OUT OPTION FOR MEMBERSHIP REQUIRED VOLUNTEER TIME. WE REALIZE MANY OF YOU JOIN JUST TO WORK YOUR HORSES. 

 

OPT-OUT CLAUSE

 

 

I________________________________CHOOSE TO PAY THE “OPT-OUT” FEE OF $20 AND IN RETURN WILL NOT BE EXPECTED TO SPEND ANY VOLUNTEER HOURS AT THE CLUB OR BE CONTACTED TO VOLUNTEER IN ANY CAPACITY.

 

IT IS MY UNDERSTANDING THAT THIS MONEY WILL GO INTO A MAINTENANCE FUND FOR UPKEEP OF THE CLUB.

 

_____________________SINGLE OPT OUT FEE ($20.00)

 

Welcome

Recent Photos

Upcoming Events

No upcoming events