2006 TVHA Membership Form

TVHA= 2009 Membership Application and Horse Registry

= &nb= sp; = Please Circle: Family Membership $25 or Individual Membership $20

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= &nb= sp; = &nb= sp; = Circle One Mail 2009 Rulebook

= &nb= sp; = &nb= sp; = &nb= sp; = &nb= sp; Email 2009 Rulebook to __________________

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= &nb= sp; = &nb= sp; = &nb= sp; = &nb= sp; = &nb= sp; = &nb= sp; = &nb= sp;

Name: _________________________________________ Phone Number ___________________

Street Address: ________________________________ City __________= __ = State: _____ Zip: ___________ = &nb= sp;

Email address: __________________________ = &nb= sp; =

EXHIBITORS: = Date Of Birth = Age = Division**

_________________ = _____________ ______ _______________________________

** Division Abbreviations: @- Western, H-Huntseat, SS-Saddle Seat, Dress-dressage,HB<= /span>-Horseback riding program, HD- Horse driving program, D-driving & All

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Name Of Horse Sex Name Of Owner/Lessee Green* Foaling<= u> Date**

_______________ ___ ____________________ ______ ____________ X $1<= /o:p>

*Green – Indicate first or second year of showing ** foaling Date – required for 2 year and under halter.

= &nb= sp; = &nb= sp; = &nb= sp; = &nb= sp; = Total Amount Due ______

= Please Note:

= 1. Your annual members= hip, horse registration and accumulation of points becomes effective<= /span>

= Three Days (3) after receipt by the Treasurer=

= 2. A family membership= will contain Family members living in the same household, including <= /span>

= children twenty-one (21) years old and un= der as of December 1, of the previous year

= 3. Please make sure th= e name of the horse entered at each show is exactly the same as the name

= of the horse on the registration form bel= ow.

= 4. As of 2007, individual membership is available to all members. Minors must have a parental

= release signature below or the membership= will not be accepted.

= 6. Complete applicatio= n and mail to Eunice Hartling, 56 TREYZ = HILL RD; L= IV MANOR, NY 12758

Release: It is agreed and understood by the undersigned that for and in consideration of the opportunity of participation in the TVHA Inc. horse sh= ows and activities, he/she does hereby and forever release and hold harmless TV= HA Inc, and any and all property owners whose premises the activities are held, the contestants and/or participants from any and all liability for damages and/or injuries of any nature or kind which may or might occur by reason of= any and all activities connected with the sport of horse showing held or sponso= red by the TVHA Inc. while the said undersigned or his/her family members are contestants, participants, viewers or visitors. TVHA also has the right to use photographs of its members for the purpose of promoting its club.

Read and signed this _= ___day of __________, 20___. Signature:__________________________

Parent or guardian sig= nature if applicant is under 18 years: ______________________________

OFFICE USE ONLY= : Method of payment _______, Date Received__/__/__, Initials of Receiver

<= /o:p>