Membership Application (please print page)

Back Country Horsemen of Western North Carolina
PO BOX 102
Almond, NC 28712

 

 

I wish to preserve the heritage and privilege of horseback riding and stock packing on public lands in Western NC. I am willing to volunteer my time and tools to assist in performing trail and resource maintenance .

Name (s) (Please print)

_______________________________________________________________________________________________________________________________________________________________________________________

Phone (Home)_________________________________________________

(Other)_______________________________________________________

 

Address ______________________________________________________

Zip______________

County __________________

Fax # __________________________ Email____________________________

 

Membership is for the 2011 year. New________ Renewal________

Enclosed is:

Family Membership………………..$30.00 __________

Single Membership………………...$25.00 __________
 
Contributing Membership................$25 _____________

Additional Donation………….$ ______________

Make checks payable to … BCHWNC
Mail Application and check to :
BCHWNC
PO BOX102
Almond, NC 28712

Note:

Membership in BCHWNC will also include an annual membership in Back Country Horsemen of America (BCHA) and an annual

subscription to the national newsletter published quarterly by BCHA.

:

Liability Release (Must be signed):

I (We) recognize the fact that there is a potential for an accident wherever horse use is involved, which can cause injuries to horses,

riders, and spectators and also recognizing the fact that Back Country Horsemen of Western North Carolina (BCHWNC), including officers, directors, or members cannot always know the conditions of trails or the experience of riders or horse taking part in Trail or other BCHWNC and affiliation functions. I hereby release the above named from any claim or right for damages which might occur to me, my minor children, horses or personal equipment.

BCHWNC is also covered under/but not limited to the following States Equine Activity Statutes, NC 99E,

TN 44-20, KY 247, SC 47-9-7, VA 3.1-796, GA 4-12.

Any images taken at a Back Country Horsemen of Western North Carolina (BCHNC) event/ride/gathering/fundraiser/function, by a

member, spectator, independent, professional, general public, once in the possession of BCHWNC, becomes the total property of

BCHWNC. All images submitted for publicity, website content, advertising, etc, will become the sole possession of the BCHWNC to do

with as deemed proper by BCHWNC and it’s affiliates. If you, your minor children, horse, or personal equipment is/are filmed at a

BCHWNC function, etc, the image belongs to the photographer, and you agree to have your image displayed via the BCHWNC.

Signed __________________________________

Date __________________

Signed __________________________________

Date __________________