EAHA YOUTH CLUB REGISTRATION FORM
2008 SHOW SEASON

Youth 1 Name:   _____________________________________________________________

Age (as of Jan. 1, 2008): ________________   Date of Birth: __________________________

Youth 2 Name:   _____________________________________________________________

Age (as of Jan. 1, 2008): ________________   Date of Birth: __________________________

Youth 3 Name:   _____________________________________________________________

Age (as of Jan. 1, 2008): ________________   Date of Birth: __________________________

Address:   _________________________________________________________________

City:   __________________________   State:    ___________   Zip:   __________________

Phone:   (_____)___________________  Email:   __________________________________

CONTACT  PREFERENCE:         EMAIL ______ or  REGULAR MAIL: ______

 

 

WARNING:

Under Alabama law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to the Equine Activities Liability Protection Act.
The undersigned named below hereby agrees to forever hold the East Alabama Horseman’s Association (EAHA) Youth Club, its officers, and members harmless from any injuries or damages which may be suffered by themself or any minor participant of whom they are a parent, guardian or responsible party, as a result of their participation, either directly or indirectly in any activity sponsored by the EAHA Youth Club; and further, the undersigned indemnifies EAHA Youth Club, its officers, and members from all and any claims, actions, causes or other remedies of law or otherwise whatsoever may result from any injuries or damages suffered by said participants. The undersigned further agrees that they are responsible under all conditions stated herein for any minor guest brought by them to any EAHA Youth Club activity.

Parent/Guardian Signature: _____________________________________

Date: ________________________

Annual Membership dues: _______ x $10 = $_________

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Office Use Only 
Dues Paid by:
  

Date: ____ / ____ / ____

Check # ______________

Cash - Rec'd by: ___________