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2024 NCRCHA Club Membership Form - $45
**EXPIRES ON JANUARY 1ST OF THE NEW CALENDAR YEAR**
**COVERS ENTIRE FAMILY**
**ALL OWNERS & EXHIBITORS MUST BE MEMBERS TO PARTICIPATE**
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PLEASE INDICATE HOW YOU WILL PAY FOR THIS MEMBERSHIP
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ADD TO MY SHOW OFFICE BILL
I WILL DROP A CHECK IN THE OFFICE
I WILL MAIL IT TO: JEN SCHUELLER - 8063 N VETA GRANDE RD, SCALES MOUND, IL 61075
NAME
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DATE OF BIRTH
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MAILING ADDRESS
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PHONE NUMBER
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EMAIL ADDRESS
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LIST NAME, RELATIONSHIP AND DATE OF BIRTH FOR ALL FAMILY MEMBERS COVERED BY THIS MEMBERSHIP
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I AM FULLY AWARE OF THE INHERENT RISKS OF EQUINE ACTIVITIES. ALL RISK OF LOSS OR INJURY TO MY HORSE, OTHERS OR MYSELF IS MY OWN.
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I ACKNOWLEDGE & HEREBY RELEASE THE NCRCHA, ITS BOARD OF DIRECTORS AND ITS AFFILIATES FROM ALL LIABILITY
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