Langley Riders Society Membership Application 2024

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Email *

Membership Requirements

1. Fees

Individual Membership $45.00
Family Membership $75.00
Non-Riding Individual Membership $45.00

2. Deposits

Two deposits - $150.00 each for individual membership and $200.00 each for family membership. Once volunteer work for each half year is completed, your deposit for that term will be destroyed/returned. If volunteer hours are not completed by the end of each half year, cheques/credit card numbers on hold will be cashed/charged and prepaid deposits will not be returned.

Non-riding memberships - deposits are not required.

Deposits may be submitted in one of the following ways:

(a) Two post-dated cheques (one dated July 1, 2024, and one dated October 31, 2024) mailed to

P.O. Box 61569 Brookswood RPO Langley BC V3A 8C8

or hand-delivered to
4303 208 Street, Langley (mail slot on meeting room door)

(b) Credit card number emailed to info@langleyriders.com for holding

(d) Pay the FULL amount for both terms via credit card

3. Volunteer Hours - shows, events, or work bees

(a) Individual membership - 8 hours completed by June 30, 2024 and 8 hours completed by October 31, 2024

(b) Family membership - 15 hours completed by June 30, 2024 and 15 hours completed by October 31, 2024

First name

Last Name

HCBC# *

Birthdate

YYYY

Address

Telephone

Family Members:

Name, Birthday, HCBC#

Name, Birthday, HCBC#

ACKNOWLEDGMENT OF RISK AND RELEASE OF LIABILITY (AR-0103) For Participants in the Province or Territory in which the Equine Activities are Provided by the Host

WARNING: THIS AGREEMENT WILL AFFECT YOUR LEGAL RIGHTS. READ IT CAREFULLY!

Every Person Must Read and Understand this Waiver Before Participating in Equine Activities

The following waiver of all claims, release from all liability, assumption of all risks, agreement not to sue and other terms of this agreement are entered into by me (the Participant) with and for the benefit of: LANGLEY RIDERS SOCIETY , its directors, officers, employees, volunteers, business operators, agents and site property owners or lessees (collectively the "Host"). Without limiting the generality of the foregoing, "Equine Activities" includes but is not limited to, competitions, tournaments organized and /or operated by the “Host”, riding instruction, coaching and training provided by the "Host" to the Participant.

Tick each item below after reading and understanding each item:

1. I am aware that there are inherent dangers, hazards and risks (collectively "Risks") associated with "Equine Activities” and injuries resulting from these "Risks" are a common occurrence. I am aware that the "Risks" of "Equine Activities" mean those dangerous conditions which are an integral part of "Equine Activities", including but not limited to: (a) the propensity of any equine to behave in ways that may result in injury, harm or death to persons on or around them and to potentially collide with, bite or kick other animals, people or objects; (b) the unpredictability of an equine's reaction to such things as sounds, sudden movement, tremors, vibrations, unfamiliar objects, persons or other animals and hazards such as subsurface objects; (c) the potential for other participants to behave in a negligent manner that may contribute to injury to themselves or others, including failing to act within their abilities to maintain control over an equine. (d) the potential of natural or man-made hazards being present that can cause me harm, including communicable disease.

2. I freely accept and fully assume all responsibility for all "Risks" and possibilities of any and all personal injury, sickness, disease, medical payments, death, property damage or loss resulting from My/ the Minor’s participation in "Equine Activities".

3. I agree that although the "Host" has taken steps to reduce the "Risks" and increase the safety of the "Equine Activities", it is not possible for the "Host" to make the "Equine Activities" completely safe. I accept these "Risks" and agree to the terms of this waiver even if the "Host" is found to be negligent or in breach of any duty of care or any obligation to me in My/ the Infant participant’s participation in "Equine Activities".

4. In addition to consideration given to the "Host" for My/ the Minor’s participation in "Equine Activities", I and my heirs, next of kin, executors, administrators and assigns (collectively my "Legal Representatives") agree: (a) to waive all claims that I/ the Minor have or may have in the future against the "Host"; (b) to release and forever discharge the "Host" from all liability for any personal injury, death, property damage, or loss resulting from My/ the Minor’s participation in the equine activity due to any cause, including but not limited to negligence (failure to use such care as a reasonably prudent and careful person would use under similar circumstances), breach of any duty imposed by law, breach of contract or mistake or error in judgment of the "Host"; and (c) to be liable for and to hold harmless and indemnify the "Host" from all actions, proceedings, claims, damages, costs demands, including court costs and costs on a solicitor and own client basis, and liabilities of whatsoever nature or kind arising out of or in any way connected with My/ the Minor’s participation in "Equine Activities".

5. Safety Headgear Release: it is strongly suggested that all competitors wear protective headgear. If protective headgear is chosen not to be worn, I freely accept and fully assume all responsibility for all "Risks” and head injuries sustained while not wearing certified equestrian helmet or headgear.

6. Photo/Video/Name Release: I understand that any photographs and/or videos taken of Me/ the Minor’s or the use of our names during the 2024 season at any Langley Riders Society function or event can be used wholly or in part in any form of media (commercial or otherwise), portfolio or public display, without remuneration. I acknowledge, with subject to the usage restrictions above, I give up all claim of ownership of the photographs, and assign copyright to the photographer and/or Langley Riders Society. Use of the photographs may be granted to third parties; however the photographs will remain the property of the photographer and/or Langley Riders Society.

7. I agree that this waiver and all terms contained herein are governed exclusively and in all respects by the laws of the Province or Territory of Canada in which the "Equine Activities" are provided by the "Host". I hereby irrevocably submit to the exclusive jurisdiction of the courts of that Province or Territory of Canada and I agree that no other court can exercise jurisdiction over the terms and claims referred to herein. Any litigation to enforce this waiver will be instituted in the Province or Territory of Canada in which the "Equine Activities" are provided by the "Host".

8. I confirm that I have had sufficient time to read and understand this waiver in its entirety. I understand that this agreement represents the entire agreement between myself and the "Host", and it is binding on myself and my "Legal Representatives".

Required

For participants over the age of majority:

I confirm that I have reached the age of majority in the province in which I am participating in "Equine Activities"

Participant Name

E-Signature of Participant

Participant Name

E-Signature of Participant

Participant Name

E-Signature of Participant

City, Province

Signed This Date

YYYY

For participants under the age of majority:

As the parent/guardian of the minor(s), I sign this waiver acknowledging the risks of them participating in “Equine Activities”. All riders under the age of Majority must wear a approved headgear and be secured while riding on the “Host’s” grounds.

Parent/Guardian Name

E-Signature of Parent/Guardian

Signed This Date

YYYY

Payment

Membership Fees *

Individual Membership - Credit Card - $45.00

Individual Membership - I will e-transfer my fee to info@langleyriders.com

Individual Membership - I will mail (P.O. Box 61569, Brookswood RPO, Langley, BC, V3A 8C8) or hand deliver (4303 208 Street, Langley Twp, BC, V3A 3B1) a cheque

Family Membership - Credit Card - $75.00

Family Membership - I will e-transfer my fee to info@langleyriders.com

Family Membership - I will mail (P.O. Box 61569, Brookswood RPO, Langley, BC, V3A 8C8) or hand deliver (4303 208 Street, Langley Twp, BC, V3A 3B1) a cheque

Non-Riding Individual Membership - Credit Card - $45.00

Non-Riding Individual Membership - I will e-transfer my fee to info@langleyriders.com

Non-Riding Individual Membership - I will mail (P.O. Box 61569, Brookswood RPO, Langley, BC, V3A 8C8) or hand deliver (4303 208 Street, Langley Twp, BC, V3A 3B1) a cheque

Deposits *

Single Membership - Credit Card - $300.00

Family Membership - Credit Card - $400.00

I will e-transfer the full amount for both terms to info@langleyriders.com

I will email my credit card number to info@langleyriders.com for holding

I will mail (P.O. Box 61569, Brookswood RPO, Langley, BC, V3A 8C8) or hand deliver (4303 208 Street, Langley Twp, BC, V3A 3B1) two post-dated cheques

Non-Riding Individual Membership - no deposit required

Donate to the LRS Arena Upgrade Project

I would like to add on a donation to the Langley Riders Society on my credit card charge - $10.00

I would like to add on a donation to the Langley Riders Society on my credit card charge - $25.00

I would like to add on a donation to the Langley Riders Society on my credit card charge - $50.00

I would like to add on a donation to the Langley Riders Society on my credit card charge - $100.00

Volunteer Work Categories I/We Am/Are Interested In: *

Horse Shows

Special Events (e.g. Little Britches Rodeo, etc.)

Concession

Gardening & Maintenance

Post-Show/Event Clean-Up

Other:

Required

Online Payments (Credit Card) - please continue after clicking Submit to input your payment info.

E-transfer and Cheques - please list the riders' names on the memo line of your cheque(s) and/or the message line of your e-transfer(s).

***After clicking Submit consider your registration submitted for approval pending HCBC verification and fees/deposits received. Please remember to have your fees and deposits submitted ASAP to expedite the membership approval process.

Thank you!

A copy of your responses will be emailed to the address you provided.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Langley Riders Society. Report Abuse

Forms