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Grand Mesa Back Country Horsemen

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Grand Mesa Back Country Horsemen

Membership Application

Instructions: Please include your check or money order and send to:

Grand Mesa Back Country Horsemen, PO Box 4872, Grand Junction, CO 81502

Name(s) ____________________________ Occupation ______________________________

Address _____________________________________________________________________

Email ______________________________ Telephone _______________________________

Please Check: New Membership _____ Renewal _______ Individual $35.00 ______________

Family $40.00 ________ Associate $100.00 __________ Youth $1.00 _________

How do you use your Horse/Mules? Pleasure/Trail riding __________ Ranching __________

Commercial Outfitting ________ Other _____________________________________

WARNING– Under Colorado Law, an equine professional is not liable for an injury or the death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to section 13-21-119, Colorado Revised Statutes. I (we) release the Grand Mesa Back Country Horsemen, its officers, directors, or agents of any and all liability which may arise as a result of injury to my (our) person or property that may be sustained in connection with the club’s activities. Each adult member must sign the release before participating in club activities. Minors must have Parent or legal guardian sign as well.

Signed: ______________________________________________ Date: _____________