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MEMBERSHIP APPLICATION
Sponsored by
Individual Membership - $40 Family Membership - $60
*(Family
Memberships: Husband, wife, and
children and/or grandchildren that are 18 and under as of January 1, 2005.
Grandchildren must live in the same household
with Grandparent or Guardian.)
Name:__________________________________________________________________
Address:________________________________________________________________
City, State &
Zip:________________________________________________________
Telephone:______________________________________________________________
If applying for
family membership, please list family members’ names.
Please include age and date of birth of children and grandchildren that are 18
and under as of January 1, 2005.
Name:______________________ Age:_________ Date of Birth:________________
Name:______________________ Age:_________ Date of Birth:________________
Name:______________________ Age:_________ Date of Birth:________________
Name:______________________ Age:_________ Date of Birth:________________
Name:______________________ Age:_________ Date of Birth:________________
WARNING: Member elects to participate at his/her own
risk.
Member releases and discharges Longhorn Barrel Racing Association and its Board
Members, representatives, employees, sponsors, show promoters, any and all
arenas and
agents from all liability, loss claims,
damages and expenses for injuries to person, property, reputation, livestock or
financial condition. Member
acknowledges that by
his/her signature on this application, he/she completely releases all parties
from liability including negligence. If
member is a minor, application
MUST be signed by parent or guardian.
_____________________________________________________ _______________________
Signature (parent or guardian) Date