Black Swamp Driving Club 2017 Membership Application
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Address_________________________________________________________________________________________
City_________________________________________________State_________ZIP___________________________
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Black Swamp Driving Club Liability Disclaimer

MUST BE SIGNED BY EVERY CLUB MEMBER, PARTICIPANT, GROOM, GUEST, AND/OR ANY PERSON WHO RIDES WITH A DRIVER ON A CARRIAGE AT ANY TIME FOR CLUB MEMBERS, THE TERMS AND CONDITIONS HEREIN APPLY TO EVERY EVENT DURING THE MEMBERSHIP PERIOD.

            I understand that neither the Black Swamp Driving Club, its officers, directors, officials, organizers, members, volunteers, trainers, helpers, employees, servants, workers and/or agents, nor the property owners, accept any responsibility for accidents, damage, injury, or illness to me, or any other persons or property in connection with any event, competition, show, schooling show, pleasure drive, clinic, horse riding activity, carriage riding activity, or any other participation in any event and/or activity by me while on any premises used by the Club, or on the premises of a Club member holding a club-related event.
            I hereby expressly agree for myself and my principals, representatives, employees, and agents that horse sports, including spectators, drivers and/or riders, involves inherent dangerous risk of serious injury or death and by participating, I do so voluntarily and expressly assume any and all risks of injury or loss, and I agree to indemnify and hold the Club, its officers, directors, members, volunteers, employees, and agents, harmless from and against all claims including any injury or loss suffered during, or in conjunction with any activity on these premises, any premises used by the Club, or any member’s premises for a club-related event, whether or not such claim, injury or loss resulted, either directly or indirectly from the negligent acts or omissions of the Club, its officers, directors, members, volunteers, trainers, helpers, employees, agents, officials, and/or organizing committee.  I further agree not to commence an action or suit, in this, or any other jurisdiction, for any such injuries or losses.

 

I __________________________________________have read this Liability Disclaimer and hereby acknowledge that I understand and agree to its terms and conditions as expressed herein, and will abide by such terms as set forth above.

Signature ________________________________________________________ Dated: _____________________
Parent Signature (if driver is under 18)  ____________________________________________________________
Groom/Navigator/Passenger/Attendants
Names (Print) ________________________________________________________________________________
Signatures ___________________________________________________________________________________

Membership:  Family or Single Adult  $25.00 – Includes Horsemen’s Corral Subscription
Make check payable to: Black Swamp Driving Club
Send to:                            Susan Murray, 558 Township Road 58, Tiffin,  OH  44883