Spokes and Spurs, Inc.

Member Registration 2022

First and Last Name *

If family membership, family names and individual email address if possible: *

Date filling out form * +

Address

City *

State/Province *

Zip/Postal Code *

Phone (if more than one, please provide other.) *

Email Address *

Membership Type (Send check made out to: Spokes and Spurs. Mail to: Hugh Bellis-Jones, Treasurer, 1145 Hill Rd., Paris, KY 40361. Membership is not official until check received and deposited by treasurer.) *

Family ($35 per year)

Single ($30 per year)

Preferred way to contact *

Phone	Email	Text
US Mail

Terms and Conditions: To be signed by individual member or family representative. The first condition must be checked or membership will not be accepted. Your signature on the registration indicates that you (and family members indicated) agree and will comply with the agreement. If the second condition is unchecked, you (or family members) will not be photographed without your permission.

*

I understand that neither Spokes and Spurs, Inc. (S&S) nor its officers accept any responsibility for accidents, damage, injury or illness to equines, owners, riders, drivers, grooms, passengers, attendants, spectators, or any other person or property in connection with any activities. I hereby expressly agree for myself and my principals, representatives, employees, and agents: to be bound by the rules of the activities; and to accept as final any decision of the officials or officers on any question arising under the local rules of the Competition, and agree to hold S&S , their officers, directors, employees and agents, judges, officials and organizing committees, harmless for any action taken. I am fully aware that equine sports, including driving, and activities, involve 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 S&S officers, directors, employees and agents, officials, and organizing committees, harmless from and against all claims including any injury or loss suffered during or in conjunction with the club or activities, or whether or not such claim, injury or loss resulted, either directly or indirectly, from the negligent acts or omissions by S&S, their officers, directors, employees and agents, officials and organizing committees.

Spokes and Spurs has my permission to photograph me (and family members) at events and possibly display the photos in the Newsletter, post it on the Spokes and Spurs Facebook page, and/or post it on the club website. We will seek your permission before submitting any such photos in other sources, such as equine publications.

Signature of individual or family representative *

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