Powder Basin Equestrian Association

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2023 Membership

(Membership Year: Jan. 1-December 31)

2023 PDF Printable Mail-in Membership Form

Join PBEA online or pay for schooling/pens with credit card. FEES APPLY

Equestrian Park waiver must be signed before riding or schooling at the Park.

Powder Basin Equestrian Association
Membership/Renewal Form

1. Area 1X of United States Eventing Association
2. cross-country course open year round
3. schooling shows and clinics
4. access to stadium and dressage arena at Equestrian Park
5. club website (http://www.powderbasinequestrian.com)

Date: ________________ New: __________ Renewal: ________________

Name: ______________________________________________________________________

Additional names, if family membership: _____________________________________________________________________________

Address: ________________________________________ Phone: ______________________

City: __________________________     State: __________Zip: __________________________

Birthdate (s) if under 18_____________________________________________

Horses name(s): __________________________        E-mail address: ______________________

Membership type:

Family: ___________$75                   Individual: __________________$50/year

Trainer teaching lessons for profit: __________$100

Non-member schooling: ___________$50

                                   
               
Please make check payable to Powder Basin Equestrian Association and mail to:

Carol Olson

14 Constitution Dr

Gillette, WY 82716

katemyfriend@gmail.com

2023 RELEASE OF LIABILITY FOR CAM-PLEX EQUESTRIAN PARK
PLEASE READ BEFORE SIGNING
CAM-PLEX Equestrian Park

By signing this form, I state that I understand that equine activities are inherently risky and potentially dangerous.  I understand that riding is a potentially risky and potentially dangerous sport.  I herby declare that I am participating in this activity entirely at my own risk  I herby assume this risk and further do herby release and hold harmless Powder Basin Equestrian Association and my fellow riders, from all liability , including any negligence, resulting in accidents, damage, injury, illness and /or death, to myself and to my property , including the horse or horses which I will ride at the Equestrian Park  This release will be considered valid any time I ride at CAM-PLEX Equestrian Park.
I further understand and accept the limitations applied by Wyoming State Law, specifically the “Recreation Safety Act” (W-S. 1-1-121 through 1-1-123) that participants in recreation activities, particularly including equine activities, accept full responsibility for the inherent risk, dangers and condition s which are characteristic of,  intrinsic to, or an integral part of any sport or recreational opportunity.
I acknowledge that I am participating entirely at my own risk.  RIDE AT YOUR OWN RISK!!  Please use your own good judgment and ride safely!

_____________________________________________             Date:___________________
 (Signature of competitor, or parent if under 18 years of age)