Pullers Assoc. of Ohio, Inc.
Membership Form & Liability Form
Send $20.00 to:
Horse Pullers Assoc. Ohio, Inc.
11231 Bean Road
Chardon Ohio 44024
Preferred method of contact:
___ Email ___ Mail
understand that participation in Buckeye Horse Pullers Assoc, of Ohio, Inc.
could include actions or tasks which might be hazardous to the participant named
above. By signing below, I assume any risk of harm or injury which might occur
to the participant due to his/her/my participation in the event or activity. I
release the Buckeye Horse Pullers Assoc. of Ohio, Inc. from all liability, costs
and damages which might arise from participation in events. If the participant
is a minor, I agree that the minor has my consent to participate in the event. I
further provide my consent for the Buckeye Horse Pullers Assoc. of Ohio, Inc. to
seek emergency treatment for the minor if necessary. I agree to accept all
financial responsibility for the costs related to emergency treatment.
IF MEMBER IS A MINOR:
Signature of Parent of
Name of Parent of