| Ohio valley Carriage Club |
Single Membership ($10)__________
Family Membership ($18)__________
Family Membership ($18)__________
2010 Membership Application
New Member__________
Are you a member of: CAA__________ ADS __________
Send My Newsletter Via:
_____Email _____U.S Mail
_____Email _____U.S Mail
Name(s): ____________________________________________________________________
Address: ____________________________________________________________________
City: _____________________________________ State: _____________ Zip: __________
Telephone (day) ____________________________ Evening: _________________________
Cell: ______________________________ Email ___________________________________
If family membership, please list family members and give ages of minors
____________________________________________________________________________
Address: ____________________________________________________________________
City: _____________________________________ State: _____________ Zip: __________
Telephone (day) ____________________________ Evening: _________________________
Cell: ______________________________ Email ___________________________________
If family membership, please list family members and give ages of minors
____________________________________________________________________________
Release, indemnity and assumption agreement (must be signed):
I/we are aware of the inherent risks of equine sports and activities including carriage driving as covered in
Ohio Revised Code Sec. 2305.321. I/we waive any claims for injury or damages against OVCC, its officers,
hosts,members, or agents for any and all injuries or damages suffered by the undersigned while
participating in any such activity. The undersigned executes this agreement as parent or legal guardian for
listed minor children under the age of 18 years.
Member__________________________
I/we are aware of the inherent risks of equine sports and activities including carriage driving as covered in
Ohio Revised Code Sec. 2305.321. I/we waive any claims for injury or damages against OVCC, its officers,
hosts,members, or agents for any and all injuries or damages suffered by the undersigned while
participating in any such activity. The undersigned executes this agreement as parent or legal guardian for
listed minor children under the age of 18 years.
Member__________________________
Date: ______________
_______________
Birthday (optional)
Birthday (optional)
Member:___________________________
Parent/Legal Guardian of:__________________________
a minor child
a minor child
Mail membership and dues to:
Bev McCoy
6776 Pondlick Rd.
Seaman, Ohio 45679
Bev McCoy
6776 Pondlick Rd.
Seaman, Ohio 45679
_______________
Birthday (optional)
Birthday (optional)
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