Can Chasin’ Association
2008 Single Membership Application
Member Information
First Name:___________________________________
Last Name:___________________________________
Address: _____________________________________
City: ______________ State: _________ Zip: _______
Phone: _____________ e-mail ____________________
Birthdate (if competing in the juniors) ______________
Membership Terms and Fees
Single membership fee $45.00 Membership is effective for the current calendar year. Membership application and fees include one nomination for points. If you are running more than 1 horse or running the same horse in the Novice Class also, you must pay an additional nomination (s) before points will accrue on the additional horses or classes.
By applying for this membership, I agree to abide by all rules and regulations set by Can Chasin’ Association. I further agree to release and hold harmless CCA, arena owners, sponsors and any person connected with CCA from losses, damages, or injury to me, my equipment, and/or my animals resulting in my attendance or participation in any CCA event. I also agree to have a current negative coggins on ALL horses in my possession at any CCA event.
Signature ___________________________ Date _____________
Mail to:
Can Chasin' Association
c/o Michelle Henderson
35119 W. Hwy 66
Bristow, OK 74010