July - California Gymkhana Association
July - California Gymkhana Association
July - California Gymkhana Association
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Page 25<br />
Office Use Only:<br />
Effective Date: ________<br />
New ____ Renew _____<br />
CGA MEMBERSHIP<br />
APPLICATION<br />
Fees: Individual - $ 25.00, Family - $ 50.00, Upgrade - $ 25.00<br />
New ____ Renewal ____ Family Upgrade ____<br />
Date: _____________<br />
# _________ Name: __________________________________________ Birthdate: ____________________<br />
Mail Address: __________________________________________________________________<br />
City: ____________________________________________ State: ______ Zip: ____________<br />
Telephone: (_______)_____________________________<br />
# _________ Member 2 Name: _______________________________________ Birthdate: _______________<br />
# _________ Member 3 Name: _______________________________________ Birthdate: _______________<br />
# _________ Member 4 Name: _______________________________________ Birthdate: _______________<br />
# _________ Member 5 Name: _______________________________________ Birthdate: _______________<br />
# _________ Member 6 Name: _______________________________________ Birthdate: _______________<br />
# _________ Member 7 Name: _______________________________________ Birthdate: _______________<br />
Fee: $ ____________ Check # ________ Cash: ________ M/O: ________<br />
Membership in the <strong>California</strong> <strong>Gymkhana</strong> <strong>Association</strong> gives members the following:<br />
1. CGA Information Manual and CGA Rule Book.<br />
2. Opportunity to sign up for CGA Year-end Awards programs.<br />
3. Opportunity to vote for CGA programs and policies.<br />
RELEASE OF LIABILITY: The <strong>California</strong> <strong>Gymkhana</strong> <strong>Association</strong> and cosponsoring organization, if any, will not be responsible for any accident that may occur<br />
to be caused by any equine competing at any show or for any article of any kind or nature that may be lost or destroyed or in any way damaged. Each competitor<br />
will be responsible for any injury that may be occasioned to any person or animal or damage to any property while on the grounds by any equine owned, or in<br />
his custody, control and shall indemnify and hold harmless the <strong>California</strong> <strong>Gymkhana</strong> <strong>Association</strong>, it's officials and directors individually and collectively and<br />
cosponsoring organization, clubs and arena owners, if any, from and against all charges and expenses of every kind and nature whatsoever arising out of or which<br />
may be incurred by reason of any accident, injury, or damage to person or property caused by the ownership, competition or custody or control of any animal<br />
competition, In signing this release, please bear in mind that <strong>Gymkhana</strong> is a contest of speed, that there is a certain element of danger involved and that you will<br />
be riding at your own risk. CGA requests that it’s members wear approved safety helmets. If you choose not to wear a safety helmet, then you as an adult rider<br />
will accept full responsibility for yourself for any injury which may result from that act when riding in any CGA sanctioned show. Effective March 1, 2003,<br />
all riders under 18 are REQUIRED to wear a helmet when riding at a CGA sanctioned show.<br />
CGA DOES NOT PROVIDE MEDICAL INSURANCE FOR IT’S MEMBERS!<br />
MUST BE SIGNED !!!<br />
I certify that I have read, understand and agree to the above: Signature _________________________________<br />
(Parent or Guardian if under 18)<br />
Mail to: CGA, PO Box 1746, Gilroy, CA 95021 831-623-9026<br />
CGA Year End<br />
Awards Application<br />
1. Only CGA members are eligible. This program is explained in sections 3 and 4 of the CGA Information<br />
and Regulations.<br />
2. Fees may be transferred to a different mount, but times may not be transferred and Fees are not<br />
refundable should you fail to achieve enough rides to earn an award.<br />
3. The CGA Season begins with the first sanctioned show after State Championship Finals and ends with<br />
the last ride of State Championship Finals the following year.<br />
Any CGA Year End Awards Application will count only shows beginning 60<br />
days prior to the Postmark date until the end of the show season.<br />
Member # ________________________ Date _______________<br />
Rider Name ______________________________________________________________________<br />
(This is the name that will appear on the jacket)<br />
Horse or Pony Name: __________________________________________<br />
If this request is for a pony, attach a copy of current CGA Pony Certificate.<br />
This application will be processed as a horse without it.<br />
Address _________________________________________________________________________<br />
City ________________________________ State _____ Zip _________ Phone _______________<br />
Signature _____________________________________<br />
Year End Awards Level 1 (3 rides per event) Fee: $35.00<br />
Silver Buckle Silver Breast Collar Set<br />
(Circle one)<br />
Year End Awards Level 2 (5 rides per event) Fee: $40.00<br />
Silver Bracelet Silver Bridle Set<br />
(Circle one)<br />
Top Rating Award (Jacket) (minimum 3 rides in 7 events)<br />
(Fee includes Level 1 Award) Fee: $ 120.00<br />
-----OR----- (Fee includes Level 2 Award) Fee: $ 125.00<br />
-----OR----- (Fee includes Level 1 and Level 2 Awards) Fee: $140.00<br />
(Circle one)<br />
(Please circle one size) Men’s Adult - Small, Medium, Large, X-Large, XX-Large<br />
Youth - Small 6-8, Medium 10-12 or Large 14-16<br />
(Circle one)<br />
Figure on back _____ Male _____ Female (default)<br />
Cash ______ Check # ______ Money Order # ______________________<br />
Mail this application with check or Money Order to:<br />
CGA State Office • PO Box 1746 • Gilroy, CA • 95021-1746