Golden State Versatility Ranch Horse Association

Membership Forms

GSVRHA & WSVRHA Membership Form

Use this single form to add a new membership or renew an existing one in both the Golden States and Western States Versatility Ranch Horse Associations. Memberships are valid November 1 through October 31 and are required both for participation in affiliated clinics, and for competition in sanctioned shows.

"*" indicates required fields

Rider Name*

First Last

Date of birth*

Address*

Street Address City State ZIP

Phone*

Email*

Choose one*

New members, or members needing to update their division status, will be directed to the Division Eligibility form after completing this form.

New Member

Renewal

Affiliate

Golden State Member #

Current Division

Affiliate & Member #

Liability Release

By checking the “I agree” box below and typing your name, you are electronically signing this liability release form. You affirm that an electronic signature has the same effect as a written signature. You also confirm you are 18 years or older.

ACKNOWLEDGEMENT OF RISK: The undersigned acknowledges that the participation in horse events as a contestant, an employee or a volunteer exposes the participant to a substantial and serious risk of property damage, personal injury or death. The undersigned expressly acknowledges that his/her participation in the event will involve such a hazard. RELEASE OF SPONSORS: The undersigned hereby releases all sponsors from liability and all property damage, personal injuries or other claims arising from the undersigned’s participation in the event, including those known and unknown, unforeseen and future contingent. COVENANT NOT TO SUE: The undersigned covenants that the undersigned shall not now, at any time in the future, directly or indirectly, commence, or prosecute any action, suit or other proceeding against Western States Versatility Ranch Horse Association, its affiliates, Officers, Board of Directors, Volunteers, or any other sponsors. ASSURANCES: The undersigned has full power, authority, capacity and right without limitation to execute, deliver and perform this release. BINDING EFFECT: The release shall be binding upon the undersigned and the undersigned’s spouse, legal representatives, heirs, successors and assigns. This release has been fully and carefully read by the undersigned and the undersigned fully understands its terms and conditions and has voluntarily executed and delivered the Release as of the date signed below.

I agree

Signer's Name

Type your full name

Date

Today's date

Membership Dues (Nov 1 - Oct 31)

Price:

Select*

$90 Regular (GSVRHA $40 + WSVRHA $50)

$40 Youth (GSVRHA $15 + WSVRHA $25)

Total

Pay by

Credit card

Personal check

After clicking Submit, below, please make checks payable to GSVRHA and mail to: GSVRHA ℅ Kelly Saunders, 4 W. Gabilan Street, Salinas, CA 93901. Your membership will not be considered complete until your payment is received.

Credit Card

Comments

This field is for validation purposes and should be left unchanged.

Horse ID Form

Prior to participation in an approved WSVRHA event, the form below must be provided to WSVRHA for each horse. This number is a permanent, lifetime identification and will remain with the horse regardless of ownership. If a horse has been sold to another WSVRHA member, an updated Horse I.D. needs to be filed.

Name of Owner

WSVRHA Member #

Address

Street Address City State / Province / Region ZIP / Postal Code

Phone

Is your horse registered?(Required)

Yes (AQHA, APHA, etc)

No (grade)

For Registered Horses

Registered Name

Registry

Registration #

Upload Registration Papers

• A scan of breed registration papers MUST accompany this application. • Ownership must correspond with the ownership on the registration papers. • If a transfer is in progress and the owner name is not yet on the papers, please also upload a copy of the transfer request.

Registration Papers

Required

Max. file size: 100 MB.

Transfer Request

Optional

Max. file size: 100 MB.

For Unregistered (Grade) Horses

Name of horse(Required)

Age(Required)

Year foaled(Required)

Horse color(Required)

Color of mane(Required)

Color of tail(Required)

Identifying marks(Required)

Include location on horse and description

Veterinarian Certification

Name of veterinarian(Required)

Vet email

Vet address

Vet phone

Veterinarian Certificate of Age

Optional: upload Veterinarian Certificate of Age here

Max. file size: 100 MB.

Horse Photos

• Non Breed-Registered Horses must provide (3) photos, one each of full left side, full right side and a head view that includes all identifying markings and brands.

Photo #1

Max. file size: 100 MB.

Photo #2

Max. file size: 100 MB.

Photo #3

Max. file size: 100 MB.

Authorized Riders

The following riders are hereby authorized to enter this horse in WSVRHA clinics and competitions (family members, college-owned, ranch-owned):

Name

Relationship

Name

Relationship

Name

Relationship

Declaration of Ownership

I hereby certify that I am the owner of the unregistered horse identified above and as shown in the photos attached.

By checking the “I agree” box below and typing your name, you are electronically signing this form. You affirm that an electronic signature has the same effect as a written signature. You also confirm you are 18 years or older.(Required)

I Agree

Name/Owner/Agent

Type your full name

Date

Today's date

Golden State Versatility Ranch Horse Association

Membership Forms

GSVRHA & WSVRHA Membership Form

Liability Release

Division Eligibility Form

Amateur Eligibility

Novice Eligibility

Intermediate Eligibility

Youth Eligibility

Signature

Horse ID Form

For Registered Horses

Upload Registration Papers

For Unregistered (Grade) Horses

Veterinarian Certification

Horse Photos

Authorized Riders

Declaration of Ownership