United States Equestrian Drill Association Annual Membership Application

   Team Membership ($125)          Individual Membership ($25)          Associate Membership ($75)

Team Name: _____________________________________________________________________

Mailing Address:___________________________________________________________________

City, State, ZIP Code: _______________________________________________________________

Contact Person: ___________________________________________________________________

Phone: ______________________________ Email: _______________________________________

Type of Team: (Women's, Posse, Co-ed, Youth, etc.) _______________________________________

Association: ______________________________________________________________________

Individual's Name: _________________________________________________________________

Address: _________________________________________________________________________

City, State, ZIP Code: _______________________________________________________________

Phone: ____________________________ Email: _________________________________________

I/We wish to join the United States Equestrian Drill Association. I/We will comply with the By-Laws, rules and regulations of USEDA. The undersigned in consideration of accepting membership into USEDA, does hereby, for himself, his heirs, executors & administrators, waive and release the USEDA, and all individual and team members thereof, and all other persons regardles of their capacity in any way connected with the association described herein. I/We also waive our representatives, heirs, executors, administrators, and assignees from any and all right and claim, or liability for damages, or for any and all injuries to animals, or from any and all claims of any kind or nature that I might have. Further, I do hereby acknowledge that said release will extend to any accidents, damages, or claims arising out of my membership caused by my own action or by the acts of anyone or any animal within my control.

Signature: ________________________________________________________________________

(Print) Name: _________________________________ Team Title: ___________________________

Complete appropriate portion of application and mail with correct fee to:

LINDA HEUSNER
USEDA REGION 7 SECRETARY
111 WINTERBERRY LANE
ATHENS GA 30606

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