LINCOLN COUNTY HORSEMAN'S

ASSOCIATION

Membership Application

LINCOLN COUNTY HORSEMAN'S ASSOCIATION
MEMBERSHIP APPLICATION

 For more information visit us at www.tnlcha.com or email sbaughn7@yahoo.com 

Date:   __________________________________

Name:  _______________________________________________________________ 

Address:  _____________________________________________________________

City:  ________________________________________________________________ 

Home No:  (   )_____________________ Cell: (   )___________________________ 

Email:  ______________________________________________________________ 

LCHA Annual Membership (Single)……………………………………………….$20  □ 
LCHA Annual Membership (Family)………………………………………………$25  □ 

Family Member Names: 



LIABILITY RELEASE

I understand that I am participating in an association which contains dangers, and risks may arise, including, but not limited to:  accidental injury, accidental death, the forces of nature, and illness.  In consideration of the right to participate in this association and the services provided for me by the Lincoln County Horseman’s Association, and its agents, I have and do hereby assume the risks associated with such events.  The member(s) shall not hold the Association, its members, management, or sponsors liable for any damage and costs arising from injury to person or property occasioned by any act or omission of the Association.

Signature of Applicant and list of family members (required):
 

__________________________________________________________________(2017)
Applications may be sent to LCHA, P.O. Box 1289,  Fayetteville, TN 37334