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Name of 3rd family member:

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CMSA # of 3rd family member:

Date of Birth of 5th family member:

ST: *

Single or Family Membership *

SINGLE CLUB MEMBERSHIP-$30

FAMILY CLUB MEMBERSHIP-$50

Date of Birth of 3rd family member:

Name of 5th family member:

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Level of 4th family member:

EMERGENCY contact:

Liability Release *

I hereby understand that I am participating in a sport which contains dangers And risks including but not limited to accidental injury, the forces of nature and illness. In consideration of the right to participate in these events and the services that are provided for me by the Florida Peacemakers Cowboy Mounted Shooting Association and its agents, I have and do hereby assume the risks associated with such events. The contestant shall at his own expense, defend management and/or all sponsors, their cardholders or employees from any and all such claims and indemnify from any and all liability, damage and costs arising from injuries to person or property occasioned by any act or omission of the contestant. By joining CMSA I am agreeing that images of my horse equipment or myself may be photographed, videoed or recorded in any way and re-used without my permission and without compensation. I agree to support and enforce CMSA rules as stated in the CMSA rulebook. This solidarity agreement binds all CMSA cardholders to enforce CMSA rules and assure our competitors they will play the same game coast-to-coast when they travel for CMSA competitions.

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Address: *

Level of 3rd family member:

Name: *

Name of 2nd family member:

Date of Birth of 2nd family member:

Level of 2nd family member:

EMERGENCY contact relationship:

Complete Peacemaker Membership Form below and press SUBMIT at the bottom.

Date of Birth of 4th family member:

CMSA # of 5th family member:

EMERGENCY contact tel #:

Email: *

Name of 4th family member:

Level of 5th family member:

CMSA #: *

CMSA # of 2nd family member:

SECTION BELOW FOR FAMILY MEMBERSHIPS ONLY

NEW L CROSS EQUESTRIAN CENTER POLICY AS OF JAN 2020:
Anyone under the age of 18 years of age shall be required to wear a ASTM/SEI certified helmet.