Please read this Liability Waiver before submitting form Youth Membership Parent / Guardian Name(Required)Note: This membership is intended for relatives (i.e. grandchildren) ages 0-18 First Last Parent / Guardian Address(Required) Street Address Address Line 2 City State Zip Code Phone(Required)EmailIf you provide your email address, you'll receive an online invoice for your membership dues, as well as announcements of future B&B events. How many children?(Required)New members joining in Oct-Nov-Dec will have their memberships extended through Dec 31st of the next year. 1st Child: $15.00 per year 2 Children: $25.00 per year 3 Children: $30.00 per year For > 3 Children, add an additional $5.00/child per year Child(ren)'s Name(s):Would you be able to help with the following activities?Please check all that apply. Trail Rides Parades Fundraising Events Maintenance (clubhouse, pasture, arena) Select AllCheck this box if:(Required) You understand and agree to the terms of the Boot and Bottle Club Liability Waiver. (Click the red button above to read the waiver.)Let my initials entered below serve as my handwritten signature.(Required)My initials also acknowledge my agreement to abide by the Liability Waiver on behalf of my minor child(ren) listed.