CITIZENSHIP: Canadian____ American____ Other ___________ S.I.N. ___________________________

PRINT FULL NAME OF APPLICANT:_____________________________________________________________

PRINT FULL PERMANENT ADDRESS: ______________________________________TOWN: ______ _____________________

POSTAL CODE:____________________ HOME PHONE:______________________FAX:________________ CELL :__________________

DELETE CLAUSE "A" IF APPLICANT IS UNDER 18 YEARS OF AGE.

N.B. "A" If applicant is under 18 years of age, then the parent(s) or the legal guardian having custody of the applicant must sign the application. I hereby warrant and represent that I am 18 years of age.

I AGREE TO BECOME FAMILIAR WITH AND ABIDE BY ALL F.C.A. LAWS, RULES AND REGULATIONS DURING THE TIME I AM A MEMBER OR PERMIT HOLDER OF THE F.C.A., AND AGREE TOT HE ASSUMPTION OF RISK AND RELEASE AND INDEMNITY SET OUT ON THE PAGE TWO OF THIS FORM.

Signature of Applicant _____________________________

BENEFICIARY (A Beneficiary must be given on the form or your membership will not be processed).

FULL NAME ___________________________________ Relationship to you: ________________________________

I HEREBY APPOINT THE ABOVE NAMED PERSON(S) AS MY BENEFICIARY(IES) AND IN THE EVENT OF MY DEATH ENTITILED TO THE PROCEEDS UNDER CITADEL GENERAL POLICY No. 9222451.

_______________________________

Signature of Applicant/Insured Person

I am a citizen of CANADA – Province of _____________________ OR USA – State of _____________________

I, _________________________ OR ________________________________________

Name of Applicant Parent(s) or Guardian Name(s)

AND THAT I AM NOT A FULL CONTESTING MEMBER, EXCEPTING SEMI-PRO STATUS, OF THE CANADIAN PROFESSIONAL RODEO ASSOCIATION, THE PROFESSIONAL RODEO COWBOYS ASSOCIATION OR THE WOMEN’S PROFESSIONAL RODEO ASSOCIATION, AND THAT IF AT ANYT IME THAT I SHOULD BECOME A FULL CONTESTING MEMBER, EXCEPTING SEMI-PRO STATUS, OF ANY OF THE ABOVE MENTIONED ASSOCIATIONS, I AGREE THAT I WILL FORFEIT MY FOOTHILLS COWBOYS ASSOCIATION CONTESTING MEMBERSHIP AND ALL ITS RIGHT AND PRIVILEGES. AND, I DO SOLEMLY DECLARE THAT I AM (WE ARE) THE PERSON(S) NAME IN THE FOREGOING INSTRUMENT AND THAT THE INFORMATION THEREIN CONTAINED IS TRUE AND CORRECT AND I (WE) MAKE THIS SOLEMN DECLARATION CONSCIENTIOUSLY BELIEVING THE SAME TO BE TRUC AND KNOWING IT IS OF THE SAME FORCE AND EFFECT AS IF MADE UNDER OATH AND BY VIRTUE OF THE CANADA EVIDENCE ACT.

DECLARED AT ______________________, ______________________, THIS ______ DAY OF __________, 2010.

City or Town Province or State

__________________________, ________________________________.

Signature of Applicant Signature of Parent(s) or Guardian(s)

________________________, in and for (Province, State) _______________ of (country) __________________.

Notary Public

(* Applications signed by Commissioner for Oaths are only applicable to the Province of Alberta)

Commissioner for Oaths in and for the Province of Alberta, my Commission expires ________________.

Signature __________________________, Print Name ______________________________________.

　　2010 FOOTHILLS COWBOYS ASSCIATION MEMBERSHIP FORM (page 2 of 2)

THIS IS AN ASSUMPTION OF RISK AND RELEASE OF LIABILITY. BY BECOMING A MEMBER OR PERMIT HOLDER OF THE F.C.A. YOU ARE AGREEING TO ASSUMY CERTAIN RISKS AND TO RELEASE THE F.C.A. AND OTHER PARTIES FROM LIABILITY. PLEASE READ THIS PROVISION CAREFULLY.

Members and Permit holders acknowledge that rodeos generally are dangerous activities by their inherent nature and that participation in a rodeo as a

Competitor, independent contractor, official, laborer, volunteer or observer in areas to which access to the general public is restricted (including without limitation, the rodeo arena, competition area, chutes, pens and other areas reserved and intended for use or access by the rodeo participants or otherwise restricted to the general public) exposes the participant to substantial and serious hazards and risks of property damage, personal injury and/or death. Members acknowledge, that their participation in F.C.A. sanctioned or co-approved rodeos likewise involves such hazards and risks. Being fully aware that participation in the F.C.A. sanctioned or co-approved rodeos will result in exposure to substantial and serious hazards and risks of property damage, personal injury and/or death, each Member and Permit holder, in consideration of being permitted to participate in the F.C.A.

Sanctioned or co-approved rodeo in any capacity, does by such participation agree to assume such hazards and risks and does thereby discharge, waive, and release the F.C.A., F.C.A. properties, all sponsors, all other Members and Permit holders (including without limitation, Contestants, Stock Contractors, Rodeo Producers and Contract Personnel), any Rodeo Committee, and any other F.C.A. sanctioned or co-approved rodeo production entity involved in the sanctioning, production, organization, conduct, sponsoring and/or performance of the subject rodeo (and such persons or entities affiliated, related or subsidiary companies and their respective officers, directors, employees and agents) from all claims, demands and liabilities for any and all property damage, personal injury and/or death or other responsibility arising from such Members or Permit holders participation in the F.C.A. sanctioned or co-approved rodeo, including claims, demands, liabilities and other responsibilities that are known or unknown, foreseen or unforeseen, future or contingent, and whether or not such claims, demands, liabilities, and other responsibilities are occasioned by the negligence of the parties so released by such Member of Permit holders, by the hazards and risks so assumed by such Member or Permit holder, or otherwise. Such Member or Permit holder shall not now or at anytime in the future, directly or indirectly, commence or prosecute any action, suit, or other proceedings against the parties so released arising out of, or related to, the claims, demands, liabilities and other responsibilities so discharged, waived and released by such Member or Permit holder. The undertakings and covenants of the foregoing provisions shall be binding upon each Member and Permit holder, his or her spouse, heirs, legal representatives, successors, and assigns.

Members and Permit holders acknowledge that they are and remain fully responsible for obtaining and maintaining proper and adequate medical and dental coverage and/or insurance and further that the F.C.A. does not carry or have any responsibility to provide any such coverage or insurance, other than the General Members Insurance Plan.

I acknowledge that I have read and agree to this assumption of risk and release and indemnity.

____________________________ ___________________________________

Applicants Signature Parent(s) or Guardian(s) Signature

SENIOR _____                                                    $ 160                                                    $ 175                                               ALL MEMBERSHIPS INCLUDE

STOCK CONTRACTOR** _____                     $ 160                                                    $ 175                                              G.S.T. & INSURANCE

JUNIOR* _____                                                  $ 50                                                       $ 65

PERMIT _____                                                 $ 100                                                      $ 115

JR BULL RIDERS/NOVICE HORSE RIDERS $ 100                                                 $ 115

CONTRACT ACT _____                                   $ 60                                                     $ 75

ANNOUNCER _____                                         $ 60                                                     $ 75

SECRETARY _____                                          $ 60                                                      $ 75

TIMER _____                                                       $ 60                                                     $ 75

PHOTOGRAPHER _____                                  $ 60                                                    $ 75

JUDGE _____                                                     $ 60                                                      $ 75

PICK UP MAN _____                                          $ 60                                                      $ 75

BULLFIGHTER _____                                       $ 60                                                       $ 75

GOLD CARD MEMBERS $ 18 for insurance

LIST FORMER MEMBER OR PERMIT CARD NUMBER: _________

• *Junior Barrel Racers are 15 years old or younger on January 1, 2010– copy of Birth Certificate must be included.
• *Boys Steer Riding are 8-14 years old January 1, 2010 – copy of Birth Certificate must be included.
• Junior Bull Riders are 13-16 years old on January 1, 2010 – copy of Birth Certificate must be included.
• Over 14 must buy a permit membership not junior.
• Novice Horse Riders over 14 on Jan 1, 2010 must buy a permit membership.
• **STOCK CONTRACTORS – COMPLETE FORM IN YOUR NAME/PER YOUR COMPANY NAME

IF PAYING BY CREDIT CARD: VISA / MASTERCARD #: _____________________________________

NAME ON CARD: ________________________________ EXPIRY DATE: MONTH______ YEAR______