Back Country Horsemen of Missouri
Referring Member *________________________________
Please check One:
___ Club or Business Membership-$60.00-entitles you to business card ad in quarterly newsletter and link on website.
New Member joining after August 1st will receive the rest of that year and the following year for one year’s membership fees.
Members may be a Chapter member or a member At Large, the dues are the same. Please indicate your chapter affiliation if applicable:
___ Brownfield Chapter – Lebanon/Waynesville area
___ Cuivre River Chapter – Troy area
___ Eastern Missouri Chapter – Desoto, Farmington area
___ Heartland Chapter – Fayette, Columbia, Boonville
___ Indian Trails Chapter – St Clair area
___ Mountain Riders Chapter – Ava area
___ Nemo River Valley Chapter – Monroe City area
___ River Springs Chapter – Winona area
___ South Central Chapter – Rolla, Salem, and Licking Area
___ State Fair Trails Chapter – Sedalia area
___ Tri-Lakes Chapter – Springfield, Bolivar, Marshfield area
___ At Large – (meaning you do not belong to a specific Chapter)
Make check payable to: Back Country Horsemen of Missouri (BCHMO)
Mail application to: Karen Mertz 1068 Highway 68 Salem, MO 65560 or
call 573-247-6922 or send to firstname.lastname@example.org
By joining BCHMO, I agree to hold harmless the Back Country Horsemen of Missouri organization, its directors, officers, and members from any and all liability, claims or demands for personal injury, sickness or death, property damages and expenses incurred by myself or family member while participating or attending a BCHMO event except in the event of gross and willful negligence.
* INCENTIVE PROGRAM: Recruitment Incentive