ENTRY FORM - RIDE AND SHINE FAMILY HUNTER PACE - SEPTEMBER 30, 2006
Name of Rider
Age if under 18
Address
Town
State
Zip
Phone
Name of Horse
Division
A
B Team Name
C Team Name
Names of team-mates
Entry Fee: $30.00 (Late: $35.00)
BBQ Dinner: $15 per person. Number attending?
Please make check payable to: Ride
and Shine Special Equestrians, Inc.
MUST BE RECEIVED BY SEPTEMBER 22nd BY:
Bethany Perron
Family Hunter Pace
1214 East Arlington Road
Arlington, VT 05250
Release of Liability: Under Vermont Law, an equine activity sponsor is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities that are obvious and necessary, pursuant to 12 V.S.A. § 1039. I understand that this is a high risk sport, and am voluntarily participating at my own risk. I assume complete responsibility for any injury, accident, loss or property damage incurred by me while a participant in this Event. Neither I nor my representatives, assignees, or heirs shall make any claim against, maintain an action against, or attempt to recover damages from the organizers, sponsors or beneficiaries of this Event, or any other organization or persons associated with this Event, or any property owners over whose land the course is laid, for injury, loss, damage, or death to myself or my property resulting from my participation. I acknowledge that I have read, understand and agree to the above statement.
Rider's Signature
Date
FOR RIDERS UNDER AGE
18, the rider and a parent or legal guardian (not a trainer or other
person) must sign. I, the parent or legal guardian of the minor named
above, acknowledge that I have read, understand and agree to the above
statement, and give my permission for his/her participation.
Signature of Parent/Guardian
Date
|