Entry Form: Ride For Red Clear Round Classic
Show to be entered (please check one):
o July 4, 2010 (Entries due July 1)
o August 29, 2010 (Entries due August 25th)
Horse Name:___________________________________________________________
Age:_______ Colour:________________ Sex:______________ Height:___________
Is this horse for sale?___________
Owner’s Name:_________________________________________________________
AEF Number:
Address:
Phone Number:
AEF Number:
Trainer:
Rider:
Name:
AEF #:
Age:
Address:
Phone Number: Email Address:
Alternate Rider:
Name:
AEF #:
Age:
Address:
Phone Number: Email Address:
Remember to include a signed release form for all riders!
Entries:
Clear Round Tickets _______ x $10.00 =
Office & Paramedic Fee $12.00 =
Total Entry Fees =
Please made Cheques Payable to Hillside Stable
Mail Entry Forms to:
Hillside Stable
53269 RR221
Ardrossan, AB
T8E 2M7
Remember, the first 20 entries received for each show receive a goody bag sponsored by Noramac Ventures! Entries will be limited!
ACKNOWLEDGMENT of RISK and RELEASE of LIABILITY – “ For Participants Not 18 Years Old” Please Print Clearly
Infant Participant’s Name: __________________________________Date of Birth: _________________
Infant’s Address: _________________________________City: ____________Prov: ___Postal:_______
Guardian’s Name: _________________________________________Date of Birth: ________________
Guardian’s Address: _______________________________City: ____________Prov: ___Postal: _______
TO: Hillside Stable their directors, employees, officers, volunteers, business operators, and site property owners. (all of them collectively called the HOST)
____1. I am the Parent and/or Legal Guardian of the infant Participant named above and am executing this form on behalf of the infant Participant in my capacity as parent and/or guardian and with the intent that this form be binding on myself and infant Participant for all legal purposes.
____2. I Understand there are Inherent DANGERS, HAZARDS and RISKS, (collectively called RISKS) associated with Equine Activities and injuries resulting from these “RISKS” are a common occurrence.
____3. I Acknowledge that the Inherent “RISKS” of Equine Activities mean those DANGEROUS conditions which are an integral part of Equine Activities, including but not limited to:
The propensity of any equine to behave in ways that might result in injury, harm or death to persons on or around them and to potentially collide with, bite or kick other animals, people, or objects.
The unpredictability of an equine’s reaction to such things as sounds, sudden movement, tremors, vibrations, unfamiliar objects, persons or other animals and hazards such as subsurface objects.
The potential for other participant (s) to act in a negligent manner that might contribute to injury to themselves or others, such as failing to act within their ability or to maintain control over an equine.
____4. I Freely Accept and Fully Assume All Responsibility for the Inherent “RISKS” and the possibility of personal injury, death, property damage or loss which might result from the infant being a Participant.
____5. I Acknowledge that it remains my Sole Responsibilty for the safety of the infant Participant and for the infant to Participate within his/her own limits.
____6. In addition to consideration given for the infant to Participate in Equine Activity, I and my heirs, executors, administrators and assigns (collectively called my “Legal Representatives”) agree
To Waive All Claims that I or the infant Participant might have against the “HOST”; and
To Release the “HOST” from Any and All Liability for any loss, damages, injury, or expense that I, the infant Participant or our “Legal Representatives” might suffer as a result of the infant’s Participation due to any cause including any NEGLIGENCE ON THE PART OF THE “HOST”; and
To HOLD HARMLESS AND INDEMNIFY THE “HOST” from any and all liability for property damage or personal injury to the infant Participant or to any third party which might result from the infant’s Participation.
Before signing this form I read it (as indicated by my initials above) and I stated that I understand it. I further state I am aware that signing this form, waives certain legal rights I and/or the infant Participant and/or our “Legal Representatives” might have against the “HOST”.
SIGNED This _________________________________day of ______________________________20 ________
_____________________________________________ ______________________________________
(Print Name of HOST Witness to signing & Initialing) (Signature of Participant)
________________________________________ _______________________________________
(Signature Host Witness) (Signature of Parent/Guardian)
Do Not Sign until you Understand All Items Above
ACKNOWLEDGMENT of RISK and RELEASE of LIABILITY – “ For Participants 18 or Older”
Participant’s Name: __________________________________Date of Birth: _________________
Address: _________________________________City: ____________Prov: ___Postal:_______
TO: _______________________________________________________ their directors, employees, officers,
(Name of Person, Organization or Company providing the Equine Activities)
volunteers, business operators, and site property owners. (all of them collectively called the HOST)
____1. I Understand there are Inherent DANGERS, HAZARDS and RISKS, (collectively called RISKS) associated with Equine Activities and injuries resulting from these “RISKS” are a common occurrence.
____2. I Acknowledge that the Inherent “RISKS” of Equine Activities mean those DANGEROUS conditions which are an integral part of Equine Activities, including but not limited to:
The propensity of any equine to behave in ways that might result in injury, harm or death to persons on or around them and to potentially collide with, bite or kick other animals, people, or objects.
The unpredictability of an equine’s reaction to such things as sounds, sudden movement, tremors, vibrations, unfamiliar objects, persons or other animals and hazards such as subsurface objects.
The potential for other participant (s) to act in a negligent manner that might contribute to injury to themselves or others, such as failing to act within their ability or to maintain control over an equine.
____3. I Freely Accept and Fully Assume All Responsibility for the Inherent “RISKS” and the possibility of personal injury, death, property damage or loss resulting from my Participation in Equine Activities.
____4. I Acknowledge that it remains my Sole Responsibilty to act in such a manner as to be responsible for my own safety and to Participate Within My Own Limits.
____5. In addition to consideration given for my Participate in Equine Activity, I and my heirs, executors, administrators and assigns (collectively called my “Legal Representatives”) agree
To Waive All Claims that I might have against the “HOST”; and
To Release the “HOST” from Any and All Liability for any loss, damages, injury, or expense that I or my “Legal Representatives” might suffer as a result of my Participation due to any cause whatsoever including any NEGLIGENCE ON THE PART OF THE “HOST”; and
To HOLD HARMLESS AND INDEMNIFY THE “HOST” from any and all liability for property damage or personal injury to any third party which might result from my Participation in Equine Activities.
Before signing this form I read it (as indicated by my initials above) and I stated that I understand it. I know that signing this form, waives certain legal rights I or my “Legal Representatives” might have against the “HOST”.
SIGNED This _________________________________day of ______________________________20 ________
_____________________________________________ ______________________________________
(Print Name of HOST Witness to signing & Initialing) (Signature of Participant)
_____________________________________________
(Signature of HOST Witness)