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Embed code for: Entry Form – Lehigh Valley Classic
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Entry Form – Lehigh Valley Classic Number________ One horse-rider combination per entry form. Show Date: ___________________ Lehigh Valley Classic Member ____Yes ____No Office Use Only Payment: cash check # _________ open ck. closed Other #s on same check ____________________________ Other #s w/ same horse ______ #’s with same rider______ Rider Information Name _______________________________________ Address _____________________________________ City/State/Zip_________________________________ Phone (_____)_______________________ Show age (on 12/1/16) __________ Horse Information (must be completed in full for Marshall & Sterling classes) Name __________________Owner____________________ Address__________________________________________ Classes Entered Fees Total class fees TOTAL FEES Pony Size_____ Small____ Medium____ Large____ Trainer Information Name ________________________________Address____________________________________________________________ Coggins/Release on File Signature of Rider _________________________________ Signature of Parent/Legal Guardian (required if rider is less than 18 years of age) ______________________________________ Release: I understand that horse sports may be hazardous and dangerous. I assume any and all risk of loss or injury to myself, my animals and equipment, other animals or persons, and agree to release from liability and to hold harmless Molasses Creek Farm, LLC, Stone Gate Stables, LLC, Boots & Saddle Riding Club and all horse show personnel, and volunteers. The Lehigh Valley Classic is used in name only and not incorporated. WARNING: Under Pennsylvania law an equine professional and equine activity sponsor is not liable for an injury to or death of a participant in equine activities resulting from the inherent risks of equine activities. Inherent risks of equine activities includes: 1. The propensity of an equine to behave in a manner, which may cause injury, harm or death to a person on or near it. 2. The unpredictability of an equine’s reaction to sounds, sudden movements, unfamiliar objects, individuals or other animals. 3. An equine’s reaction to certain natural hazards, such as surface and subsurface ground conditions. 4. A collision with other equines or objects. 5. An equine’s response to the participant’s manner of handling or controlling it or inability to handle or control it.