Oak Rise Farm, LLC 2012 Gymkhana show series

ENTRY FORM FOR ALL SHOWS

8:30 start time

CIRCLE DATE OF SHOW AND CLASSES ENTERING

April 29, May 13, June 3, July 1, July 15, Aug 5, Aug 26, Sept 9, Sept 30, Oct 14

1   2   3   4   5   6   7   8   9   10   11   12   13   14   15   16   17   18   19   20   21

   22   23   24   25   26   27   28   29   30   31   32   33   34   35

36   37   38   39   40   41   42   43   44   45   46  

Under NH law a participant in equine activities assumes the risk of any injury, harm, damage, or death and any legal responsibility that may occur to participant from the inherent risks associated with equine activities.

Pursuant to R.S.A. 508:19 Equine professionals are not liable for damages resulting from the inherent risks of equine activities.

I/We hold harmless Oak Rise Farm, LLC its managers, members, volunteers, and agents from and against all claims, demands, actions, and causes of action for damages that may be sustained by those indicated on the entry form or anyone else, including any and all claims arising from Oak Rise Farm, LLC or it’s agents’ own negligence. This includes personal injury, death, or property damage.  Please make checks payable to Oak Rise Farm, LLC.

_________________________________    ____________________________________

Name of Rider                                                            Name of Horse              

_________________________________    ___________________________   ________

Signature of Rider                                          Signature of Parent/Guardian          Date

OR

#of classes_____    x $10 =______+$5 post entry fee (if applicable) Total $_________

Address:________________________Town:____________ State:_______Zip:________

Email:_______________________________Phone:________________