NAME:_______________________________________________________________
ADDRESS:____________________________________________________________
CITY:_____________________________________STATE:________ZIP:_________
JR RIDER BIRTH DATE:__________________PHONE#(_____)_________________
REGISTRATION: REGISTRATIONS IN BY MAY 8, 2010 RECEIVE A $10 DISCOUNT.
MAIL CHECKS PAYABLE TO: FOUR WINDS FOXHOUNDS
MAIL FORMS AND CHECKS TO: MARY NORD 16145-87 LANE NORTH, LOXAHATCHEE, FL., 33470
REFUND POLICY: IN THE EVENT OF SICKNESS (HORSE OR RIDER), YOUR ENTRY FEE WILL BE REFUNDED MINUS $10 IF WE ARE NOTIFIED PRIOR TO WEDNESDAY MAY 12, 2010.
PROOF OF NEGATIVE COGGINS REQUIRED.
CLINIC FEE ADULTS $75 ______________
JUNIORS (UNDER18) $55 ______________
4H MEMBERS $45 ______________
EARLY ENTRY -$10 ______________
TOTAL _____________
TEE SHIRT SIZE S____ M_____ L ______ XL______
ARE YOU BRINGING A HORSE YES_____ NO ______
ARE YOU CAMPING AT DUPUIS YES_____ NO______
UNDER FLORIDA LAW, AN EQUINE ACTIVITY SPONSOR OR EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES.
THIS IS A RELEASE - IT CONTAINS LIMITATIONS ON LIABILITY - READ IT!
I REQUEST PERMISSION TO Participate IN CROSS-COUNTRY RIDING AND FOXHUNTING WITH FOUR WINDS FOXHOUNDS.
I FULLY UNDERSTAND THAT CROSS-COUNTRY HORSEBACK RIDING AND FOX HUNTING (WHICH INCLUDES RIDING OVER FENCES, OTHER OBSTACLES AND STEEP AND ROUGH TERRAIN) ARE VERY DANGEROUS.i ACCEPT AND ASSUME ALL THE RISKS AND INJURY (INCLUDING DEATH) TO ME OR MY PROPERTY.
IN EXCHANGE FOR BEING PERMITTED TO PARTICIPATE IN THESE ACTIVITIES, FOR MYSELF, MY HEIRS, GUARDIANS AND LEGAL REPRESENTATIVES, I RELEASE AND AGREE NOT TO MAKE OR BRING ANY CLAIM OF ANY KIND AGAINST FOUR WINDS FOX HOUNDS, OR ITS MASTERS, OFFICERS, DIRECTORS, MEMBERS, EMPLOYEES OR GUESTS OR ANY LAND OWNERS, LANDHOLDERS OR OTHERS PERSONS MAKING PROPERTY AVAILABLE FOR FOUR WINDS FOXHOUNDS, FOR ANY INJURY (INCLUDING DEATH) TO ME OR ANY DAMAGE TO MY PROPERTY WHETHER FROM ANYONE'S NEGLIGENCE OR NOT, OR ANY OTHER CAUSE ARISING OUT OF MY PARTICIPATION IN DANGEROUS HORSEBACK RIDING, FOR HUNTING OR RELATED ACTIVITIES; AND I ALSO AGREE IF ANYONE MAKES ANY CLAIMS BECAUSE OF ANY INJURY TO ME (INCLUDING DEATH) OR FOR ANY DAMAGE TO MY PROPERTY, I WILL KEEP ALL THOSE RELEASED BY THIS AGREEMENT FREE FROM ANY DAMAGES OR COSTS BECAUSE OF THOSE CLAIMS (INCLUDING BUT NOT LIMITED TO ANY AND ALL DEMANDS, DAMAGES, ACTIONS, CAUSES OF ACTION IN EQUITY OF WHATEVER KIND OR NATURE).
I HAVE READ AND UNDERSTAND THIS LIABILITY RELEASE
RIDER'S SIGNATURE: ____________________________________________________________________
PARENT/GUARDIAN SIGNATURE (rider under 18): _____________________________________________
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