Rider Name: Male Female Age:


Parent/Guardian Name:

I understand that the sport of horses is a high-risk sport and that I am participating at my own risk and in full knowledge that there is some element of risk, that an accident could occur and may result in injury or death to the rider or their mount. In consideration of acceptance of this entry or my being permitted to take part in this event, I agree to save harmless and keep indemnified, Circle H Ranch, Directors, Counselors, and anyone assisting in the program, and the property from and against all claims, actions, costs and expense and demands in respect of death, injury, loss or damage to my person or property, however caused, arising out of or in connection with my taking part in this program. It is understood and agreed that this agreement is to be binding upon myself, my heirs and assigns.

Parent/Guardian Signature: _____________________________________ Date:_____________________

Witness: ___________________________________________________ Date: ____________________