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ENTRY
FORM SMCHA WESTERN
SCHOOLING SHOW
Sunday, May 17, 2009
ENTRY
Entry #:_________ PLEASE
USE ONE FORM PER HORSE & RIDER
Name of Rider:
Name of Horse:
Address:
City/Zip:
Phone #:
Email:
Check each class you wish to
participate in:
Entries received by May 14
are $12.00 per class. All entries
received after May 14 are $15.00.
NO EXCEPTIONS
PLEASE Early Entry Fee @
$12.00/class:
Make checks payable to SMCHA Late Entry Fee @ $15.00/class: Mail form and check to:Drug Fee @ $5.00/horse:
5.00
SMCHA P.O. Box 620092TOTAL :
Woodside, CA 94062
I, the
undersigned, wish to participate in the SMCHA event on May 17, 2009. I understand that during portions of
this event, I will be in close proximity to one or more horses under
circumstances which may expose me to some risk of serious injury and damage to
both person and property, including the risk of death, because of the nature of
horses, the facility, and the activities in which I will be
engaged. In consideration of SMCHA allowing my participation in this
event, I, on behalf of myself, and my heirs, administrators, personal
representatives, assigns and children and spouse, if any, do hereby agree to
hold harmless, release and discharge SMCHA which includes its officers,
directors, members, agents, representatives, affiliates and insurers, the
Horseshow Committee and Webb Ranch and their employees from all claims, demands,
causes of legal action and legal liability whether known or unknown,
anticipated, or unanticipated, due to the ordinary negligence of SMCHA. I shall not bring any claims, demands,
legal actions or cause of action against SMCHA for any damage or loss due to
bodily injury, death or property damage arising out of my participation in this
event. ________________________________________________________________________ Signature of
Participant
Date ________________________________________________________________________ Signature of Parent or
Guardian (if participant is a minor)
Date San Mateo County Horsemen’s
Association www.SMCHA.org |