NEW HAMPSHIRE HORSE & TRAIL ASSOCIATION
ANNUAL OPEN PLEASURE TRAIL RIDE
SUNDAY—JUNE 24, 2007
![Text Box: NEW HAMPSHIRE HORSE & TRAIL ASSOCIATION
TRAIL RIDE ENTRY BLANK
ANNUAL PLEASURE TRAIL RIDE – JUNE 24, 2007
Date _______________ Ride Fee = $26.00 (adults) $15.00 (juniors) TOTAL AMOUNT
Extra Meals @ $5 ea. #_______ = $_______ DUE $__________
NAME OF RIDER________________________________________________________________
NAME OF HORSE_______________________________________________________________
Complete Mailing Address__________________________________________________________
______________________________________Phone_________________________
Mileage credit - check one ____ Long Loop ____ Short Loop
Member of NEW HAMPSHIRE HORSE & TRAIL ASSOCIATION ? ____________
Member of New England Horse & Trail ? ______ NEHT Rider # __________ Horse #__________
WAIVER OF LIABILITY
Every entry at a recognized trail ride shall constitute an agreement that the person making it, and the horse, shall be subject to the constitution and the rules of NEW HAMPSHIRE HORSE & TRAIL ASSOCIATION [NHH&TA] . It shall further constitute that every horse and rider is eligible as entered, and that the owner and his/her representatives are bound by the decision of the hearing committee on any questions arising under said rules, and agree to hold harmless the ride, the NHH&TA and their officials, directors, and employees for any action taken.
I, my party, and my heirs, further agree that if any damage is occasioned by, or injury or loss occur to myself or the horse entered, or to any vehicle or other article or possession that I may send with such horse, that I will make no claims, either now or forever thereafter. I further agree to indemnify, forever, the ride, the Committee, NHH&TA, Gelinas Farm, and any other property owners and any participants in the event against all claims, demands, suits, and loss or damage to any property or person caused by myself, my horse, my attendants or my vehicle.
I understand that trail riding can involve being in remote areas for extended periods of time, far from communications, transportation, and medical facilities; and that these areas may have many natural hazards which ride management cannot anticipate, identify, modify, or eliminate; that horses can be excitable, difficult to control, and unpredictable; and that accidents can happen to anyone at any time.
Signature of Rider ___________________________________________________ Date __________________
FOR MINORS signature of parent or guardian ____________________________________
Medical Waivers & Information(This waiver is required for minors unaccompanied by parent)
In case of injury to a minor, this authorizes NEW HAMPSHIRE HORSE & TRAIL ASSOC., or its agents to secure whatever emergency medical treatment is needed for my minor child entered in this event, with no liability whatsoever to NHH&TA, the owners of the properties, or anyone involved in this ride.
Signature of Parent/Guardian for minor child___________________________________________________
Phone number where parent or guardian may be reached____________________________________
FOR ALL RIDERS (This information could be of help in an emergency.)
List Allergies _______________________________________________________________
Other Pertinent Information _______________________________________________________________
Regular Doctor & Phone _______________________________________________________________
Insurance Carrier _______________________________________________________________
Name and Phone of nearest relative _______________________________________________________________](image1385.gif)
