Point-to-Point: Minor Rider Release

Parents or Guardian of Minor (under 18) GREEN SPRING VALLEY POINT-TO-POINT PERMISSION, REPRESENTATION, RELEASE, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
We are the parents or guardians of*
for whom we give permission to ride in one or more horse races, including jump races, conducted by the Green Spring Valley Hounds, Inc at Shawan Downs race course owned by Land Preservation Trust, Inc. (hereinafter collectively referred to as the race Organizers).
We fully understand that riding in horse races is inherently dangerous to the participants and that there is serious possibility of our child suffering injury or death as a result of participation. We hereby state that we have been given notice of the risks of riding in and otherwise participating in races including, but not limited to, (i) the propensity of an equine to behave in dangerous ways which many result in injury to the participant; (ii) the inability to predict an equine’s reaction to sound, movements, objects, persons, or animals; and (iii) hazards of surface or subsurface conditions. We expressly agree, upon behalf of our child and ourselves, to assume all of the above described risks and all other risks of riding in and otherwise participating in these races.
In order to induce the Race Organizers to allow our child to participate in such races, we represent to the Race Organizers that our child is properly trained and supervised to ride and has that degree of skill to participate in races without endangering our child or other participants. We further represent that the horses our child will ride are properly trained for the endeavor and will provide a safe conveyance without unduly jeopardizing the safety of our child or others.
As a further inducement to the Race Organizers to allow our child to participate in such races, we agree to hold harmless and fully indemnify the Race Organizers, their committees, committee members, officers, directors, employees, agents, officials and any other persons acting on behalf of the Race Organizers from any and all claims, actions, causes of action or demands, including attorneys’ fees and costs, made or claimed by or on behalf of our child for any injury or other claim or other matter arising out of or related to our child riding in or otherwise participating in these races, including any negligence on the part of the Race Organizers , their committees, committee members, officers, directors, employees, agents, officials and any other persons acting on behalf of the Race Organizers, and we further agree to hold harmless and indemnify all landowners on whose land the above described Race Organizers are conducted from any and all claims actions, causes of actions (including negligence) or demands, including attorneys’ fees and costs, made or claimed by or on behalf of our child for any injury or other claim or other matter arising out of or related to our child riding in or otherwise participating in these races.
And we further waive any and all claims, actions, causes of action (including negligence) or demands that we may now have or which may arise in the future, and further covenant not to sue the above named organizations or persons, including landowners, for any injury of damages resulting from our child’s participation in such races.
We further represent and certify that the above-named child is currently covered by health insurance policy no. below and written by the following insurance company below
I further certify that my child is currently covered by:*
- a Health Insurance Policy (details below)
- a Workman's Compensation Insurance Policy (details below)
Health insurance policy number:
written by the following Insurance Company:
Worker’s Compensation insurance policy number
issued in the name of owner/farm (policy-holder);
written by the following insurance company:
and that we shall keep such insurance in effect at all times that our child is participating in the above-described races. We will provide written proof of such insurance prior to our child being allowed to ride.
IN WITNESS WHEREOF, I have hereunto set my hand and seal this*
Please enter the date followed by the month.
Guardian (of rider under 18) Signature*
Signatory's Name - Printed*
First Last
Rider's Name - Printed*
First Last
Mobile Phone*
Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Emergency Contact*
First Last
Emergency Contact Mobile Phone Number*
CAPTCHA

Quick Links

Foxhunting

Events

Members