XC Schooling Entry - June 2023

06/07/23 - 3:30-7:30
06/10/23 - 10:00am-2:00pm
*Starter through Training Offered*

Riders Name
Horse
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Phone Phone - ### - ### ####
Emergency Contact Name
Emergency Contact Phone Number Emergency Contact Phone Number - ### - ### ####
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Date Date / MM / DD YYYY
GVRDC Agreement for Release and Hold Harmless
The undersigned acknowledges the inherent risk involved in riding and working around horses, which risks include bodily injury from using, riding or being in close proximity to horses among OTHER risks, and further that both horse and rider can be injured in normal use, competition & schooling. The undersigned hereby agrees to hold harmless and indemnify the Genesee Valley Riding and Driving Club, its officers, David Chugg (Foxrun Farm), Beth Anne, Sean and Terumi Harris ( Hideaway Farm), Jeremy and Eric Grace and Doug and Judy Hart. I furthermore release all landowners and GVRDC officers from any liability or responsibility for accident, illness or injury to undersigned or any horses owned by, leased by or in the control of undersigned or to any family member or spectator accompanying the undersigned on the grounds comprising the GVRDC grounds or any of its landowners. In exchange for being permitted to participate in this GVRDC activity, my heirs, guardian and legal representatives and I release and agree not to make or bring any claim of any kind against the landowners mentioned above or the GVRDC officers. My signature hereby indicates my agreement to wear protective headgear at all times as per safety guidelines set forth by the United States Eventing Association. Signature (parent or legal guardian if under 18)
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Choose a date 6/07/2023 3:30pm-7:30pm 6/10/2023 10am-2pm
Payment (online payment preferred)

Payment (online payment preferred) XC Schooling GVRDC Member - $45.00 (June) XC Schooling Non-member Fee - $60.00 (June) XC Schooling - Pay on arrival
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XC Schooling Entry - June 2023

XC Schooling Entry - June 2023

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Total

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