Moonrise Trail Ride
RIDER INFORMATION
Rider's Name
*
I am 18 years old or older
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Yes
No
Parent or legal guardian's name
Parent or legal guardian's phone number
Rider's Email
*
Rider's Phone
*
Rider's Address
*
Rider's Address
Rider's Address
Rider's Address
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Emergency Contact Name
*
Emergency Contact Phone
*
Barn's Name/Address
*
Name of Person/Barn I will be trailering with
*
By submitting this form I am participating in a WNRDC Moonrise Ride at Pipestave Hill, West Newbury which is made at my own risk. Further, in doing so, I understand that this event can be dangerous for both horse and rider. In addition, I release the West Newbury Riding and Driving Club, its members, all volunteers, the Town of West Newbury, landowners and organizers from any and all liability actions, causes of action, claims and demands of every kind and nature whatsoever which may arise in connection with or resulting from participation in any activities. I also give permission for the WNRDC to use any photograph, video or other likeness of me and my horse for promotion, coverage or benefit of the club, with the condition that such likeness will not be used to commercially promote any product. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropriation. By typing my name below I agree. (If under 18 parent must electronically sign by typing their name.)
Electronic Signature
*
Date
*
Submit
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