XC Clinic with Ashley McVaugh – Registration – West Newbury Riding & Driving Club

Rider's Information

Riders Name

First Name

Last Name

Rider Age Category

Senior

Junior(<18), (parent/guardian must sign form)

Jr Age

Address

City

State/Province

Zip/Postal

Phone

Email Address

Confirm Email Address

Please type your email address again so we can make sure it is correct.

Emergency Contact Information

Please provide someone who will be on site during the clinic.

Emergency Contact's Name

First

Last

Emergency's Contact Phone

Horse Information

I will be riding more than one horse

No

Yes (submit a separate entry for each horse)

Horse's Name

Horse's Name on Coggins (if different than above)

Upload Coggins

Maximum file size: 67.11MB

Rabies/Flu Rhino

Horses must be up to date on rabies/flu rhino vaccinations. Type "YES" to indicate horse is up to date.

Horse Breed

Horse Height (in hands)

Horse Age (in years)

Horse Gender

Mare

Gelding

Stallion

Clinic Requirements

This clinic is open to Intro (18") through Beginner Novice/Novice (2'7") level horse and rider pairs. Riders must be comfortable controlling their horses in a group and in the open to participate. An approved helmet and cross-country vest are required.

Group & Open Field Confirmation

I confirm my horse and I are comfortable and in control riding in a group and in the open.

Choose Your Level & Group

Groups are organized by level. We will contact you with your group assignment and ride time.

Horse/Rider Level

Intro (18")

Elementary (2')

Starter (2'3")

Beginner Novice/Novice (2'7")

Group Type

Semi-Private: 1 hour, 2 riders per group ($150)

Group: about 1.5 hours, 3-4 riders per group ($125)

Special Requests

Anyone you would like to ride with, scheduling needs, or anything Ashley should know.

Liability Waiver

Paragraph

By submitting this form and payment I enter the WNRDC Cross Country Clinic with Ashley McVaugh which is made at my own risk and subject to the conditions of the sponsoring Club. Further, in doing so, I understand that this clinic can be dangerous for both horse and rider, including sickness and disease (including communicable diseases.) 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 taken during the WNRDC Cross Country Clinic with Ashley McVaugh 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 electronically signing my name below, I agree. If under 18, the rider’s parent or guardian must electronically sign.

Signature (parent must sign for minor)

Clear

Date

Medical Armbands

Please note that while we no longer require medical armbands, riders with pre-existing medical conditions or allergies are strongly encouraged to wear an armband or medical bracelet. Please type YES to indicate you are aware.

Manual Payment

Payment Information

Payment Total

$

Payment total includes a $5.00 processing fee

Cardholder Name