MeCTA Adult (Fossils) Clinic Entry Form

At what level do you normally ride or compete?____________________________________

Will you need stabling?   Friday night____; Saturday Night____

Name________________________________________________________________________________

Address______________________________________________________________________________

Phone___________________________________E-Mail______________________________________

Please attach information on what would you like to accomplish at this clinic?

Are there any specific issues that you want to have addressed?

If you are competing, would you be interested in instruction on how to be more competitive? ____(check, if yes)   This would be for beginner novice through preliminary levels, and would include wheeling courses to measure distances, practice pacing, and riding at appropriate and competitive speeds.

MeCTA Membership # (see Omnibus Label)_____________________________

Release: I understand that this is a high-risk sport and that I am participating at my own risk. I hereby assume this risk and further do hereby release and hold harmless the organizer, instructors, MeCTA, their officers, agents, employees and volunteers assisting in the conduct of this MeCTA educational activity, and the owners of the property on which it is to be held, from all liability for negligence resulting in accidents, damage, injury, death or illness to myself and to my property, including the horse(s) which I may ride.

Signature:_____________________________________________________________________

Date:_________________________       

Note: You will also be asked to sign a Hyl-Tun Farm release