MeCTA Young Riders Clinic Entry Form

Please check level:  Elementary___; Beginner Novice___;

Novice___; Training___

Will you need stabling?  Friday night___; Saturday night___

Young Rider's Name_____________________________________Age____

Parents Name_________________________________________________

Address______________________________________________________

_____________________________________________________________

Phone__________________________

E-Mail_______________________________________________________

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 of Young Rider:________________________________________

Parent Signature:_______________________________________________

Date:_______________________

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