Sunday, October 16, 2011 (Rain date, Sunday, October 23rd) Feldman Property, 586 Briggs Road Athol, MA 01331 |
NAME:_____________________________________________________________________
ADDRESS:_________________________________________________________________
PHONE NUMBER:________________________ EMAIL:____________________________
HORSE’S NAME:_____________________________________________________________
EMERGENCY CONTACT NAME & PHONE NUMBER:_________________________________
__________________________________________________________________________
*Registration: 9 AM Ride-Out: 10 AM
*Refreshments in morning, lunch served after ride
$15.00/NEECA, $20/Non-Member
Lunch may be ordered in morning for add'l $5.00 (pizza, soda, dessert), or bring your own
*All riders under 18 years old MUST wear ASTM approved riding helmet
*please make checks payable to “NEELMCC”,
and mail c/o Susie Feldman, 586 Briggs Road, Athol, MA 01331
Under Massachusetts Law, an equine professional is not liable for an injury to or the death of, a participant in equine activities
resulting from the inherent risks of equine activities, pursuant to Chapter 128, section 2D of the General Laws.
“I hereby enter the above ride at my own risk. I understand that trail riding can involve being in remote areas for extended periods of
time, far from communication, transportation and medical facilities.
That these areas may have natural hazards which management cannot anticipate, eliminate, modify or control. That accidents can
happen to anyone at any time.
I hereby release, today and forever, New England Equestrian Center of Athol, New England Equestrian Land Management
Conservation Corporation, Ben and Susie Feldman, Cutthroat Brook Tree Farm, Harvard Forest, ride personnel and any landowners,
public or private, over whose land the trail may pass, from any suits or charges resulting from any accidents or losses, either caused by
me or my horse, or to me or my horse, or equipment.”
MY SIGNATURE INDICATES THAT I HAVE READ AND FULLY UNDERSTAND THIS LIABILITY RELEASE.
______________________________________ Date:_________________________
Signature
______________________________________ Date:_________________________
Signature of Parent/Guardian if rider under 18 yrs. of age.
ADDRESS:_________________________________________________________________
PHONE NUMBER:________________________ EMAIL:____________________________
HORSE’S NAME:_____________________________________________________________
EMERGENCY CONTACT NAME & PHONE NUMBER:_________________________________
__________________________________________________________________________
*Registration: 9 AM Ride-Out: 10 AM
*Refreshments in morning, lunch served after ride
$15.00/NEECA, $20/Non-Member
Lunch may be ordered in morning for add'l $5.00 (pizza, soda, dessert), or bring your own
*All riders under 18 years old MUST wear ASTM approved riding helmet
*please make checks payable to “NEELMCC”,
and mail c/o Susie Feldman, 586 Briggs Road, Athol, MA 01331
Under Massachusetts Law, an equine professional is not liable for an injury to or the death of, a participant in equine activities
resulting from the inherent risks of equine activities, pursuant to Chapter 128, section 2D of the General Laws.
“I hereby enter the above ride at my own risk. I understand that trail riding can involve being in remote areas for extended periods of
time, far from communication, transportation and medical facilities.
That these areas may have natural hazards which management cannot anticipate, eliminate, modify or control. That accidents can
happen to anyone at any time.
I hereby release, today and forever, New England Equestrian Center of Athol, New England Equestrian Land Management
Conservation Corporation, Ben and Susie Feldman, Cutthroat Brook Tree Farm, Harvard Forest, ride personnel and any landowners,
public or private, over whose land the trail may pass, from any suits or charges resulting from any accidents or losses, either caused by
me or my horse, or to me or my horse, or equipment.”
MY SIGNATURE INDICATES THAT I HAVE READ AND FULLY UNDERSTAND THIS LIABILITY RELEASE.
______________________________________ Date:_________________________
Signature
______________________________________ Date:_________________________
Signature of Parent/Guardian if rider under 18 yrs. of age.
