Crystal Valley Ranch

HORSE SHOW ENTRY FORM

NAME OF RIDER: ________________________________________________________    BACK NUMBER: _______________

NAME OF HORSE: _______________________________________________________   COGGINS DATE: ________________

ADDRESS: ____________________________________________________ CITY/STATE/ZIP:__________________________

PHONE NUMBER: _______________________ NAME OF TRAINER: _______________________________________________

CLASS NUMBER          CLASS DESCRIPTION                                                                                                         JACKPOT (Y/N)

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TOTAL # OF CLASSES: ______    TOTAL # OF JACKPOT CLASSES: ______   STALL FEE: _________  RING FEE: _________

TOTAL FEE FOR:  CLASSES: ___________   JACKPOT CLASSES:___________ TOTAL ENCLOSED:  ___________________

LEGAL NOTICE - Liability Release

We, the undersigned, hereby request Crystal Valley Ranch to permit me to enter upon and use the facilities which consist of stable, outdoor riding arena, indoor riding arena, pasture, exercise areas, and other riding areas to participate in horse-related activities. I assume all risks of injury to my person and property that may be sustained connected with the stated and associated activities in riding shows, working with and caring for horses, being around horses, and observing horse-related activities.

In consideration of the permission granted to me to enter the premises of Crystal Valley Ranch, and participate in horse-related activities in the facilities provided thereon, I hereby, for myself, my heirs, administrators, and assigns - release, remise, and discharge Crystal Valley Ranch, their agents and employees, and all other participants of and from all claims, demands, actions, and causes of actions of any sort, for injuries sustained of my person and/or property while engaged in any of the foregoing activities.

I have read and understand the foregoing release.

Signature: ___________________________________________________________________              Date: ____________________

Signature of Parent/Guardian (if under 18): _________________________________________              Date: ____________________