EmailMe Form - RockNHorse Arena Pop Up Race

Riders Name *

First Last

Email

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region

Cell Phone:

### - ### - ####

Horses Registered Name: *

Class and Fees
Time onlys are pay at the gate $5 for 1 minute.

Run or Roll to Senior

Roll

Run

Run or Roll to Youth

Roll

Run

Payment Method *

Pay by Credit Card, Check or Cash at the Race

Comments or Instructions:

Release *

By checking this box, I do hereby declare that I am a participant or legal custodial parent of guardian of my child or ward participating in this event. I hereby agree to comply with all rules and regulations of the arena, producers and sponsors. For myself, my executors, heirs, next of kin, administrators, successors and assigns, I hereby waive and release all claims that I may have against RockNHorse Productions LLC. and co-sanctioning organizations, its officers, members, volunteers, sponsors, facility owners including all claims for damage caused by negligence of any of them, arising out of my participation in this event and its related activities. I further agree to indemnify, release, hold harmless and defend the RocknHorse Productions LLC. and co-sanctioning organizations, its officers, volunteers, sponsors and arena owners against all claims of injury or damage to persons or property. I understand that horses and activities involving horses can cause serious injury or death. I hereby acknowledge that participation in this event carries potential hazard, I therefore release Rocknhorse Productions LLC. and co-sanctioning organizations, its officers, members, volunteers, sponsors and facility owners of any liability resulting from injury or death during this event or related activity.

Signature

Clear

Below is the amount that will be paid at the office please have your check or cash ready