EmailMe Form - LESSON STUDENT SHOW

Rider's name

First Last

Lesson teacher's name

Rider's age

under 12

12-17

Adult

Parental/Guardian info

Name

First Last

Phone

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

Email

Rider under 12 Walk
may only enter these classes

1 Walk

2 Walk trot "Leadline"

Rider under 12 Walk-Trot

3 Walk trot

4 Walk trot back

5 Walk trot x rails or pattern

Rider under 12 Walk-Trot

6 Walk trot

7 Walk trot canter

8 Walk trot x rails or pattern

Rider 12-17

9 Walk trot

10 Walk trot back

11 Walk trot x rails or pattern

Rider 12 and over Walk-Trot

12 Walk trot

13 Walk trot canter

14 Walk trot x rails or pattern

Adult Pleasure Horse

15 Walk trot

16 Walk trot back

17 Walk trot x rails or pattern

Any age rider. Judged on the horse

Adult Pleasure Horse

18 Walk trot

19 Walk trot canter

20 Walk trot x rails or pattern

Any age rider. Judged on the horse

Hard copy of entry form is available at the barn. It must be returned with the entry fee and parental signature by Saturday June 15 No entries the day of the show

I have read and agree to the following waiver

I am an adult over 18 years of age and I am executing this release of claim on my own behalf and/or on behalf of my minor child, and on behalf of my heirs, personal representatives and assigns. I understand that horseback riding is a dangerous sport and that serious injury and disability and/or death may result from accidents while riding. I acknowledge the risk I undertake for myself and/or my minor child while riding. I do so voluntarily and agree to release the WaterGap Stables, , its trainers, and its agents, servants and employees from any claims I may have resulting from injury to me or to my minor child. In the event I allow my minor child to ride, I also assume the risk of injury, disability or death of said child. I execute this release and disclosure knowingly and in consideration of being allowed to participate in the WaterGap Stables Lesson Student Show