15 km TRAIL RIDE
Beautiful forest trails near the village of Lanark
No riding on the road!
Saturday, June 5th,
2010
Start time:
9:00 - 11:00 am
To benefit the
Lanark County Therapeutic Riding Program
For more information call JoAnn:
256-3477 or
Susan at 257-7121, ext. #236 or register online
REGISTRATION FORM
Name and Address: __________________________________________________________
Postal
code: ________ Phone: __________
E-Mail address:
_______________________
2nd Name and Address:
______________________________________________________
Postal code: ________ Phone: ____________ E-Mail address: ______________________
Please put additional names and addresses
on the back if needed.
Please print out and mail registration, Waiver Form and $30.00 to:
JoAnn Donaldson,
R.R. # 4, Almonte, Ontario.
K0A-1AO
or
register online or by phone before May 27th 2010
and bring your $ with you on June 5th.
Please make cheques payable to L.C.T.R.P.
Please register before the Ride so we know
How much food to have on hand for you.
I request
permission to participate in the Trail Ride sponsored by the Lanark County
Therapeutic Riding Program Society on June 5th
2010. I fully understand that
Cross-Country Riding (which includes riding over and around some obstacles,
steep and rough terrain) is a risk activity. I wish to participate in this activity
knowing that it is a risk. I accept and
assume all the risks of injury (including death) to me and my property.
In exchange
for being permitted to participate in this activity, for myself, my heirs,
guardians, and legal representatives, I release and agree not to make or bring
any claim of any kind against Lanark County Therapeutic Riding Program &
or its executives, employees or guest of any
land owners, landholders, or other persons making property available for this activity,
for injury (including death), to me or any damages to my property whether from
anyone’s negligence or not, or any other cause, arising out of my
participation; in these dangerous horseback riding or related activities; and I
also agree if anyone makes any claims because of any injury to me (including
death), or for any damage to my property, I will keep all those released by
this agreement free of any damages or costs because of those claims.
Printed
Name & Address:
____________________________________________
Postal Code:
_________ Dated:
________________
Signature: X__________________________________
Proof of
Liability Insurance:
Insurance
Company: __________________________________________________
Address: ___________________________________________________________
Policy
Number: _________________________________
Expiry Date (MM/DD/YYYY): _______________________
