AUTUMN RIDERS
2010 Horse Show Series May 23_____June 6_____July 11_____August 15_____September 26_____October 24_____ REGISTRATION FORM RIDER INFORMATION (please print) E-Mail Address:______________________________ Riders Name______________________________________Address__________________________________________________ City, State, Zip________________________________________________Phone____________________ HORSES INFORMATION Name______________________________________Breed__________________Age____Height_______Color__________ Sex____________Owner’s Name_______________________________________________________________________________ DIVISION CLASS #_____ _____ _____ _____ _____ _____ DIVISION_________________________________ CLASS #_____ _____ _____ _____ _____ _____ DIVISION_________________________________ CLASS #_____ _____ _____ _____ _____ _____ DIVISION_________________________________ CLASSES x $17.00 _______ CLASSES x $15.00________ ACADEMY DIVISION $12.00 PER CLASS / Division fee $50.00_______ Back Number $1.00 TOTAL $_____________ LIABILITY RELEASE: I understand that Handy Acres Ranch LLC / Autumn Riders / Bella Rosa Riding Academy and its staff, volunteers, judge, or any other person acting on their behalf are not responsible for accidents, damage, injury or illness to the horse ,riders, auditors, or any other person in connection with this show. _____________________________________________________________ _______________________________Rider’s Signature Date ______________________________________________________________ __Signature of parent/Guardian (if rider is under 18) Date WARNING: UNDER NEW JERSEY LAW, AN EQUESTRIAN AREA OPERATOR IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ANIMAL ACTIVITIES RESULTING FROM THE I INHERENT RISKS OF EQUINE ANIMAL ACTIVITIES PURSUANT TO P.L.. CHAPTER 287.