Memorial Day Ride Registration Form

USTR Benefit Ride Secretary:

Peggy Niesciur

703-430-1451

LIABILITY RELEASE AND HOLD HARMLESS AGREEMENT

THIS LIABILITY RELEASE AND HOLD HARMLESS AGREEMENT is made this 25th day of May 2008 by and between United States Trail Ride, Inc., Glenwood Park Trust and landowners and __________________________________, hereinafter referred to as participant and _____________________________________ parent or guardian of participant.

In consideration, therefore, for the privilege of riding and/or working with and around horses at Glenwood Park, Middleburg, VA or at any event or trail ride participant attends or competes in with United States Trail Ride, Inc., its agents or assigns, the undersigned does hereby agree NOT TO SUE and to HOLD HARMLESS and INDEMNIFY United States Trail Ride, Inc., its agents or assigns, and successors, and further releases them from any liability or responsibility for accident, damage, injury, illness, or death to the Undersigned or to any horse owned by the undersigned, or to any family member or guest accompanying the undersigned onto the premises or to the event or trail ride.

Further, participant understands that there are intrinsic dangers of equine activities, including but not limited to (i) the propensity of equines to behave in ways that may result in injury, harm, or death to persons on or around them; (ii) the unpredictability of an equine’s reaction to such things as sounds, sudden movement, and unfamiliar objects, persons, or other animals; (iii) certain hazards such as surface and subsurface conditions; (iv) collisions with other animals or objects; and (v) the potential of a participant acting in a negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the equine or not acting within the participant’s ability.

Further, the undersigned understands that he/she is responsible for any and all insurance coverage on either his/her horse, property, or his/herself. United States Trail Ride, Inc. does not and will not carry insurance on you or your property, including your horse.

This release shall remain in full force and effect until expressly revoked in writing. The undersigned acknowledges that they have read and understand the terms of this release.

The undersigned understands that a riding helmet is required and agrees to wear a riding helmet at all times while mounted.

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Signature (Participant)

__________________________________________________

Printed name and address

In the event participant is under age eighteen (18), signature of Parent or Guardian is required

__________________________________________________

Parent/Guardian

United States Trail Ride, Inc.

Presents Their 14th Annual Benefit Pleasure Trail Ride

Sunday, May 25, 2008

Glenwood Park, Middleburg, VA

Riders may start their ride anytime between 9:00 and 11:00AM and ride at their own pace. Ride a 5-12 mile trail that includes some rocky areas, gravel roads and creek crossings (depth of water will vary depending on recent rainfall). Number of riders limited to 150. Lunch will be provided at the end of the ride. Photos and t-shirts will be available for purchase at the ride.

Rider’s Name: _________________________________________________________________

Street Address: ________________________________________________________________

City, State, Zip: ________________________________________________________________

Phone: ________________ Email (print clearly):____________________________________

Emergency Contact for day of ride: ______________ Phone #:_______________________

I will be carrying a cell phone, phone number: __________________________________

This registration form must be filled out front & back completely, include a non-returnable COPY of current negative Coggins test, signed Release Form, entry fee $40 payable to USTR, ($50 if not received by May 21^st). Mail to: