Hat Creek Hustle Endurance Rides                                Ride Entry Form

     Saturday, June 21, 2008 – 25 & 50 miles                           

      Sunday, June 22, 2008 – 25 & 50 miles                             **Limited to first 125 paid entries**        

                  AERC Sanctioned

 

 

Please check which day(s) you will be riding:

 

Saturday 25 mi.                          Saturday 50 mi.                               Sunday 25 mi.                        Sunday 50 mi.                         10 Mi. Fun

                   $95.00                                      $110.00                                            $95.00                                   $110.00                                $55.00

 

               (includes all Aerc ins. Fees and CA drug testing fee)                                                                                      Rides Total     $              

 

Both Days Discount (if postmarked by June 7th)……………………………………………..……………………………… -$10.00 per ride      $

 

AERC non member fee ……………………………………………………………………………………………………….……  +$15.00 per day     $

 

Juniors rider Discount  ……………………………………………………………………………………………………………   -$25.00 per day     $ 

 

2008 Ride managers   - Free ride entry with written evaluation of our ride ………… ….……………………………………………………  $

 

Extra Tri Tip Dinner Tickets per night  $15.00  Saturday  #__________     Sunday #__________   .....................................................  $

  

Checks will be cashed as received.  Refunds will be paid promptly.                                                        Total Enclosed         $

 

Entries received after we have reached 125 paid entries will be placed on a waiting list and notified if a spot opens.    

Cancellations by June 17th receive a full refund. After the 17th all but $20 will be refunded. No shows will receive no refund.

Mail checks & send entries to ride secretary:  Jana Lydon, 4955 Wilson Hill Rd.  Manton, Ca  96059     530-474-4753

 

 

 

 

Rider _________________________________________________________________   Age ________  AERC # ____________

 

    Sponsor’s Name & AERC # (if this entry is for a junior rider) ____________________________________________     AERC # _________________

 

Phone _____________________________________ Email address ________________________________________________

 

Address ___________________________________________________________________________________________________

City __________________________________________ State __________________________ Zip ____________________

 

Division: ___FW (up to 160lbsw.tack) ___LW (162-185llbs w/tack) ___MW (186-210 lbs w/tack) ___HW (211 lbs & up w/tack) ____JR

 

Saturday Horse ___________________________________________________ Age ____ Sex _____ Breed _______________

 

AERC # ______________ Color / Markings ___________________________________________________________________

 

   Horse owner (if other than yourself) _________________________________________________________________________ AERC # ______________

 

Sunday Horse ____________________________________________________ Age ____ Sex _____ Breed _______________

 

AERC # _____________ Color / Markings ____________________________________________________________________

 

   Horse owner (if other than yourself) _________________________________________________________________________ AERC # ______________

 

Emergency Contact: ___________________________________________________ Phone: ____________________________

 

Liability Release must be signed!!

Thank you from the Hat Creek Hustle Group.

 

 

Rider Liability Release

 

I, _____________________________________, acknowledge that I have voluntarily applied to participate in the Hat Creek Hustle Rides. I am aware that distance riding on horseback involves being in remote areas for extended periods of time, far from communication, transportation and medical facilities; that these area have many natural and manmade hazards which ride management cannot anticipate, identify, or eliminate; that horses can be excitable, unpredictable and difficult to control; that accidents can happen to anyone at anytime and that such accidents can result in great bodily harm or even death of the horse and/or rider. I agree to take full responsibility for myself and the animal I am riding. As consideration for being permitted to participate in the ride and use the facilities provided by ride management. I agree that I, my assignees, heirs, distributees, guardians and legal representatives will not make a claim against Rob Lydon, ride management, any ride personnel, volunteers or veterinarians, or the American Endurance Ride Conference for any accident, injury or loss that might occur due to my participation in the ride or related activities. I hereby release any and all of those persons and organizations from all actions, claims, or demands that I, my assignees, heirs, distributees, guardians and legal representatives now have or may hereafter have for injury or damage resulting from my participation in the Hat creek Hustle Rides or related activities. I agree to indemnify any and all of those persons and organizations from any damages or expenses, including attorney’s fees, occasioned by claims made by me or on my behalf relating to the ride. I have carefully read and understand this Liability Release. I fully understand its contents and my signature below constitutes acceptance of the above terms and conditions.

 

Date: ______________________   Rider Signature: _____________________________________________________

 

Minor Rider Liability Release & Consent:

  (The parent or guardian of All Riders under 18) must sign below.

 

I, __________________________________________________ am the parent or legal guardian of the minor

 ______________________________________________, who will be attending and/or riding in the Hat Creek Hustle Rides. I, the undersigned parent/guardian of, for and in consideration of my child’s participation in the Hat Creek Hustle Ride, agree not to make a claim against or sue Rob Lydon, ride management, any ride personnel, volunteers or veterinarians, or the American Endurance Ride Conference for any accident, injury or loss to my child or my child’s horse under my child’s direction and control. I hereby release any and all of those persons and organizations from all actions, claims, or demands, that I, my assignees, heirs, distributees, guardians and legal representatives now have or may hereafter have for injury or damage resulting from my child’s participation in the Hat Creek Hustle Rides or related activities. I agree to indemnify any and all of those persons for any damages or expenses, including attorney’s fees, occasioned by claims made on behalf of my child relating to the ride. I also authorize any officer, director or supervisory personnel of the Hat Creek Hustle Ride to consent on my behalf for any emergency medical treatment which may be required for my child and do agree to indemnify and hold harmless anyone giving such consent. I also know that AERC rules require a rider under 16 years of age to wear a protective helmet. I have carefully read and understood this Liability Release. I fully understand its contents and my signature below constitutes acceptance of the above terms and conditions.

 

Date: _________________  Signature of Parent/Guardian: ____________________________________________________

 

 

 

PS.     I will have fun and won’t be a dork!                  Initial ___________

 

Thank You.