2024 Winter Schooling Show Series Entry Form

Show Date

Horse Name

Height

Owner of Horse

Rider's Name

Rider's Age

Trainer

Contact Email *

Parent/Guardian Name *

First

Last

Phone Number *

Address *

Select Classes $18/class and $5 Office Fee

Participant/Parent or Guardian* Signature/Date for Equine Activity Release Waiver, Assumption of Risk & Identification Agreements & Notification of Risks. *

In consideration of my child’s/my participation in any equine activity with Picturesque Farm, LLC at 7769 Piccadilly Drive, Warrenton, VA. I hereby release and waive any rights to legal action against Picturesque Farm, LLC, Kristy Willwerth, employees, agents, and representatives of either the LLC or the farm for any loss, damage, injury, or death to the person or property sustained by myself or child in any equine activities by any cause whatsoever, including but not limited to any risk inherent in an equine activity, such as (1) The propensity of an equine to behave in dangerous ways which may result in injury or death to a participant or bystander, damage to property (2) The inability to predict an equine’s reaction to sound, movements, conditions, objects, persons, or animals (3) Hazards of surface or of subsurface conditions whether known or unknown (4) The experience level or any participant (5) A known or unknown health condition of any participant (6) The condition and age of tack and equipment. I assume all of the forgoing risks and any other risks inherent in equine activities and accept complete responsibility for making any and all examinations or inspections relating to those risks and other potential risks of recreational activities and I agree and understand that Picturesque Farm LLC, Kristy Willwerth and employees shall have no responsibility whatsoever to make any such examination or inspection. I further assume all risk of, and agree to hold harmless the LLC owner, farm owners, their employees, representatives, and agents from and against, any and all loss, dam age, injury, or death to person or property, by whatever cause, including: any act of omission, negligent or otherwise, on the part of the farm or LLC owners, their employees, representatives, or agents or on the part of any other person. I hereby certify that the foregoing statements and representation are being made knowingly, freely, and voluntarily and I understand that Kristy and Picturesque Farm LLC, are expressly relying upon the foregoing statement and representations in permitting me/my child’s participation in any equine activities.