Criswood Farm I (Manassas) - Summer Riding Camp Release and Hold Harmless Agreement

Please complete, sign and date the below agreement and mail or bring to the farm with deposit.

Name of Rider:___________________________ Age:________  Phone Number____________________



Previous Riding Experience:______________________________________________________________

To reserve your course dates, complete this application and return to Criswood with a deposit of $50 for each week desired. The remaining balance is due the first full day of camp. Deposits are non-refundable. You may sign up for more than one session.

June 11 - 15 July 2 - 6   August 6 -10  
June 18 - 22
July 9 - 13   August 13 - 18  
June 25 - 29 July 16 - 20   August 20 - 24  
  July 23 - 27      
    July 30 - Aug 3      

Please indicate an allergies or medical conditions that could affect participation during horse camp:



The Undersigned assumes the unavoidable risks inherent in all horse related activities, including but not limited to, body injury or physical harm to horse, rider, and spectator. In consideration, therefore, for the privilege of riding and receiving riding instructions, and/or working around/with horses at Criswood Farm (Hoadly Road, Manassas, VA) or other equestrian facility assigned, the Undersigned does hereby agree to hold harmless and indemnify Criswood Farm Manager, Instructor, Connie Christopher, Criswood Farm, Inc., owners and heir assigns and further release the Farm from any liability or responsibility for accident, damage, death, injury, or illness to the Undersigned and his/her children or any horse owned and/or boarded by the Undersigned or to any other family member of spectator accompanying the Undersigned on the premises. I, the Undersigned person, intending to be legally bound, hereby waive for myself, agents, guardians, heirs, executors, administrators, legal representatives, assigns, and any other persons have against any of the above named individuals, or their property, arising from my equestrian or boarding activities.

By my signature, I acknowledge that I understand the above, and that handling and/or riding horses is considered hazardous activity, and I assume full liability for any personal injury or property damage to my person, child and children, person accompanying me, personal property and horses.

Signature of Parent or Guardian:________________________________________________________________

Printed Name of Parent or Guardian:_____________________________________________________________