Hop in the Saddle Again!

Size: px
Start display at page:

Download "Hop in the Saddle Again!"

Transcription

1 2016 Horse Lover s Camps at the Oglebay Stables Hop in the Saddle Again! English Camp Cost: $265.00/week tax included Weight Restrictions: Riders need to be at least 7 years old and must weigh under 200 pounds Beginner Appropriate for campers with little or no horse experience. Camps will include instruction on topics of horse safety, grooming and basic horse care. Weather permitting, campers will swim in the afternoon. June 6-10, 2016 June 13-17, 2016 June 20-24, 2016 June 27 - July 1, 2016 Intermediate Campers will have had 6 months of riding lessons. Campers should be able to groom and tack with little assistance and trot independently. Camps will include instruction on safety, horse care, breeds, colors & bandages. Weather permitting, campers will swim in the afternoon. July 11-15, 2016 July 18-22, 2016 Advanced Campers will be learning to canter and should be able to walk and trot along the rail and during exercises without assistance. Campers should be able to groom and tack independently. Camps will include instruction on safety, equine nutrition, exercising horses and disciplines. Campers will ride twice daily. Please submit a riding video of student's previous riding lesson for advanced camp acceptance. July 25-29, 2016 All camps will begin at 9AM and drop off will be located at the office of the barn. Pickup is at 3PM for Beginner and Intermediate Camps at the outdoor pool, weather permitting. Pickup is at 3PM at the office of the barn for Advanced Campers. Parents will need to show identification. Call the stables at to register or download forms at FREQUENTLY ASKED QUESTIONS How soon do I have to register? Class size is limited, so reserve your space today! Registrations will be accepted as long as openings are available. All riders must have a registration, liability release and emergency medical release completed by a parent / legal guardian. The forms are available on our website or you may pick one up at the stables. Can I/my family come to watch my child ride? Family and friends are welcome to come watch campers from designated areas. There will be a brief presentation on the last day of camp for all families and guests. How much time will campers spend riding? Campers will ride for approximately 1 hour each day (including mounting time). They will also have 2-3 hours of groundwork with the horses. What should campers wear? Do they need to bring anything for camp? All campers/riders must wear long pants and boots with a low heel. Tennis shoes or sneakers are acceptable. Open-toed footwear is not permitted. All campers/riders are required to wear and ASTM/SEI certified helmet. Helmets will be provided. Bicycle helmets are not approved or allowed for horseback riding. Weather permitting, all riding will be outside. Campers should bring a packed lunch and an extra drink or water bottle. They may order a boxed lunch for an additional fee. Other suggestions: Sunscreen, a jacket for cooler weather, bug repellent. Will my child be able to choose his/her horse/pony? We use both horses and ponies for camp. Horse/pony assignments will be made by the riding instructor, and will be based on the riders skill level and size. Campers will usually ride the same horse/pony throughout the week but groundwork will be done with other horses/ponies. Campers who have ridden here before may request their favorite mount, and we will do our best to accommodate all requests. However, we cannot guarantee that all requests will be met. What do you offer besides camp? We offer trail rides, pony rides, English/ Western lessons and EAGALA services. For more information on any of the services we offer, you can contact us at

2 2016 Horse Lover s Camps at the Oglebay Stables 2016 Horse Lover s Camp at the Oglebay Stables - Registration Form Camper s Name: Date of Birth: Camp Date/Level: Parent or guardian: Allergies: Phone #: Other #: Address: City: State: Zip code: Does the rider have any physical/mental limitations that would prevent them or make them less able to participate in horseback riding? If so, please explain. Does the rider have any previous riding experience? If so, what discipline? Photographs will be taken at the 2016 Horse Camp. By signing below, I agree to allow Bethany College and Oglebay Stables to use my son or daughters photo in any Oglebay Park or Bethany College related publications or on their websites. Signature of parent or guardian: Lunch Chart Calculator: My child will bring his/her lunch: No charge My child will bring his/her lunch but will also purchase box lunch(es) on Mon 1 Tues 1 Wed 1 Thurs 1 Fri 1 x $5.75 = $ My child will purchase box lunches for the week. _ week(s) x $26.95 = $ Lunches must be ordered at least 1 week prior to the start of camp. The following people are authorized to pick up my child. Proper ID required at pick-up: I understand that the information provided above is accurate to the best of my knowledge. I know of no reason that the rider should not participate in horseback riding at Bethany College/Oglebay Stables. Date: Signature of parent or guardian: Mail completed registration form, emergency medical treatment form and payment to: Oglebay Stables Route 88 N, 465 Lodge Drive Wheeing, WV Make checks payable to Oglebay Stables

3 2016 Horse Lover s Camps at the Oglebay Stables Please return this form with registration form. AUTHORIZATION FOR EMERGENCY MEDICAL TREATMENT In the event that medical aid/treatment is required due to illness or injury while at Bethany College/Oglebay Stables, I authorize Bethany College/Oglebay Stables to 1) Secure and retain medical treatment and transportation if needed and 2) Release any client records upon request to the authorized individual or agency involved in the emergency medical treatment. Name: Date of Birth: Emergency contacts: Name Relation Phone number Name Relation Phone number Allergies: Physician s name: Phone: Preferred medical facility: Health insurance company: Policy #: Consent Plan This authorization includes x-rays, surgery, hospitalization, medication, any treatment deemed life saving by the physician. This provision will only be involved if the emergency contacts listed above are unable to be contacted. Date: Signature: Non-consent Plan I do not give my consent for emergency medical treatment/aid in the case of illness or injury while at Bethany College/Oglebay Stables. In the event emergency medical treatment/aid is required, please follow the steps listed below or on the back of this sheet. Date: Signature: Mail completed registration form, emergency medical treatment form and payment to: Oglebay Stables Route 88 N, 465 Lodge Drive Wheeing, WV Make checks payable to Oglebay Stables

4 Duties of Participant Bethany College Release Form I, hereinafter referred to as participant, hereby duly acknowledge and understand the following concerning my participation in the equestrian activities at Bethany College/Oglebay Stables: 1. I understand that there are inherent risks in my participation in equestrian activities which are essentially impossible to eliminate; 2. I assume the risk of any legal responsibility for any injury, loss or damage to any person or property from my participation in equestrian activities at Bethany College/Oglebay Stables; 3. I have the sole responsibility for knowing the range of my ability to manage, care for, and control any particular horse or perform any particular equestrian activity, and it is at all times my duty to act within the limits of my ability to maintain reasonable control of any horse with which I come in contact; 4. I agree to abide by all posted warnings and to perform equestrian activities only in the areas designated by Bethany College/Oglebay Stables; 5. I agree to refrain from acting in any manner which may cause or contribute to the injury of any person or property; 6. If I am involved in any accident or collision while on the premises of Bethany College/Oglebay Stables, I will not leave the premises without providing Bethany College/Oglebay Stables with my name address and telephone number and I shall advise Bethany College/Oglebay Stables immediately if I am in need of medical attention for any such accident or collision. I shall complete an accurate written accident report on forms provided by Bethany College/Oglebay Stables; 7. I agree to abide by all direction, rules and instructions made by the operators of Bethany College/Oglebay Stables. Any failure to follow directions, rules and instruction will result in my inability to participate further in the equestrian activities., 2016 Date / Year Signature of Participant -or- *Legal Guardian Printed name of Participant Printed name of *Legal Guardian (if appl.) *Form must be signed by a legal guardian if the participant is under 18 years of age.

5 Participants Release of Liability, Assumption of Risk and Waiver of Claims This Release of Liability, Assumption of Risk, and Waiver of Claims is made and entered into by the participant named above, or his/her legal guardian, in favor of Bethany College/Oglebay Stables. For and in consideration of the Participant s opportunity to use the property, facilities and services of Bethany College/Oglebay Stables, the Participant, on behalf of himself or herself, his or her heirs, guests, employees, servants and agents, assigns and legal representatives, hereby expressly agrees as follows: 1. Participant agrees to assume any and all risks involved in or arising from participant s use of or presence upon Bethany College/Oglebay Stables property or facilities, including without limitation, but not limited to, the risk of death, bodily injury, paralysis, property damage, and emotional distress from falls, kicks, bites, trampling, collisions with vehicles, horses or objects, fire, explosion or the unavailability of emergency medical care. 2. I understand that equestrian activities are inherently dangerous and that serious injury or death are risks of participating in equestrian activities and I affirmatively desire to assume those risks among others listed herein, and to release Bethany College/Oglebay Stables from any liability for injuries to me as a result of my participation in equestrian activities or my presence on the property of Bethany College/Oglebay Stables. I have been provided with a copy of the West Virginia Equestrian Activities Responsibility Act, which is attached, and I have read and understand the same. 3. I understand that no person under the age of 18 is permitted to mount a horse or to participate in equestrian activities at Bethany College/Oglebay Stables at any time without wearing an ASTM or SEI certified helmet. 4. Except with respect to claims arising from the intentional, willful or wanton misconduct of Bethany College/Oglebay Stables, Participant agrees to RELEASE and DISCHARGE Bethany College/Oglebay Stables and all of its affiliated entities, its successors, assigns, subsidiaries, franchisees, affiliates, officers, directors, employees and agents and hold them completely harmless and not liable, and release them from all liability whatsoever and AGREES NOT TO SUE them on the account of or in connection with any claims, causes of action, injuries, damage, costs or expenses arising out of the Participant s use of any horses for recreational purposes, or presence upon Bethany College s/oglebay Stables property and facilities, including, without limitation, those based on death, bodily injury, property damage, and consequential damages., 2016 Date / Year Signature of Participant -or- *Legal Guardian Printed name of Participant Printed name of *Legal Guardian (if appl.) *Form must be signed by a legal guardian if the participant is under 18 years of age. Address City, State, Zip Code Telephone Number *Form must be signed by a legal guardian if the participant is under 18 years of age.

6 WEST VIRGINIA CODE ANNOTATED CHAPTER 20. NATURAL RESOURCES ARTICLE 4. EQUESTRIAN ACTIVITIES RESPONSIBILITY ACT W. Va. Code (1994) Definitions In this article, unless a different meaning plainly is required: (1) "Equestrian activity" means any sporting event or other activity involving a horse or horses, including, but not limited to: (A) Shows, fairs, competitions, performances or parades; (B) Any of the equine disciplines such as dressage, hunter and jumper shows, grand prix jumping, three day events, combined training, rodeos, driving, western games and hunting; (C) Rides, trips or hunts; (D) Riding classes, therapeutic riding programs, school and college sponsored classes and programs, or other classes in horsemanship; (E) The boarding or keeping of horses; and (F) Providing equipment or tack. (2) "Horseman" or "operator of a horseman's business" means any individual, sole proprietorship, partnership, association, public or private corporation, in the United States or any federal agency, this state or any political subdivision of this state, and any other legal entity which engages, with or without compensation, in organizing, promoting, presenting or providing equestrian activities or in providing facilities for equestrian activities. (3) "Horse" means each animal of the horse kind, in every class or breed of horses, and, without limitation or exception, all members of the genus Equus and family Equidae. (4) "Participant" means any person using the services or facilities of a horseman so as to be directly involved in an equestrian activity. W. Va. Code (1994) Duties of horsemen Every horseman shall: (1) Make reasonable and prudent efforts to determine the ability of a participant to safely engage in the equestrian activity, to determine the ability of the horse to behave safely with the participant, and to determine the ability of the participant to safely manage, care for and control the particular horse involved; (2) Make known to any participant any dangerous traits or characteristics or any physical impairments or conditions related to a particular horse which is involved in the equestrian activity of which the horseman knows or through the exercise of due diligence could know; (3) Make known to any participant any dangerous condition as to land or facilities under the lawful possession and control of the horseman of which the horseman knows or through the exercise of due diligence could know, by advising the participant in writing or by conspicuously posting warning signs upon the premises; (4) In providing equipment or tack to a participant, make reasonable and prudent efforts to inspect such equipment or tack to assure that it is in proper working condition and safe for use in the equestrian activity; (5) Prepare and present to each participant or prospective participant, for his or her inspection and signature, a statement which clearly and concisely explains the liability limitations, restrictions and responsibilities set forth in this article. W. Va. Code (1994) Duties of participants It is recognized that equestrian activities are hazardous to participants, regardless of all feasible safety measures which can be taken. Each participant in an equestrian activity expressly assumes the risk of and legal responsibility for any injury, loss or damage to person or property which results from participation in an equestrian activity. Each participant shall have the sole individual responsibility for knowing the range of his or her own ability to manage, care for, and control a particular horse or perform a particular equestrian activity, and it shall be the duty of each participant to act within the limits of the participant's own ability, to maintain reasonable control of the particular horse or horses at all times while participating in an equestrian activity, to heed all posted warnings, to perform equestrian activities only in an area or in facilities designated by the horseman and to refrain from acting in a manner which may cause or contribute to the injury of anyone. If while actually riding in an equestrian event, any participant collides with any object or person, except an obviously intoxicated person of whom the horseman is aware, or if the participant falls from the horse or from a horse-drawn conveyance, the responsibility for such collision or fall shall be solely that of the participant or participants involved and not that of the horseman. A participant involved in an accident shall not depart from the area or facility where the equestrian activity took place without leaving personal identification, including name and address, or without notifying the proper authorities, or without obtaining assistance when that person knows or reasonably should know that any other person involved in the accident is in need of medical or other assistance. W. Va. Code (1994) Liability of horsemen (a) A horseman shall be liable for injury, loss or damage caused by failure to follow the duties set forth in section three [ ] of this article where the violation of duty is causally related to the injury, loss or damage suffered. A horseman shall not be liable for any injury, loss or damage caused by the negligence of any person who is not an agent or employee of such horseman. (b) A horseman shall be liable for acts or omissions which constitute gross negligence or willful and wanton conduct which is the proximate cause of injury to a participant. (c) A horseman shall be liable for an intentional injury which he or she inflicts upon a participant. (d) Every horseman shall carry public liability insurance in limits of no less than one hundred thousand dollars per person, three hundred thousand dollars per occurrence and ten thousand dollars for property damage. W. Va. Code (1994) Liability of participants Any participant shall be liable for injury, loss or damage resulting from violations of the duties set forth in section four [ ] of this article. W. Va. Code (1994) Applicability of article The provisions of this article do not apply to the horse racing industry that is regulated by the provisions of article twenty-three [ et seq.], chapter nineteen of this code.

King s Derby Registration Form

King s Derby Registration Form Thank you for choosing to enter OBIC s where over $4000 in Cash and prizes will be given away!! It is our heart to be able to offer our services to children and special needs individuals at no cost. Currently

More information

Whispering Manes Therapeutic Riding Center 6255 SW 125th Avenue Miami, FL 33183 305.909.4343

Whispering Manes Therapeutic Riding Center 6255 SW 125th Avenue Miami, FL 33183 305.909.4343 Whispering Manes Therapeutic Riding Center 6255 SW 125th Avenue Miami, FL 33183 305.909.4343 LQIR#ZKLVSHULQJPDQHV RUJ Volunteer/ Employee Information Form And Health History Name: Date: Date of Birth:

More information

Cassidy s Cause Therapeutic Riding Academy 6075 Clinton Rd Paducah, KY 42001 270-554-4040

Cassidy s Cause Therapeutic Riding Academy 6075 Clinton Rd Paducah, KY 42001 270-554-4040 VOLUNTEER / INTERN APPLICATION 2014 Thank you for your interest in volunteering with Cassidy s Cause! Our volunteers are the backbone of our program and without them our riders could not ride. Please complete

More information

camp rules/behavior agreement

camp rules/behavior agreement camp rules/behavior agreement Lake Metroparks camps use assertive discipline techniques that are used to strengthen good behavior by the use of positive reinforcement such as verbal praise, smiles, awards,

More information

Backcountry Outdoor Adventure Camp

Backcountry Outdoor Adventure Camp Backcountry Outdoor Adventure Camp Get outdoors. Connect with nature. Focused on combining a passion for biology, conservation, and ecology with outdoor recreation. Registration Packet is due by: Registration

More information

LIABILITY 2010 AGRI-TOURISM IS IT FOR YOUR FARM OR RANCH?

LIABILITY 2010 AGRI-TOURISM IS IT FOR YOUR FARM OR RANCH? LIABILITY 2010 AGRI-TOURISM IS IT FOR YOUR FARM OR RANCH? Kathie Troudt Riley Practice emphasis includes agricultural and rural law issues Loveland law office 150 East 29 th Street, Suite 265, Loveland,

More information

NE Horse Training Contract 1/6 TRAINING CONTRACT

NE Horse Training Contract 1/6 TRAINING CONTRACT NE Horse Training Contract 1/6 TRAINING CONTRACT WITNESS THIS AGREEMENT this day of, 20, by and between, hereinafter referred to as Trainer and, hereinafter referred to as Owner, and if Owner is a minor,

More information

PARTICIPANT AGREEMENT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

PARTICIPANT AGREEMENT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT PARTICIPANT AGREEMENT RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT I, the undersigned, on behalf of my minor child: ( Participant ), hereby acknowledge that Participant has

More information

IMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING

IMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING IMPORTANT: THIS IS A LEGAL DOCUMENT, PLEASE READ AND UNDERSTAND THIS DOCUMENT BEFORE SIGNING. ASSUMPTION OF RISK, WAIVER OF LIABILITY AND INDEMNIFICATION AGREEMENT This agreement (the Agreement ) must

More information

2014 TOTAL WIMPS ODE

2014 TOTAL WIMPS ODE TARC PROUDLY PRESENT THE 2014 TOTAL WIMPS ODE Equestrian Park Curtin Sunday 26 th October, 2014 TARC is pleased to present our annual One Day Event for the less confident rider (aka The Wimps). There will

More information

2016 FLORISSANT SUMMER PLAYGROUND INFORMATION AND POLICIES

2016 FLORISSANT SUMMER PLAYGROUND INFORMATION AND POLICIES 2016 FLORISSANT SUMMER PLAYGROUND INFORMATION AND POLICIES CAMP LOCATIONS CAMP DATES/TIMES June 6 July 15, 2016 James J. Eagan Center (300) 9:00am 3:00pm Koch Park (320) No camp July 4th All Prices Subject

More information

One Day Show Bill ~ Thursday, July 9th, 2014, 8:00 a.m. Location: Red River Valley Fairgrounds Check-in Opens at 7:00 a.m.

One Day Show Bill ~ Thursday, July 9th, 2014, 8:00 a.m. Location: Red River Valley Fairgrounds Check-in Opens at 7:00 a.m. One Day Show Bill ~ Thursday, July 9th, 2014, 8:00 a.m. Location: Red River Valley Fairgrounds Check-in Opens at 7:00 a.m. Judge: Laurie Holverson Dressage test Pre-entries must be postmarked on or before

More information

Clackamas County 4- H Oregon City, Oregon. Oregon s Equine Inherent Risk Law: An Overview. February 12, 2014

Clackamas County 4- H Oregon City, Oregon. Oregon s Equine Inherent Risk Law: An Overview. February 12, 2014 An Overview Clackamas County 4-H Meeting Canby, Oregon February 12, 2014 ORS 30.687 30.698 Only applies to certain injuries/harm Only protects certain people/entities Each state s equine inherent risk

More information

NEW STUDENT REGISTRATION

NEW STUDENT REGISTRATION NEW STUDENT REGISTRATION High Performance: Academy Prep: Early Childhood: $20.00 registration fee (includes 2 Academy T-shirts) $20.00 registration fee (includes 2 Academy T-shirts) $10.00 registration

More information

$138 $138. ($125 + $13 shavings) $138

$138 $138. ($125 + $13 shavings) $138 UF/IFAS Okeechobee County 4-H Program in conjunction with Children s Services Council of Okeechobee County Presents: 2013 Just Horsing Around Day Camp $125/Week + $13 shavings fee Youth must be 8 years

More information

FUN IN THE SUN SUMMER DAY CAMP BEHAVIORAL CONTRACT

FUN IN THE SUN SUMMER DAY CAMP BEHAVIORAL CONTRACT FUN IN THE SUN SUMMER DAY CAMP BEHAVIORAL CONTRACT This contract is to be signed by both the participant (child) and his or her parent/guardian. This ensures that both the child and the adult understand

More information

Brandon Light Horse & Pony Society Inc. Spring Schooling Show

Brandon Light Horse & Pony Society Inc. Spring Schooling Show Brandon Light Horse & Pony Society Inc. Spring Schooling Show Keystone Centre Brandon, MB Westoba Agricultural Centre of Excellence Arena February 16 & 17, 2013 General Information Judge: Jane Haglund

More information

LIABILITY RELEASE. Walk on Water Ministries 3330 Perkinson Lane Merritt Island, FL 32953 (321) 412-8057 Praisedancer.bryan426@gmail.

LIABILITY RELEASE. Walk on Water Ministries 3330 Perkinson Lane Merritt Island, FL 32953 (321) 412-8057 Praisedancer.bryan426@gmail. Walk on Water Ministries 3330 Perkinson Lane Merritt Island, FL 32953 (321) 412-8057 Praisedancer.bryan426@gmail.com LIABILITY RELEASE In consideration of being allowed to participate in horseback riding

More information

Kansas Speedway 400 Speedway Blvd Kansas City KS 66111 Ticket Office 913.328.3300 www.kansasspeedwaycorp.com COMING 70E

Kansas Speedway 400 Speedway Blvd Kansas City KS 66111 Ticket Office 913.328.3300 www.kansasspeedwaycorp.com COMING 70E Kansas Speedway 400 Speedway Blvd Kansas City KS 66111 Ticket Office 913.328.3300 www.kansasspeedwaycorp.com COMING 70E TAKE 435N EXIT 411B TO STATE AVE WEST EXIT 13B COMING 70W TAKE 435N EXIT 411B TO

More information

Earn money from you racing, from your pictures, Youtube videos and more! Only by posting on DRR Riders Group on Facebook.

Earn money from you racing, from your pictures, Youtube videos and more! Only by posting on DRR Riders Group on Facebook. Earn money from you racing, from your pictures, Youtube videos and more! Only by posting on DRR Riders Group on Facebook. Eligibility: All payouts are based on model year Current model year vs non current

More information

CHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING

CHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING CHICAGO RUNNING TOURS & MORE, LLC WAIVER AND RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT PLEASE REVIEW THOROUGHLY BEFORE SIGNING The undersigned, in consideration of being permitted to participate

More information

West Virginia University 2015 Forensic Science Summer Camp

West Virginia University 2015 Forensic Science Summer Camp Thank you for registering for the! This packet contains the following forms that must be completed and returned before the student will be allowed to attend camp: Participant Information Form Event Participant

More information

Youth Camp Civic Center

Youth Camp Civic Center Youth Camp Civic Center Household ID # Please circle the session(s) that your child(ren) will attend Session One June 8- June 12 Session Two June 15 June 19 Session Three June 22 June 26 Session Four June

More information

Indianapolis Motor Speedway 4790 West 16 th Street Indianapolis IN 46222 Ticket Office 317.484.6700 www.brickyard400.com

Indianapolis Motor Speedway 4790 West 16 th Street Indianapolis IN 46222 Ticket Office 317.484.6700 www.brickyard400.com Indianapolis Motor Speedway 4790 West 16 th Street Indianapolis IN 46222 Ticket Office 317.484.6700 www.brickyard400.com From the Airport: Take I-465 north to exit 16A. Turn right at the top of the exit

More information

Elk Grove Park District Preschool Date

Elk Grove Park District Preschool Date Class For Office Use Only New/Readmit Birth Cert. In/Out of Dist Release Medical Elk Grove Park District Preschool Date Name of Child M F Date of Birth Age Primary Phone # Address City Zip Primary e-mail:

More information

ARCADIA YOUTH RODEO ASSOCIATION, INC. 124 Heard Street, Arcadia, Florida 34266 863-494-2014 2015-2016 SEASON MEMBERSHIP APPLICATION

ARCADIA YOUTH RODEO ASSOCIATION, INC. 124 Heard Street, Arcadia, Florida 34266 863-494-2014 2015-2016 SEASON MEMBERSHIP APPLICATION 2015-2016 SEASON MEMBERSHIP APPLICATION MEMBER INFORMATION: BACK TAG # ISSUED: MEMBER NAME: ADDRESS: CITY: STATE: ZIP: HOME PHONE: CEL #: E-MAIL ADDRESS: (Please send newsletter via: Mail E-Mail ) DATE

More information

GATEWAY DISCOVERY CAMP

GATEWAY DISCOVERY CAMP GATEWAY DISCOVERY CAMP SUMMER 2 0 1 6 REGISTRATION FORM Gateway Science Museum will host three sessions of the Gateway Discovery Camp. All sessions run 9am to 3pm and include daily snacks and lunches.

More information

RYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME

RYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME RYE AIRFIELD 6 AIRFIELD DRIVE RYE, NEW HAMPSHIRE 03870 WAIVER, RELEASE OF LIABILITY AND INDEMNITY AND HOLD HARMLESS AGREEMENT PARTICIPANT S NAME UNDER 18 YEARS (SIGNED AND INITIALED BY PARTICIPANT AND

More information

Boarder s Contact Information: Name: E-mail: Phone Number(s): Sex: Social Security Number:

Boarder s Contact Information: Name: E-mail: Phone Number(s): Sex: Social Security Number: Killingsworth Arena LLC P.O. Box 1903 Alpine, Texas. 79830 phone(432)294-2335 Equine Boarding Agreement & Release of Liability This Equine Boarding Agreement is being entered into by and between the Boarder

More information

Race Guide. Orange County. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run!

Race Guide. Orange County. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Be Happy. Be Healthy. Be You. Race Guide Orange County Welcome to The Color Run! Thanks to you and all of your newest friends for making The Color Run one of America s biggest 5k events! We have made this

More information

ECKERD COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS PARTICIPANTS

ECKERD COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS PARTICIPANTS ECKERD COLLEGE RELEASE AND WAIVER: CAMP PROGRAMS PARTICIPANTS Summer Watersports Camp All-Sports Camp Baseball Camp Basketball Camp Golf Camp Sailing Camp Soccer Camp Softball Camp Tennis Camp Volleyball

More information

Karate Adventure Summer Camp

Karate Adventure Summer Camp Karate Adventure Summer Camp Our Summer Karate Camp is one of the most unique summer camps available to children. It provides an enriching selection of self defense activities as well as many fun summer

More information

Race Guide. Seattle. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Seattle Center Pavillion 305 Thomas St Seattle, WA 98109

Race Guide. Seattle. Packet Pick-Up. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Seattle Center Pavillion 305 Thomas St Seattle, WA 98109 Be Happy. Be Healthy. Be You. Race Guide Seattle Welcome to The Color Run! Thanks to you and 7,500 of your newest friends for making The Color Run one of America s biggest 5k events! We have made this

More information

California Polytechnic State University, Pomona Vietnamese Student Association. Family. Honor. Tradition.

California Polytechnic State University, Pomona Vietnamese Student Association. Family. Honor. Tradition. California Polytechnic State University, Pomona Vietnamese Student Association Family. Honor. Tradition. ACCIDENT WAIVER AND RELEASE OF LIABILITY FORM Name of Activity or Event: CAL POLY POMONA VSA WINTER

More information

Equine Commercial General Liability

Equine Commercial General Liability Equine Commercial General Liability Exclusively Underwritten By AMERICAN EQUINE INSURANCE GROUP Producer: Policy and/or Renewal #: Expiration Date: Requested Effective Date: Number: Incomplete applications

More information

Compass Road to College Summer Tour Application

Compass Road to College Summer Tour Application Compass Road to College Summer Tour Application Student Information Name: Email Address: Sex: F M Birth Date: Primary Language Spoken at Home: English Spanish Other: Current School: School You ll be Attending

More information

2210 High Tech Road, State College, PA 16803 814-357-6898 fax 814-357-6897 www.pennskates.com

2210 High Tech Road, State College, PA 16803 814-357-6898 fax 814-357-6897 www.pennskates.com Dear Summer Camp Parents, 2210 High Tech Road, State College, PA 16803 814-357-6898 fax 814-357-6897 www.pennskates.com Welcome to our 2015 Summer Day Camp program! Your children will have the opportunity

More information

Release of Liability. Printed Name of Participant:

Release of Liability. Printed Name of Participant: Release of Liability IN CONSIDERATION of being given the opportunity to participate in any USRowing activity, including scheduled, supervised club activities, and registered regattas, during the policy

More information

SAINT LOUIS UNIVERSITY STUDY ABROAD PARTICIPATION AGREEMENT AND ASSUMPTION OF RISK AND RELEASE OF CLAIMS

SAINT LOUIS UNIVERSITY STUDY ABROAD PARTICIPATION AGREEMENT AND ASSUMPTION OF RISK AND RELEASE OF CLAIMS SAINT LOUIS UNIVERSITY STUDY ABROAD PARTICIPATION AGREEMENT AND ASSUMPTION OF RISK AND RELEASE OF CLAIMS I, ( ) the undersigned student wish to participate in a study abroad Program offered by Saint Louis

More information

Welcome to Camp Gan Israel of Beachwood s 3 rd summer of Horseback Riding Camp!!

Welcome to Camp Gan Israel of Beachwood s 3 rd summer of Horseback Riding Camp!! Camp Gan Israel of Beachwood ~ Where being Jewish is fun! Mailing Address: 25400 Fairmount Blvd. ~ Beachwood, Ohio 44122 Office: 216-282-2267 Fax: 216 920-9555 בס "ד Welcome to Camp Gan Israel of Beachwood

More information

2016 Release and Waiver of Liability PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS!

2016 Release and Waiver of Liability PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS! 2016 Release and Waiver of Liability PLEASE READ CAREFULLY! THIS IS A LEGAL DOCUMENT THAT AFFECTS YOUR LEGAL RIGHTS! This Release and Waiver of Liability (the Release ) is executed on this day of (month),

More information

Delaware, Dubuque and Jackson County Regional Transit Authority. 7600 Commerce Park Dubuque, IA 52002 1 800 839 5005 www.rta8.org

Delaware, Dubuque and Jackson County Regional Transit Authority. 7600 Commerce Park Dubuque, IA 52002 1 800 839 5005 www.rta8.org Delaware, Dubuque and Jackson County Regional Transit Authority 7600 Commerce Park Dubuque, IA 52002 1 800 839 5005 www.rta8.org How it works: Pick up a volunteer drivers handbook (see page 3 for where

More information

without a signed waiver Santa Fe, NM 87506 Fax: 505 820 Student Name: City: Zip: State: Physician's Name: Parent Name(s): Parent Address: City:

without a signed waiver Santa Fe, NM 87506 Fax: 505 820 Student Name: City: Zip: State: Physician's Name: Parent Name(s): Parent Address: City: Please mail application to: Las Campanas Compadres, Inc. 15 Buckskin Circle Santa Fe, NM 87506 Fax: 505 820 2709 Las Campanas Compadres, Inc. Student Application Form Please be sure to sign the waiver

More information

COMMERCIAL EQUINE LIABILITY

COMMERCIAL EQUINE LIABILITY BLUE BRIDLE INSURANCE AGENCY, INC. COMMERCIAL EQUINE LIABILITY APPLICATION P. O. BOX 27, PITTSTOWN, NJ 08867 A Program Limited to Horse Related Exposures Only (800) 526-1711 (908) 735-6362 FAX (908) 735-2254

More information

2015 ADF School Medical/Insurance Information & Liability Waivers INSURANCE INFORMATION

2015 ADF School Medical/Insurance Information & Liability Waivers INSURANCE INFORMATION These forms must be completed and signed in all appropriate places by the participant, the participant s physician, and if under age 18, by the participant s legal guardian. The medical information we

More information

Georgia Tech North Ave. NW Atlanta Ga. 30332

Georgia Tech North Ave. NW Atlanta Ga. 30332 Welcome to Fun Weird STEM Saturdays 2014 The functioning objective of Fun Weird Science STEM Saturdays is to: 1. Provide students with hands-on STEM experience; and 2. Engage students in the exciting ways

More information

Math + Leadership Camp at CSUSM Registration Forms

Math + Leadership Camp at CSUSM Registration Forms Math + Leadership Camp at CSUSM Registration Forms CONTACT INFORMATION Math for America San Diego Email: sandiego@mathforamerica.org Phone: 858-822-6284 Registration Checklist Complete all sections of

More information

Motorcycle RiderCourse WAIVERS

Motorcycle RiderCourse WAIVERS Motorcycle RiderCourse WAIVERS General Instructions All pages must be completed and signed. If you have any questions, call (231) 591-5819. Mail completed forms to: Motorcycle Rider Courses, Ferris State

More information

Emerald Hills Junior Golf Camp - Summer 2016. 938 WILMINGTON WAY REDWOOD CITY, CA 94062 www.playemeraldhills.com E-Mail - jrgolf.ehgc@gmail.

Emerald Hills Junior Golf Camp - Summer 2016. 938 WILMINGTON WAY REDWOOD CITY, CA 94062 www.playemeraldhills.com E-Mail - jrgolf.ehgc@gmail. OUR CAMPS ARE FOR GIRLS AND BOYS (AGES 5 THRU 14) Visit our website at Junior Golf Camp (9:00am 12:30pm) We start camp early (8:45am) on Monday for check-in and orientation. The camp is designed for beginners

More information

CONTRACT AND LIABILITY WAIVER

CONTRACT AND LIABILITY WAIVER CONTRACT AND LIABILITY WAIVER HUNTING CONTRACT 1. This agreement, entered between Sawtooth Outfitters East or Sawtooth Outfitters West or Sawtooth Outfitters ULC or Grizzly Basin Outfitters ULC (hereinafter

More information

Atlanta 04.05.14. Party. Check-In. Welcome to The Color Run! Check-in Party

Atlanta 04.05.14. Party. Check-In. Welcome to The Color Run! Check-in Party Atlanta 04.05.14 Welcome to The Color Run! We have developed this race guide to provide you with all the information you will need to make your experience at the event as FANTASTIC as possible. You and

More information

POLICIES, PROCEDURES AND BARN RULES HANDBOOK

POLICIES, PROCEDURES AND BARN RULES HANDBOOK POLICIES, PROCEDURES AND BARN RULES HANDBOOK Let the warmth of a horse carry you to your dreams In a triangle all sides are equal Each Side Represents a Part of Our Program Horse Instructor Volunteers

More information

J UNE 15 - AUGUST 7 GRADES (going into) HEADSTART - 7th grade

J UNE 15 - AUGUST 7 GRADES (going into) HEADSTART - 7th grade J UNE 15 - AUGUST 7 GRADES (going into) HEADSTART - 7th grade Our day camp offers structured activities from 8:00 a.m. to 5:00 p.m., 5 days a week for an eight-week program, all at one low price. Children

More information

Volunteer Registration Form

Volunteer Registration Form Volunteer Registration Form Entered by: Reviewed: : Today's : I. Personal Information Birth : Name: E-Mail: Address: Work Ph: ( ) City: Zip: Home Ph: ( ) May we contact you at work? Yes No Mobile Ph: (

More information

BOARDING AGREEMENT 1. FEES, TERMS AND LOCATION

BOARDING AGREEMENT 1. FEES, TERMS AND LOCATION BOARDING AGREEMENT THIS AGREEMENT, for good and valuable consideration receipt of which is hereby acknowledged, dated the day of, 2001 made by and between, hereinafter referred to as "STABLE", providing

More information

TERMS AND CONDITIONS, RIDERS RELEASE OF LIABILITY & ASSUMPTION OF RISK INDEMNITY AND HOLD HARMLESS

TERMS AND CONDITIONS, RIDERS RELEASE OF LIABILITY & ASSUMPTION OF RISK INDEMNITY AND HOLD HARMLESS Deco Bike, LLC. 3301 NE 1 st Avenue, LPH-6 Miami, Florida TERMS AND CONDITIONS, RIDERS RELEASE OF LIABILITY & ASSUMPTION OF RISK INDEMNITY AND HOLD HARMLESS THIS IS A LEGAL AND BINDING AGREEMENT. RIDERS

More information

FOOTBALL CAMPS OF AMERICA, LLC CONSENT FORM

FOOTBALL CAMPS OF AMERICA, LLC CONSENT FORM FOOTBALL CAMPS OF AMERICA, LLC CONSENT FORM NOTICE: ALL ATHLETES WILL BE REQUIRED TO HAVE A SIGNED CONSENT FORM BEFORE TAKING THE FIELD. Football Camps of America, LLC. Parental Release Physical Form Waiver

More information

RELEASE OF LIABILITY, INDEMNITY, AND BACKGROUND CHECK AUTHORIZATION AGREEMENT

RELEASE OF LIABILITY, INDEMNITY, AND BACKGROUND CHECK AUTHORIZATION AGREEMENT RELEASE OF LIABILITY, INDEMNITY, AND BACKGROUND CHECK AUTHORIZATION AGREEMENT In consideration, the receipt and sufficiency of which is hereby acknowledged, for being allowed entry into and participation

More information

GUATEMALA SURGERY TRIP Youth Volunteer Information and Release Form

GUATEMALA SURGERY TRIP Youth Volunteer Information and Release Form Team Name: Guatemala Surgery Travel Dates GUATEMALA SURGERY TRIP Youth Volunteer Information and Release Form Please complete this entire form, including the release and liability form and return immediately.

More information

To apply please complete application and return to: Harris Towers Attn: Volunteer Coordinator 233 Peachtree Street; Suite 1700 Atlanta, Georgia 30303

To apply please complete application and return to: Harris Towers Attn: Volunteer Coordinator 233 Peachtree Street; Suite 1700 Atlanta, Georgia 30303 To apply please complete application and return to: Harris Towers Attn: Volunteer Coordinator 233 Peachtree Street; Suite 1700 Atlanta, Georgia 30303 For more information please call 404-546-6788 Front

More information

BLACK HORSE RUN PROPERTY OWNERS ASSOCIATION BARNS AND TRAILS (Homeowner s Barn Lease Agreement)

BLACK HORSE RUN PROPERTY OWNERS ASSOCIATION BARNS AND TRAILS (Homeowner s Barn Lease Agreement) BLACK HORSE RUN PROPERTY OWNERS ASSOCIATION BARNS AND TRAILS (Homeowner s Barn Lease Agreement) THIS LEASE AGREEMENT is made and entered into as of this day, 2012, by and between, a resident of Black Horse

More information

SUMMER ZOO CAMP 2016

SUMMER ZOO CAMP 2016 Scholarships are non-transferable INDIVIDUAL ZOO CAMP SCHOLARSHIP SUMMER ZOO CAMP 2016 APPLICATION AND GUIDELINES APPLICATION DEADLINE March 18, 2016 1 2016 SCHOLARSHIP GUIDELINES Thank you for your interest

More information

Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms

Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms Aquaculture, Biology, and Conservation Summer Camp 2015 Registration Forms All forms and payment are due no later than June 15, 2015 Note: There is a $25 non-refundable registration fee, and no refunds

More information

2014 Fort Worth Regional Science and Engineering Fair, University of Texas at Arlington, RadioShack. Media Release Form

2014 Fort Worth Regional Science and Engineering Fair, University of Texas at Arlington, RadioShack. Media Release Form 2014 Fort Worth Regional Science and Engineering Fair, University of Texas at Arlington, RadioShack Media Release Form I hereby consent to and authorize the use and reproduction by Fort Worth Regional

More information

Texas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment

Texas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment Texas A&M University-Corpus Christi Youth Program Medical Emergency Information/Consent for Treatment Youth s name: Address: Date of birth: Parent/guardian phone: Home Work Pager/Cellular Medical Information

More information

San Jose 05.31.14. Party. Check-In. Welcome to The Color Run! Check-in Party. Where: Sports Authority 5170 Steven Creek Blvd, San Jose, CA 95129

San Jose 05.31.14. Party. Check-In. Welcome to The Color Run! Check-in Party. Where: Sports Authority 5170 Steven Creek Blvd, San Jose, CA 95129 San Jose 05.31.14 Welcome to The Color Run! We have developed this race guide to provide you with all the information you will need to make your experience at the event as FANTASTIC as possible. You and

More information

WELCOME TO Y CAMP! Virginia Summer Camps Identity Verification Commonwealth of Virginia School Entrance Health Form and Immunization Record.

WELCOME TO Y CAMP! Virginia Summer Camps Identity Verification Commonwealth of Virginia School Entrance Health Form and Immunization Record. WELCOME TO Y CAMP! The following pages are the registration materials required to complete your registration. In addition to these forms, some jurisdictions require additional forms as outlined below to

More information

GLOBAL TECH ACADEMY INC. AFTERSCHOOL ENRICHMENT PROGRAM REGISTRATION PACKET FOR 2015-2016 SCHOOL YEAR

GLOBAL TECH ACADEMY INC. AFTERSCHOOL ENRICHMENT PROGRAM REGISTRATION PACKET FOR 2015-2016 SCHOOL YEAR GLOBAL TECH ACADEMY INC. AFTERSCHOOL ENRICHMENT PROGRAM REGISTRATION PACKET FOR 2015-2016 SCHOOL YEAR Welcome Child s Enrollment Form Parent Pick-Up Authorization Emergency Information, Waiver & Medical

More information

Indemnity to ERC, and to Minor Release

Indemnity to ERC, and to Minor Release Universal Release of Liability This is a release of claims, a waiver of liability, an assumption of risk, and an indemnity agreement. By signing this document, you will irrevocably waive and release certain

More information

YOUTH MENTORING PROGRAM. Mentee Application (To Be Completed by the Parent/Guardian)

YOUTH MENTORING PROGRAM. Mentee Application (To Be Completed by the Parent/Guardian) Personal Information YOUTH MENTORING PROGRAM Mentee Application (To Be Completed by the Parent/Guardian) Youth s Name: Date: Parent/Guardian Name: Relationship to Youth: Mother Father Other, specify: Street

More information

Santa Monica College Administrative Regulation - Students Activities and Student Conduct

Santa Monica College Administrative Regulation - Students Activities and Student Conduct Santa Monica College Administrative Regulation - Students Activities and Student Conduct (AR5319-091481) Extracurricular Trips Arrangements for trips by clubs and other non-athletic extracurricular activity

More information

2016 Bowdoin Summer Art Camp Registration

2016 Bowdoin Summer Art Camp Registration 2016 Bowdoin Summer Art Camp Registration Hours and Location Bowdoin Summer Art Camp will run for four weeks from June 27 th through July 22 th. The times and length of each session vary. Please refer

More information

City State Zip Home Phone Priority. Place of Employment Work Phone Priority. Parent/Guardian Name Date of Birth Cell Phone/Pager Priority

City State Zip Home Phone Priority. Place of Employment Work Phone Priority. Parent/Guardian Name Date of Birth Cell Phone/Pager Priority , Camper s Last Name, First Initial YMCA of Metropolitan Washington Camp Registration Form Please print clearly. Please complete all blanks on this form. If there is a blank that is not applicable, please

More information

Bikecat s Terms and Conditions

Bikecat s Terms and Conditions 1 Bikecat s Terms and Conditions WHAT IS INCLUDED? The following items are included in the trip: English-speaking expert guides, land transportation to and from Barcelona airport and Girona, including

More information

WHAT TO BRING TO CAMP Backpack

WHAT TO BRING TO CAMP Backpack JOHNSTON YMCA DAY CAMP FAQ Q. What does my child need to bring to camp? A. Swimsuit, towel, tennis shoes, comfortable clothing, book bag, and journal (provided). Please also apply waterproof sunscreen/bug

More information

Shotgun Coaching Workshop Registration and Information Package

Shotgun Coaching Workshop Registration and Information Package Shotgun Coaching Workshop Registration and Information Package Edmonton Conservation Education Centre for Excellence #88, 4003 98 th Street Edmonton, Alberta, Canada T6E 6M8 Phone: (780) 466-6682 or Toll

More information

Race Guide. South Portland. Check-In Party. Be Happy. Be Healthy. Be You. Welcome to The Color Run!

Race Guide. South Portland. Check-In Party. Be Happy. Be Healthy. Be You. Welcome to The Color Run! Be Happy. Be Healthy. Be You. Race Guide South Portland Welcome to The Color Run! Thanks to you and 5,000 of your newest friends for making The Color Run one of America s biggest 5k events! We have made

More information

PROJECT EXCEL MENTORING PROGRAM Creating Vision Through Mentoring / What They See is What They Will Be

PROJECT EXCEL MENTORING PROGRAM Creating Vision Through Mentoring / What They See is What They Will Be Personal Information Mentee Application (To Be Completed by the Parent/Guardian) Youth s Name: Date: Parent/Guardian Name: Relationship to Youth: Mother Father other, specify: Street Address: City: State:

More information

HARVARD UNIVERSITY. INTERNATIONAL INTERNSHIP OR OTHER PROGRAM CONDITIONS OF PARTICIPATION and ASSUMPTION OF RISK AND GENERAL RELEASE

HARVARD UNIVERSITY. INTERNATIONAL INTERNSHIP OR OTHER PROGRAM CONDITIONS OF PARTICIPATION and ASSUMPTION OF RISK AND GENERAL RELEASE HARVARD UNIVERSITY Harvard University Risk and Release Form INTERNATIONAL INTERNSHIP OR OTHER PROGRAM CONDITIONS OF PARTICIPATION and ASSUMPTION OF RISK AND GENERAL RELEASE THIS IS A RELEASE OF LEGAL RIGHTS

More information

2016 SUMMER DAY CAMP REGISTRATION YMCA OF BEAUFORT County SITE LOCATION

2016 SUMMER DAY CAMP REGISTRATION YMCA OF BEAUFORT County SITE LOCATION $15 Online Registrations / family $25 In person Registration / family Weekly Fees: Please see Camp Brochure 2016 SUMMER DAY CAMP REGISTRATION YMCA OF BEAUFORT County SITE LOCATION I have attached a valid

More information

2015 Nature Explorers Registration Form (Rising 1st to 3rd graders)

2015 Nature Explorers Registration Form (Rising 1st to 3rd graders) Information 2015 Nature Explorers Registration Form (Rising 1st to 3rd graders) Camper Name: DOB: Parent/Guardian Name(s): Address: City: State: Zip: Home Cell Work Email: *If emergency contact is different

More information

Bartow County C.E.R.T.

Bartow County C.E.R.T. Dear Applicant, I would like to take this opportunity to thank you for your interest in the Community Emergency Response Team. The CERT Program is presented by the Bartow County Emergency Management Agency

More information

Vietnam Veteran Application*

Vietnam Veteran Application* FOR HONORAIR-KNOXVILLE USE ONLY Last Name Date Received / / Vietnam Veteran Application* HonorAir-Knoxville recognizes American veterans for your sacrifices and achievements by flying you to Washington,

More information

Johns Creek Montessori School Of Georgia

Johns Creek Montessori School Of Georgia ENROLLMENT FORM Pre-Primary (Toddler) Primary Half Day Full Day All Day Start : Child s Information: Child s Name Street Address Nickname of Birth Subdivision Name Primary Language Spoken Parent/Guardian

More information

SAINT LOUIS UNIVERSITY STUDY ABROAD PARTICIPATION AGREEMENT AND ASSUMPTION OF RISK AND RELEASE OF CLAIMS

SAINT LOUIS UNIVERSITY STUDY ABROAD PARTICIPATION AGREEMENT AND ASSUMPTION OF RISK AND RELEASE OF CLAIMS SAINT LOUIS UNIVERSITY STUDY ABROAD PARTICIPATION AGREEMENT AND ASSUMPTION OF RISK AND RELEASE OF CLAIMS I, ( ), the undersigned student, wish to participate in a study abroad Program offered by Saint

More information

WELCOME TO YMCA Teen Scene Middle School Enrichment Program (This sheet is for parents to keep for informational purposes)

WELCOME TO YMCA Teen Scene Middle School Enrichment Program (This sheet is for parents to keep for informational purposes) Robert D. Fowler Family YMCA Middle School Enrichment Program Student Registration Form 2015-16 Ivy Prep Academy Program Hours: 7am-7:45am & 4pm-7pm Transportation AM: Group leaves at 7:30am Transportation

More information

WHEREAS, Participants desire to participate in ALL the recreational activities available at the Trampoline Park; and

WHEREAS, Participants desire to participate in ALL the recreational activities available at the Trampoline Park; and THIS PARTICIPATION AGREEMENT is made and effective as of the last date executed (hereinafter the "Effective Date") by and between Get Air Savannah (hereinafter "Get Air") and the adult or guardian identified

More information

Cyber Defenders Summer Camp Application Form Instructions

Cyber Defenders Summer Camp Application Form Instructions Cyber Defenders Summer Camp Application Form Instructions The Cyber Defenders Summer Camp is put on by the San Antonio College Computer Information Systems Department. It will be an overview of material

More information

Open English Horse/Pony Show Rules

Open English Horse/Pony Show Rules 66 CECIL COUNTY FAIR 2015 Department F - HORSES 1. Pre-entry fees are $10 per class. Post-entry fees are $12.00. Pre-entries Will NOT be accepted after midnight July 01, 2015. NO EXCEPTIONS. Please make

More information

I UNDERSTAND THAT THESE RISKS MAY RESULT IN INJURY OR EVEN DEATH.

I UNDERSTAND THAT THESE RISKS MAY RESULT IN INJURY OR EVEN DEATH. CORNELL COLLEGE S RELEASE, WAIVER AND INDEMNIFICATION AGREEMENT FOR NON-EMPLOYEES ATTENDING FOR CREDIT ACTIVITIES OFFERED BY NON- EIIA MEMBER INSTITUTIONS OR OTHER THIRD PARTIES OR INDEPENDENT STUDY OR

More information

DATE OF BIRTH: STREET ADDRESS: CITY/STATE/ZIP:

DATE OF BIRTH: STREET ADDRESS: CITY/STATE/ZIP: Get Noticed Beach Volleyball Waiver WAIVER AND RELEASE, EXPRESS ASSUMPTION OF RISK, INDEMNITY AND HOLD HARMLESS AGREEMENT, AND GRANT OF RIGHTS NAME OF PLAYER: PLAYER AGE DATE OF BIRTH: PLAYER GRADE as

More information

2016 MONTANA YOUTH RANGE CAMP

2016 MONTANA YOUTH RANGE CAMP 2016 MONTANA YOUTH RANGE CAMP Hosted by the Cascade Conservation District Sponsored by the Department of Natural Resources and Conservation http://dnrc.mt.gov/cardd/camps/rangecamp/default.asp Camp Rules

More information

Wilderness First Aid. Basler Center for Physical Activitiy. Saturday Feb. 25 - Sunday Feb. 26. Non Credit Instruction. Wilderness First Aid

Wilderness First Aid. Basler Center for Physical Activitiy. Saturday Feb. 25 - Sunday Feb. 26. Non Credit Instruction. Wilderness First Aid Non Credit Instruction Saturday Feb. 25 - Sunday Feb. 26 Wilderness First Aid Offered at ETSU through Landmark Learning. Saturday Feb. 25 through Sunday Feb. 26 8 a.m 5 p.m. Wilderness First Aid $125 ETSU

More information

I Can Bike Information about the program

I Can Bike Information about the program I Can Bike Information about the program I Can Bike is a not-for-profit organization whose mission is to teach individuals with disabilities to ride a conventional two wheel bicycle and become lifelong

More information

Hornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823

Hornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823 Hornets Youth Enrichment Summer Program 1200 North DuPont Highway Dover, Delaware 19901 Telephone: 302-857-6824 Fax: 302-857-6823 Participant Last Name: Participant First Name: Grade: Age: Gender: Male

More information

SPORTS CAMP CONTRACT

SPORTS CAMP CONTRACT STATE OF NORTH CAROLINA WAKE COUNTY SPORTS CAMP CONTRACT This agreement made and entered into this day of, 20, by and between North Carolina State University (hereinafter referred to as NC STATE ), and,

More information

APPENDIX B. Adult Check here if the intern is an adult. Minor Check here if the intern is a minor.

APPENDIX B. Adult Check here if the intern is an adult. Minor Check here if the intern is a minor. APPENDIX B Adult Check here if the intern is an adult. Minor Check here if the intern is a minor. IMPORTANT: ALL ADULT INTERNS AGREE: [Insert Name] ( Intern ), by my own request, desire to participate

More information

The Merritt Kids College Program - A Review

The Merritt Kids College Program - A Review Parent s Name: Address: Email Address: Cell Phone: Emergency Contact Name: Registration Form Home Phone: Number: Child s Name: Grade: Age: School Name: Gender: Male: Female: T-Shirt Size: Small: { } Medium:

More information

2015 RACE REGISTRATION packet

2015 RACE REGISTRATION packet 2015 RACE REGISTRATION packet First annual Delaware Charity Challenge Saturday, May 2, 2015 Lums Pond State Park Bear, Delaware delawarecharitychallenge.com Saturday, May 2, 2015 Lums Pond State Park 2015

More information

Wisconsin s Premiere RODEO HORSE GAMES Saturday, June 18 th, 2016 º 8:00 a.m. 3:30 p.m.

Wisconsin s Premiere RODEO HORSE GAMES Saturday, June 18 th, 2016 º 8:00 a.m. 3:30 p.m. Wisconsin s Premiere RODEO HORSE GAMES Letter to New or Less Experienced Game Show Riders Welcome to our Horse Game Show. We are new rider friendly as we cater to the inexperienced riders. This is where

More information