Registration for April 2024 Dressage Ride Review with Kathryn Hitzig “L”

Rider Name

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

Horses Name

Riders Age

Dressage Test(s) and Special Requests

Rider Status

Junior/Young Rider (Under 21 as of the first of the year)

Senior

Session Options

Half Hour Ride Review or Lesson ($60)

One Hour Ride Review or Lesson ($110)

Under NH law a participant in equine activities assumes the risk of any injury, harm, damage, or death and any legal responsibility that may occur to participant from the inherent risks associated with equine activities. Pursuant to R.S.A. 508:19 Equine professionals are not liable for damages resulting from the inherent risks of equine activities. I/We hold harmless Contry Hill Farm, its managers, members, volunteers, and agents from and against all claims, demands, actions, and causes of action for damages that may be sustained by those indicated on the entry form or anyone else, including any and all claims arising from Contry Hill Farm or its agents’ own negligence. This includes personal injury, death, or property damage.

Electronic Signature of Rider or Parent/Guardian

First Name

Last Name

Date

MM

DD

YYYY

Electronic Owners Signature (if applicable)

First Name

Last Name

Electronic Trainers Signature (if applicable)

First Name

Last Name

Payments can be made online or mailed to the farm and made out to Contry Hill Farm. For questions, please call 978-855-2693 or email ejsumner@gmail.com.

Pay Online