2011 Summit County Open Show Entry Form Back #:
Sponsored by Summit County 4-H Saddle Horse Association
Age as of Jan 1, 2011: Birth Date:
Exhibitor's Name: Horse's Name:
June 11 July 16 & July 17 Aug 13
Classes: Classes July 16th Classes:
Classes July 17th
All Day Fee ($40) All Day Fee ($40) All Day Fee ($40)
Two Day Fee ($50)
Per Class ($5 ea) Per Class ($5 ea) Per Class ($5 ea)
Grounds ($5) Grounds ($5) Grounds ($5)
Total*all day incl grounds Total*all day incl grounds Total*all day incl grounds
Cash or Check Cash or Check Cash or Check
Summit County 4-H Saddle Horse Association
Under Ohio Law, section 2305.40 of the Revised Code, an equine activity sponsor, professional volunteer, participant or other person is
NOT liable for an injury to or to the death of a participant in the equine activities resulting from the inherent risks of equine activities.
I have chosen to participate in the 2011 Summit County 4-H Saddle Horse Association Open Show Series and/or Fun Show.
I am aware that the inherent risks include but are not limited to the following:
A. Horses have propensity to behave in ways which may result in injury, death, or loss to rider or other persons in the immediate vicinity.
B. Horses may react in an unpredictable way to sounds, sudden movements, unfamiliar objects, persons, or other animals.
C. Riding a horse may give rise to risk of injury from hazards arising from the surface or subsurface of the ground in which the riding activity occurs.
D. While riding a horse, I may be involved in a collision with another horse, another animal, a person, or an object.
E. Other participants in the program may fail to maintain control over a horse or fail to act within their abilities,
thus causing harm to other participants or me.
F. Other participants in the program may act in a negligent manner which otherwise may result in harm to me.
I release and forever discharge the Summit County 4-H Saddle Horse Association, the Summit County Agricultural
Society, the OH 4-H Extension Office, Summit County 4-H Clubs, Show Management, members, leaders and volunteers
from all claims, demands, and causes of action for personal injury or any other damage which may arise out of or be in
any way related to my participation in the 2011 Summit County 4-H Saddle Horse Association Open Shows.
By signing as rider/handler, you agree to the release stated above.
Permission for Minor (under 18)
I hereby consent to the entry of _____________________whose name also appears at the top of this form, in the 2010
SC4-HSHA Open Show Series. I have read the above liability waiver and understand the inherent risks involved.
By signing as a parent or guardian of a minor, you agree to the release stated above