Box Lunch Choices - Great and Small Therapeutic Riding

Murder Mystery Trail Ride
Rider Name: _______________________________________ Phone Number: _______________
Address: _______________________________________________________________________________
E-Mail Address: _______________________________________________________________________
Rider Age: _____ under 18 _____over 18
Emergency Contact (name and phone number):
Team (check one):
I will ride as a part of a team with the following persons:
Cell phone number for team: ___________________________________
Is your team willing to include riders who do not have a team? If
so, please indicate the level of experience of the riders on your
team (see questions below for riders who are looking to be put on
a team): _______________________________________________________________
__________ Please put me on a team. So that you may put me with a
compatible group, my horse and I are comfortable with:
_____Walk/Trot on flat ground
_____Walk/Trot over varied terrain
_____Walk/Trot/Canter over varied terrain
Box Lunch Choices (for riders who enter on or prior to Oct. 14):
Please reserve the following box lunch for me (all lunches come with chips
and sodas/water will also be available)
______ Turkey
______ Veggie
______ Italian Cold Cut
______ Ham
Thank you to Subway for donating the box lunches!
This Release, Waiver of Liability and Indemnification Agreement is being given in consideration for my
(and/or my minor child’s) participation in the Great and Small Murder Mystery Trail Ride (the “Mystery
Trail Ride”).
I understand that:
 horses, even the most well trained, are often unpredictable and often difficult to control;
 it is dangerous to be in the proximity is of horses which can bite, kick or cause other serious damage
or injury at any time;
 there are inherent risks involved in all horse related activities, including handling of horses, whether
mounted or on the ground, and that horseback riding, including cross-country horseback riding, is a
dangerous activity;
 the Mystery Trail Ride will be taking place across uneven terrain that may include fields, woods,
mud, water, rocks, ditches, holes, wild animals, low hanging branches, logs or branches on the
ground, and other physical hazards;
 the activities of other riders, horses and/or persons on the ground may create conditions that could
cause my horse to spook or otherwise become unsafe;
 in any Great and Small sponsored activity I (and/or my minor child) or my horse may be injured as
a result of my (or my child’s) negligence, the negligence of another, or through no fault of anyone,
because of the nature of the activity in which I (and/or my minor child) am going to be engaged.
I agree to be responsible for the safety of myself, my horse and other persons and their property. I accept and
assume all the risks of injury (including death) to me (and/or my minor child) and my property. By signing
below I, on behalf of myself, (and/or my minor child), my heirs, guardians, legal representatives and
insurers, release, and agree not to make or bring any claim of any kind against: Great and Small; its officers,
directors, and employees; and/or any landowners, landholders (including their families, employees, guests,
invitees or tenants) or other persons making property available for use for the Mystery Trail Ride
(collectively, “Releasees”), for any injury (including death), to me (and/or my minor child) or any damage to
my property, whether from anyone’s negligence or any other cause, arising out of my (and/or my minor
child’s) participation in the Mystery Trail Ride.
I also agree that if anyone makes any claims because of any injury to me (including death to me and/or my
minor child), or for any damage to my property, I will keep all Releasees free of any damages or costs
because of those claims. By signing below, I agree to indemnify and hold harmless each of the Releasees for
any loss or damage (including reasonable attorneys fees and costs) from any claim resulting from injury to
myself (and/or my minor child), my horse and/or to third parties as a result of my actions or inactions or the
actions of my horse.
This Agreement shall be interpreted according to the laws of the state of Maryland, with venue in
Montgomery County, Maryland.
Rider (Name Printed): _______________________________________
Rider’s Signature: _______________________________________
Parent or Guardian (Name Printed for Minor Rider): _______________________________________
Signature of Parent or Guardian: ______________________________________
Date: ____________________________________