Ellis River Riders

Liability Release Form

I/We hereby release the Ellis River Rider, hereafter called the club, their officers, members and affiliates 
& sponsor of any event from any liability for injury or loss to my child, myself, my horse or my property 
while attending any club event.  We further release any landowner, who owns land or property any 
club event may cross from any liability for accident or injury incurred for any reason whatsoever. 
I/We understand the inherent dangers involved with any horse related activity and enter into this 
activity of our own will. I/We understand the danger of riding on trails, which may be changed by 
random acts of nature and or unforeseen human intervention. We understand that children, 
must be attended by a guardian for their safety, at all times.

             I hear by give permission for my child: ________________________________________________ 
to attend activities in the company of: _______________________________________________ who has full responsibility and guardianship during the time spent at Ellis River Riders events. . _________________ 
is authorized to seek and grant permission for _____________________ to receive medical attention should 
the need arise. __________________________ has medical insurance through ______________________________,
ID#___________________________.    His/Her date of birth is _____________.
Emergency contact phone number: _____________________________

Signature of Parent(s): _________________________________ Date: _______

                                               ____________ __________________________________

Signature of Guardian: _________________________________ Date: _______

By signing above we hereby acknowledge that we have read and agree with all the 
limitations of the above liability release.