2017 Application for Boca Negra Cross Country Course Riding Permit

Please use one form per person. Print Clearly. Thank you!

100% of fees collected are used for the maintenance and support of the cross country course.

Rider’s Name ______Minor Child? ______

Mailing Address ______

Phone numbers: Home: ______Cell/Work: ______

Email: ______Name of Pony Club (if applicable): ______

The payment of this fee entitles the member to use La Boca Negra Cross Country Facilities on the West Mesa in Albuquerque, New Mexico, for the 2017 calendar year. Membership does not include the use of other horse park facilities such as the clubhouse or roping arenas.

RELEASE, ASSUMPTION OF RISK, WAIVER AND INDEMNIFICATION:
I AGREE to the following, in consideration of my use of La Boca Negra Cross Country Facility, to be legally binding.

I AGREE that I am using La Boca Negra Cross Country Facility with my horse, as a rider, handler, lessee, owner, agent, coach, trainer, or as a parent or guardian of a minor voluntarily and at my own risk.

I AGREE and understand that there are inherent risks that come with all equine activities including but not limited to accident and injury (including serious bodily injury), pain and suffering and even death. I expressly assume all risk of harm to me, my child or ward, my horse and other property when using La Boca Negra Horseman’s Complex.

I AGREE to waive and release the Watermelon Mountain Pony Club, the United States Pony Clubs, Inc., and the City of Albuquerque, including their Board of Governors, Instructors, Administrators, Volunteers, Officials, Directors, Officers, Agents, Employees and/or Sponsors (referred to the remainder of this document as the “Pony Club/USPC/City”) from any and all responsibility and liability for any losses, damages and injury and from all claims for money damages, for any harm to me, my horse, other property, or to my child or ward that may be sustained in association with my use, or the use by my child or ward, of La Boca Negra Cross Country Facility, even if that harm resulted directly or indirectly from the negligence of the Pony Club/USPC. In addition, I intend this release to apply to any harm caused to me, to my horse or other property, or to my child or ward, by other people, horses or the property or facilities at La Boca Negra Horseman’s Complex, even if that harm resulted directly or indirectly from the negligence of the Pony Club/USPC/City.

I AGREE to indemnify (that is to pay any losses, damages, or costs incurred by) the Pony Club/USPC/City and to hold them harmless with respect to any claims for myself, my horse, my child, ward or me and for claims made by others for any harm caused by me, my horse, my child or ward.

I AGREE and understand that I am required to wear protective equipment, including proper footwear, an ASTM approved helmet and a safety vest when riding at La Boca Negra Cross Country Facility. I also understand that no protective equipment can completely protect against all injuries.

I AGREE to all of the above provisions and AGREE to assume all of the obligations of this Release. If I am a parent or guardian of a minor, I consent to the child’s use of La Boca Negra Cross Country Facility and AGREE to all of the above provisions and AGREE to assume all of the obligations of this Release on this child’s behalf.

______

Signature (Parent Guardian must sign if rider is under 18) Print Name (clearly) Date

Fees (check one)

____ Individual – Full Year $75.00/rider/calendar year

____ Individual (Pony Club/Horsemaster) $50.00/rider

____ One Day Usage Fee $35.00/rider Please arrange ahead of time.

Make Checks Payable to WMPC
Mail application form(s) and fees to:
WMPC, c/o Stacie Macdonald, 43 Juniper Rd, Placitas, NM 87043