Stanislaus County 4-H Horse Group

ACHIEVEMENT DAY REGISTRATIONSATURDAY, APRIL 30, 2016

MandatoryOrientation - PROMPLY AT 8:30 AM

Achievement Day Evaluations - starts AT 9:00 AM SHARP

Registration forms will be turned in by your Horse Project Leader
New for 2016:AllLevels—No Entry Fee
Lunch will NOT be provided
Participants in full 4-H uniform will earn an extra 5 points.
Long sleeve button down shirts, long pants, boots & belt are required. Long hair must be tied back.
Equestrian helmet meeting current ASTM/SEI standards must be worn at all times while riding.
All Participants must complete & include: 1. Achievement Day Individual Sign-Up Form
2. 4-H Medical Release Form
3. Release of Liability for Waterford Horseman’s Club
4-H Uniform
BOYS – Cap, green through 8th grade, white for 9th and above; white shirt with collar (long sleevesare required for riding), with minimum of five buttons in front; white or off white tailored or jean style pant; green 4-H emblem tie; English or Western. Equestrian helmet meeting current ASTM/SEI standards must be worn at all times while riding. English hunt coat and breaches are not considered 4-H uniforms. / GIRLS – May wear same as listed for boys, or may wear white blouse with same requirements as shirt; green 4-H collar fastened with a simple white plastic or metal ring; English or Western boots. Long hair must be tied back. Equestrian helmet meeting current ASTM/SEI standards must be worn at all times while riding.
English hunt coat and breaches are not considered 4-H uniforms.
APPEARANCE – Cap must be worn on head; shirt must be tucked into pants; belt must be worn if pants have loops; pants must be outside of boots; 4-H collar must be over shirt collar. Baggy pants and spandex are not acceptable. English or western boots are required for horse. English riders may wear light colored breech.

Leaders: Please return Registration Forms to the County Office on or before Thursday, March 3, 2016. Applications and formsmay be turned

at the Achievement Day Warm Up – date to be announced.

Applications will be considered late on March 4th, 2016.

A participation list will be e-mailed to each leader by April 1st.

No additions after April 15th, 2016.

For more info: Marla or Kiaya Bettencourt at209-634-2360

ACHIEVEMENT DAY SIGNUP

Member Name:
Phone: E-mail Address:
Level: (Circle One) Entry Novice 1 2 3 4
Pattern: (Circle One) I DO DO NOT need my Riding Pattern called. (For Levels Novice, 1, & 2 only!)
Club:
Parent Name (please print)
Parent Signature
Horse Project Leader (please print)
Leader Signature
Achievement Day will be held on Saturday,April 30, 2016, at the Waterford Horseman’s Club arena at13006 Vineyard Road in Waterford (at corner of Tim Bell Road).
Mandatory Orientation starts promptly at 8:30 am; all evaluations start at 9:00 am.
There is noRegistration Fee.

Entry Forms are due on or before March 3rd, 2016 @ 4:00pm.!

Results will be available at the May Horse Leaders Group meeting.

Study guides are available. Use them, but remember, they are meantto be guides only!

You are responsible for your entire level from theCHA Composite Horsemanship Manual and the study guides posted on the Stanislaus County 4-H Horse Project pages.

Entry Level - No riding. Demonstrations & oralreview (no written review).
Novice Level - Walk only riding pattern. Demonstrations & written review. See website for pattern.
Level 1 - Walk and Jog (Trot) riding pattern. Demonstrations written review.
Level 2 - Must have passed Level 1 in previous year(s). Riding pattern, demonstrations, written review.
Level 3 - Must have passed Level 2 in previous year(s). Riding pattern, demonstrations, written review.
Level 4 - Must have passed Level 3 in previous year(s). Riding pattern, demonstrations, written review.
NOTE: Riding patterns need not be memorized for Novice Level, Level 1, or Level 2, per CHA Manual. Member may have the pattern called to them. Please specify on this form if you need your pattern called.

Waterford Horseman's Club

Release of Liability

Rider/s: ______
Address: ______

I/we acknowledge that horseback riding is a sport, which carries inherent risks of injury and damage to myself, my horse, and property. I knowingly assume all risks, whether known or unknown, of horseback riding.

I/we hereby release the WATERFORD HORSEMAN’S CLUB (herein referred to as W.H.C.) from any liability for any act of negligence or want of ordinary care on the W.H.C. or any of its agents. In consideration of my participation in events organized or sponsored by W.H.C., I waive, release, and discharge W.H.C., their directors, officers, agents, members and volunteers, their representatives, heirs, executors, and assigns from any and all claims of liability for injury and damage to myself, my animals, or my property rising out of my voluntary participation. This agreement is binding on my executors, heirs, and assigns.

I/we expressly waive any rights I may have under California Civil Code 1542, which states: “A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him might have materially affected his settlement with the debtor.”

I/we agree that I will indemnify and hold harmless W.H.C., their officers, directors, members, and agents against all claims, demands, and causes of action, including court costs, and actual attorney fees, arising from any proceedings or law suits brought by or prosecuted for my benefit, in which this release is upheld.

W.H.C., its agents, employees, or volunteers shall not be held liable for any damage, which may accrue from any cause or result of fire, theft, running away, state of health, injury to person, horse or property.

I/we acknowledge that I have read this Release of Liability and know and understand its contents.

Signature: ______Date:______

Signature: ______Date:______

Parent/Guardian Consent for Minor

I, the undersigned parent or guardian of the above participant, in consideration of my minor's participation in the event, agree the terms and conditions of this Release of Liability shall be binding as to damage or injury to my minor, his animal, and property arising out of his/her participation.

______

Minor’s name Minor’s Signature

______

Parent’s name Parent/Guardian’s Signature