Bed and Barn Farms 661 Big Island Rd
Forest City, NC 28043 Web: bedandbarnnc.com
PH: 828-248-4463 Email:
Mark Russell Natural Dressage Clinic Registration Form
Thank you for your interest in registering for a Mark Russell clinic. This packet contains the information to register for the clinic including hotel information. This packet along with total amount due is required to be registered for the clinic. We look forward to having you at the clinic and are committed to making it a memorable learning experience. Please call us if you have any questions.
Clinic Time:
- Clinic runs from 7:45 am – 6:00 pm each day
- Special arrangements need to be made if you are checking in BEFORE 3pm the day prior to the clinic OR if you are requesting to stay an additional night AFTER the clinic
- Please arrive at least 1 ½ hours in advance to check in and get ready for your ride.
What to Bring to Clinic:
- Hay/grain for horses (if lodging at Bed and Barn Farms)
- Bucket for feed and water
- Bring tack; saddle, pad, bridle, halter & lead line
- Proper riding attire; including helmet; boots
- If you are riding; lunch is provided; If you are not riding please bring your lunch
or pre-order
- As much as we love dogs, we ask that your dog remain at home
Cancellation Policy: Clinic will be held rain or shine. In the event you need to cancel, a refund will only be given if the clinic has been filled and we were able to backfill with someone from our waiting list.
What to Mail to us to be Registered:
- Completed Registration Form
- Make sure all signatures are complete in sections of the form
- Total Clinic Fee (Make check or money order payable to Bed and Barn Farms) and mail to: Bed and Barn Farms 661 Big Island Rd Forest City, NC 28043
- Please make sure that your email address is clearly written so we can send you a confirmation email regarding receipt of your registration
- Current Negative Coggins for each horse you are bringing
Mark Russell Dressage Rider Registration Form
Name: First______Last:______
Street:______
City:______State:______Zip:______
Rider’s age:______If participant is under 18, name of guaradians:______
Phone:( H)______(C)______
Email:______
Emergency Contact: ______
(Name)(Telephone)
Your primary discipline and riding level:______
Explaine:______
Horse’s name:______Age:______Sex:______
Horse’s level and experience:______
What would you most like to get out of this clinic:______
Clinic dates: March 7th & 8th. Day Amount
Cost: One ride: $190.00…………………………………………………… ______
Second ride: $150.00……………………………………………………. ______
* Paddock: $15.00 per night per Horse…………………………… ______
*Stall: $25.00 per night per Horse…………………………………. ______
*Audit: $30.00 one day; $50.00 both day……………………… ______
*Pre-ordered lunches: $10.00……………………………………….. ______
Total Rides/Costs:.. ______
**(stalls and paddocks are on a first come basis; we will try to accommodate your request)
Rooms are available at Bed and Barn Farms. Visit or call
Tammy at: 828-248-4463 for reservations and directions. Additional lodging : call the Holiday Inn Express: 828-755-2000
Horseback Riding/Stabling & Lodging Liability Release and Hold Harmless
Please Read Carefully Before Signing
BED AND BARN FARMS DOES NOT GUARANTEE YOUR SAFETY
SERIOUS INJURY MAY RESULT FROM YOUR PARTICIPTATION IN THESE ACTIVITIES, WHICH MAY INCLUDE BUT ARE NOT LIMITED TO: Equine riding, Room Rental; Horse Stalls and Paddocks; Trail Riding; Clinic Instruction; Lessons, and other activities on premises, referred to collectively as “Premise Activities”
Under North Carolina Law, an equine sponsor or equine professional is not liable for an injury or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 99E of the North Carolina General Statutes.
I further agree to waive all liability of the Released Parties for any loss, injury, damage or death which arises from the “inherent risks” of an equine activity, including those arising out of the alleged negligence of the “released parties”. “Inherent risks of an equine activity” mean a danger or condition that is an integral part of an equine activity, including, but not limited to, any of the following: (a) Propensity of an equine to behave in ways that may result in injury, death, or loss to persons on or around the equine; (b) The unpredictability of an equine’s reaction to sounds, sudden movement, unfamiliar objects, person, or other animals; (c) Hazards, including, but not limited to, surface or subsurface conditions; (d) A collision with another equine, another animal, a person, or an object;(e)The potential of an equine activity participant to act in a negligent manner that may contribute to injury, death, or loss to the person of the participant or to other persons, including but not limited to, failing to maintain control over an equine or failing to act within the ability of the participant. “Released Parties” in this document refers to: Bed and Barn Farms, Premise Owners, Clinician, Sponsor and/or each of the respective directors, officers, employees, agents and/or volunteers.
BED AND BARN FARMS recommends that all participants wear ASTM-approved safety helmets while engaging in equine activities.
Participant has:
______Provided own safety helmet _____Used Stable –provided Helmet ____Declined Helmet
______
Participant: Print NameSignatureDate
______
Parent/Guardian Print NameSignatureDate
READ AND INITIAL THE FOLLOWING TERMS AND CONDITIONS OF THIS LIABILITY RELEASE
_____ 1.ACTIVITY RISK CLASSIFICATION-I UNDERSTAND THAT: Horseback riding is classified as a
RUGGED ADVENTURE RECREATIONAL SPORT ACTIVITY, and that there are numerous obvious and non-obvious inherent risks always present in such activity despite all safety precautions. According to NEISS (National Electronic Injury Surveillance Systems of United States Consumer Products) horse activities rank 64th among the activities of people relative to injuries that result in a stay at U.S. hospitals. Related injuries can be severe, requiring more hospital days and resulting Inmore lasting residual effects than injuries in other activities.
_____ 2.NATURE OF STABLE HORSES-I UNDERSTAND THAT: Whether riding my own horse or one
selected and provided by the Stable, a rigid safety program is followed by this Stable. However, no horse is a completely safe horse. Horses are 5 to 15 times larger, 20 to 40 times more powerful, and 3 to 4 times faster than a human. If a rider falls from a horse to the ground it will generally be at a distance of from 3-1/2 to 5-1/2 feet, and the impact may result in injury to the rider. If a horse is frightened or provoked it may divert from its training and act according to its natural survival instincts which may include, but are not limited to: stopping short; changing directions or speed at will; shifting its weight; bucking, rearing, kicking, biting, or running from perceived danger.
_____ 3.PARTICIPANT RESPONSIBILITY: I UNDERSTAND THAT: Upon mounting a horse and taking up
the reins the Participant is in primary control of the horse, and his/her safety largely depends upon his/her ability to carry out the instructions of this Stable, to adhere to Stable rules, and to remain calm and balanced aboard the moving animal. I/WE agree that the Participant shall be responsible for his/her own safety, and that of an unborn child if the Participant is pregnant. INSTRUCTOR advises pregnant women not to ride horses unless permission is given under advice of her physician.
_____ 4.CONDITIONS OF NATURE: I UNDERSTAND THAT Stable is NOT responsible for total or partial
acts, occurrences or elements of nature that can scare a horse, cause it to fall, or react in some other unsafe way. SOME EXAMPLES ARE: Thunder, lightning, rain, wind, water, wild and domestic animals, insects, reptiles, which may walk, run, or fly near, or bite or sting a horse or person and irregular footing on out-of-door groomed or wild land which is subject to constant change in condition according to weather, temperature, and natural and man-made changes in landscape.
_____ 5.CARRY-ON OBJECTS AND SHARP NOISES: I UNDERSTAND THAT: Participants must not carry
loose items on rides which may fall, blow away, flap in the wind, bounce, or make sharp noises, possibly scaring a horse. SOME EXAMPLES ARE: Cameras, hats not securely fastened under chin, toys, and purses. Riders must not make sharp, loud noises, such as screaming or yelling, which may scare a horse.
_____6.SADDLE GIRTHS NATURAL LOOSENING: I UNDERSTAND THAT: Saddle girths (saddle
fasteners around horse’s belly) may loosen during a ride. If a Participant notices this he/she must alert the nearest Stable wrangler as quickly as possible so action can be taken to avoid slippage of
saddle and a potential fall from the animal. If riding unsupervised, Participant is fully responsible for maintaining proper fit of tack.
_____ 7.APPLICABLE LAW, JURISDICTION, VENUE - This contract shall be construed and governed by the
laws of the State in which Premises are located. Jurisdiction and venue for all disputes connected with this contract shall be proper in the county or district in which Premises are located.
_____ 8.INDEMNIFICATION. “Participation”, for purposes of this indemnification and release, shall include
any activity of Participant while on premises. “Equestrian area” includes all locations where horses are or can reasonably be expected to be present. Participant and Participant’s parents or legal guardians agree to indemnify and hold harmless the Released Parties and their Members, Directors, employees or agents from any and all liabilities, settlements, expenses and costs, including reasonable attorney’s fees, incurred in defending against any and all claims which arise from participation in Premise Activities, including those involving the alleged negligence of the Released Parties.
______
Participant: Print Name SignatureDate
______
Parent/Guardian: Print Name SignatureDate
BARN RULES
1. Carefully enter all arenas to avoid traffic
2. To mount or dismount horse, go to an unoccupied area. Go to an area with adequate space without interfering with the work of other riders. The same applies to a rider wanting to halt, rest, or adjust tack, girth or stirrups.
3. Do not get too close to other horses. A safe distance from other horses is 6 to 10 feet away from other horses in front of or behind your mount, and 3 to 4 feet from horses at your side. Greater distance should be kept for beginning riders and horses.
4. Riders walking (or slower riders) should ride the center of the arena, allowing faster horses to use the outside or rail area.
5. All horses should work the same direction; Riders working on a smaller circle or area should give way to riders working horses on the rail or wall around the entire arena.
6. When riders meet face to face, they should always pass each other left leg to left leg. Always keep right.
7. If riders are present in an arena, lunging of a horse in that arena should only be done after asking and receiving permission from those already in the arena. Only well behaved horses should be lunged while riding horses are in the arena.
8. Poorly behaved untrained or extremely unpredictable horses should be worked alone in the arena or at times when the arena is not busy.
9. Recreational riders should yield arena use to lessons.
10. MINORS MUST BE SUPERVISED ON PREMISES AT ALL TIMES.
11. No unleashed dogs or other pets on premise.
12. No smoking or alcohol on premises.
13. No spectators in equestrian areas. Entry into an equine area constitutes your participation in an equine activity and your knowing assumption of risk of injury or death.
______PARTICIPANT: PRINT NAME SIGNATURE DATE
______
PARENT/GUARDIAN:PRINT NAME SIGNATUREDATE
I further agree to waive all liability of the Released Parties for any loss, injury, damage or death which arises from the “result of equine activities”.
Mark Russell Natural Dressage
Clinic: March 7th & 8th
Location: Bed and Barn Farms
661 Big Island Rd Forest City, NC 28043
Cost: 1st Ride: $190.00
2nd Ride: $150.00
Audit: $30 for 1 day; $50.00 for both
Limited to
8 Riders per day
Sign up Now!!!
Contact: Tammy Martell at 828-248-4463
Lunch will be provided for all riders.
Auditors may pre-order lunch for a fee of $10.00.