Piscataqua Hounds Hunter Pace, Saturday, September 4, 2010

 Directions:   Carl Siemon Family Charitable Trust/Branch Hill Farm, Milton  Mills, NH
Go north on the Spaulding Turnpike to Exit 18 (Also Exit for the Farm Museum)
Turn right at the bottom of the ramp onto Route 125 South.
Take the first left turn onto Applebee Road.  Continue straight approx 1 mile.
Branch Hill Farm is on the left.   Look for Piscataqua sign.  Park in the field.

Times:            Indicate preferred time on entry form.  Rideout is between 9:00 and 11:30am.
Preferred times will be given to pre-registered riders.

Divisions:      Hilltop, Field and Non-Competitive. Fences maximum height 3’ (all gapable

Weather:        PACE WILL BE HELD RAIN OR SHINE.

Entries:          Pairs or teams of three or four.

Dress:             Hard hat with harness whenever mounted & hard soled shoes with heels required.

Awards:         Six ribbons in competitive.  No ribbons will be awarded in non -competitive.

Fees:               Hilltop/Field Divisions                          $25.00       $10.00 Juniors (18 years and younger)

                        Non-Competitive                                    20.00         10.00 Juniors (18 years and younger)

                        Late Fee                                                      5.00     (received after September 1 or day-of-event)

Questions?

Cheryl Niles   (603) 749-0452 or piscataquahounds@comcast.net

    There will be a rest (a stirrup cup in the middle with lemonade, water, cookies & carrots provided.

Bring water & a picnic lunch to enjoy afterwards!

Make check payable to Piscataqua Hounds.                Mail Entries, signed release and current negative Coggins to:

                                                                                Cheryl Niles, 200 Sixth Street, Dover, NH  03820

Agreement for Release &Waiver of Liability

For

Carl Siemon Family Charitable Trust (Branch Hill Farm)

Horseback riding is inherently dangerous and my cause injury to the rider or people on the ground, and I accept and assume full responsibility for any damages incurred, including death.

NEITHER BRANCH HILL FARM NOR THE CARL SIEMON FAMILY CHARITABLE TRUST ARE RESPONSIBLE FOR THEIR OWN NEGLIGENCE OR THAT OF THE PARTICIPANTS.

In exchange for being permitted to participate in the hunter pace at Branch Hill Farm, otherwise known as the Carl Siemon Family Charitable Trust (CSFCT), Milton Mills, NH on _______________, for myself, my heirs, guardians, and legal representatives release and agree not to make or bring claim of any kind against Branch Hill Farm or CSFCT, or their officers, directors, employees, members, or guests.    Myself, my heirs, guardians, and legal representatives also release and agree not to make or bring claim of any kind against the Piscataqua Hounds, its masters, officers, directors, members, employees, or guests, or any landowner, landholders, or other persons making property available for this fundraiser, for any injury (including death) to me or any damage to my property whether from negligence or not, or any other cause, arising out of my participation in these activities; and I also agree that if anyone makes any claims because of any injury to me (including death), or for any damage to my property, I will keep all those released by this agreement free of any damages or costs because of those claims.

Dated:

_________________________________              _____________________________

Witness                                                                        Particpant

Agreement For Release & Waiver of Liability

In exchange for being permitted to participate in the Piscataqua Hounds Pace at Branch Hill Farm, Milton Mills, NH, on Sept. 4, 2010, for myself, my heirs, guardians, and legal representatives, I release and agree not to make or bring any claim of any kind against the Piscataqua Hounds, or its masters, officers, directors, members, employees, or guests, or Branch Hill Farm, or the “Carl Siemon Family Charitable Trust”, or any landowners, landholders or other persons making property available for the Piscataqua Hounds, for any injury (including death) to me or any damage to my property whether from anyone’s negligence or not, or any other cause, arising out of my participation in these dangerous horseback riding, fox hunting or related activities;  and I also agree that if anyone make any claims because of any injury to me (including death) or for any damage to my property, I will keep all those released by this agreement free of any damages or cost because of those claims

Rider #1                                                                                         Rider #2

Name                                                                                               Name                                                                                              

Address                                                                                           Address                                                                                          

Signature                                                                                         Signature                                                                                        

                    If rider is under 18, signature of guardian required.                     If rider is under 18, signature of guardian required.

Horse’s Name                                                                                 Horse’s Name                                                                                

Date                               Phone                                                        Date                               Phone                                                       

          E-mail                                                                                              E-mail                                                                                   

Rider #3                                                                                         Rider  #4

Name                                                                                               Name                                                                                              

Address                                                                                           Address                                                                                          

Signature                                                                                         Signature                                                                                        

                    If rider is under 18, signature of guardian required.                     If rider is under 18, signature of guardian required.

Horse’s Name                                                                                 Horse’s Name                                                                                

Date                               Phone                                                        Date                               Phone                                                       

          E-mail                                                                                              E-mail