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Criswood Farm, 5304 Hoadly Road, Manassas, VA 20112
2022 Summer Riding Camp Release and Hold Harmless Agreement

Summer Camp starts the week of Jun 21, 2022 and runs to the week of Aug 16, 2022 for 9 weeks.
Summer Camp operates Tuesday, Wednesday, Thursday and Friday from 8am to 1pm each week.
Each session lasts 1 hour.

June 21 to 24____ June 28 to July 1____ July 5 to 8____ July 12 to 15_____ July 19 to 22____ July 26 to 29____
August 2 to 5____ August 9 to 12____ August 16 to 19____

Please complete, sign and date the below agreement and mail or bring to the farm with deposit.


Name of Rider:___________________________ Age:________  Phone Number____________________

Address:____________________________________________________________________________

Email:____________________________________________________________________________

Previous Riding Experience:______________________________________________________________

Session Date Required:__________________________________________________________________

To reserve your session dates, complete this application and return to Criswood Farm with a deposit of $50 for each week desired. Cash and checks are the only method of payment for all our services. The remaining balance is due the first full day of camp. Deposits are non-refundable. You may sign up for more than one session. Please call us at (703) 590-4224 to make sure the session you desire is not full. The sessions fill up fast.

Please indicate an allergies or medical conditions that could affect participation during horse camp:

___________________________________________________________________________________

___________________________________________________________________________________

The Undersigned assumes the unavoidable risks inherent in all horse related activities, including but not limited to, body injury or physical harm to horse, rider, and spectator. In consideration, therefore, for the privilege of riding and receiving riding instructions, and/or working around/with horses at Criswood Farm (Hoadly Road, Manassas, VA) or other equestrian facility assigned, the Undersigned does hereby agree to hold harmless and indemnify Criswood Farm Manager, Instructor, Connie Christopher, Criswood Farm, Inc., owners and heir assigns and further release the Farm from any liability or responsibility for accident, damage, death, injury, or illness to the Undersigned and his/her children or any horse owned and/or boarded by the Undersigned or to any other family member of spectator accompanying the Undersigned on the premises. I, the Undersigned person, intending to be legally bound, hereby waive for myself, agents, guardians, heirs, executors, administrators, legal representatives, assigns, and any other persons have against any of the above named individuals, or their property, arising from my equestrian or boarding activities.

By my signature, I acknowledge that I understand the above, and that handling and/or riding horses is considered hazardous activity, and I assume full liability for any personal injury or property damage to my person, child and children, person accompanying me, personal property and horses.

Signature of Parent or Guardian:________________________________________________________________

Printed Name of Parent or Guardian:_____________________________________________________________

Date:_____________________________________________________________________________________