WAIVER AND NOTICE

In consideration of the actions of the ___________________________________Pony Club "CLUB" which is a member of the Virginia Region Pony Club "VRPC" and of the United States Pony Club Inc. "USPC", and provides instruction, Rallies and other equestrian related activities for its members; and having notice that

there are risks inherent in participating in any equine activity including: 1) the propensity of an equine to behave in dangerous ways which may result in injury to or death of the participant; 2) the inability to predict an equine's reaction to sound, movements, objects, persons, or animals; and 3) certain hazards such as surface or subsurface conditions; and

The undersigned, on behalf of himself or herself and all members of his immediate family and household, and his and their heirs, executors, administrators and assigns (collectively the "Participant") does hereby forever release and discharge the CLUB, VRPC, and USPC and their members from any and all claims, demands, causes of action and liability, of any nature, which may arise from or in connection with activities run or sponsored by the CLUB, VRPC, or USPC, including but not limited to lessons, ground school, and Rallies; and

The undersigned agrees on behalf of the Participant to waive and not to assert by action at law or in equity or otherwise any claim, demand, cause of action, or liability against the CLUB, VRPC, and USPC and its members; and

This waiver continues to be binding unless revoked in writing and personally delivered to the District Commissioner (DC) of the CLUB. Upon revocation the member's rights to take part in riding activities of the DRPC is automatically terminated.

FOR THE PARTICIPANTS - All members of the CLUB 18 and over must sign below. A parent's signature on behalf of a minor participant is also required.

__________________________________________________________________

Signature: (parent or guardian if under 18)

__________________________________________________________________

Name of Minor Participant:

Date: ______________________________