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Roman Nose Hills Charitable Trail Ride

Benefiting Watonga Hospital Foundation

Base Camp: Wolfe Ranch,  Adjacent Roman Nose State Park

Liability Waiver

Required for all participants

                                    Name :_____________________________Address:________________________________

                                              City :_________________St :_______ Zip :___________Phone :______________________

                                              Vehicle Description :______________________Tag # :_______________________________

                                               In Case of Emergency Notify : ______________________Phone : ______________________

                                                                                                                    To be completed at Gate

                                               Number of Horses : ____________ Cogins Checked by : _____________________________

Participants under 18 years of age require signature of Parent or Guardian.

          Minimum age for riders 6 years old.                

In consideration of my voluntary participation in this charitable trail ride, I hereby for myself, my heirs and my personal representative,  assume any and all risks which may be associated with this trail ride, and release, discharge, covenant not to sue, and hold harmless Watonga Hospital Foundation, Inc, its officers, members, sponsors, organizers, agents, ranch owners, and any other cooperating individuals or groups,  and their successors, in connection with any and all injuries, illnesses and damage of any kind whatsoever, including loss of property suffered by me as a result of my voluntarily taking part in this trail ride and any related activities whether caused by the negligence or any fault of Watonga Hospital Foundation, organizers, volunteers, or otherwise.  I certify that my horse and I are in proper physical condition to participate in this trail ride without risk of injury.  I have carefully read this liability waiver and fully understand its contents. I am releasing certain legal rights that I otherwise may have, and enter into this liability waiver in behalf of myself and/or my family on my own free will.

Signature of Adult Participant/Parent/Guardian__________________________________________

Name of Minor Participant ________________________________________________________

Return to :

Watonga Hospital Foundation, Inc.

Trial Ride

P.O. Box 370, Watonga, Ok. 73772