148, FOX HILL RD, ANCRAMDALE, NY, 12503
I the undersigned hereby waive any and all claims that I, my estate, heirs and / or assigns may have against Beckenrah farm, Saida Baxt, Woody Baxt, their Children and Employees and property owners surrounding Beckenrah Farm. The Columbia land Conservancy herein ("the releasees") for any personal injuries to me, my horses and / or my property that I may sustain or which may arise out of riding the trails and jumps during the hunter pace, or while riding at Beckenrah Farm and surrounding property with permission, including any failure on the part of the releasees to exercise due care or any negligence in or defects in the course, equipment and / or grounds provided by the releasees. I also assume full responsibility for any damage that I may do or cause while participating in an event or riding at any time.
Signature:_______________________ Date:__________
Print Name:____________________________________
Email address: __________________________________
Signature of Parent or Guardian (if minor):____________________________________