Iron Range Saddle Club WSCA Horse Show #_________

Saturday July 31, 2010                      _________ Jackpot $10 each                  __________

                                                                                           Entries                       __________

I hereby absolve St. Louis Co. Agricultural Fair Association the office of the Commissioner of the IRRRA an Administrative Agency of the State of MN and the Iron

Range Saddle Club and all parties connected with the horse show from any and all claims to injury to horses, equipment, or attendants, AND I agree to take full

responsibility for any injury or damage caused by my horse or myself. All Balkan Saddle Club events are open to all people regardless of race, religion, age, gender or

disability.

Name __________________________________________Horse__________________________________________

Address________________________________________________________________________________________

Club Affiliation__________________________________Signature________________________________________

                                                                                                                                                                                                             If under 18 must have a Parent or Guardian sign

Participant and or owner agrees to indemnify and hold the St. Louis County Agricultural Fair Association, the IDCC, and the Office of the Commissioner of the IRR, an

administrative agency of the State of Minnesota, any and all sponsors, and officers, directors, members, employees, and agents of all, harmless for any and all liability claims and

damages or any type or from any cause which may arise from myself and or my horse being on one the St. Louis County Fairgrounds and/or participating in any and all horse

events held on the St. Louis County Fairgrounds. I further agree to assume personal responsibility and liability for any and all damages caused by or to myself, my horse, my

equipment and/or attendants while on the St. Louis County Fairgrounds, or while within any area used by the St. Louis County Agricultural Fair Association.

____________________________________ __________

Participant Signature (parent or legal Date guardian if under 18)

____________________________________ __________

Horse owner's Signature (parent or legal Date guardian if under 18)

If participant owns horse, they must sign in both places. If owner is different than participant BOTH must sign. Note if either is under 18,

parent or legal guardian must sign for them.

__________________________________

Participant Signature (parent or legal guardian if under 18) Date

___________________________________

Horse owner's Signature (parent or legal guardian if under 18) Date

If participant owns horse, they must sign in both places. If owner is different than participant BOTH must sign. Note, if either is under 18,

parent or legal guardian must sign for them.