Pacific Penning and Sorting Association

PPSA Membership form coming soon!

Pacific Penning and Sorting Association
Minor Release Form



MINORS MUST HAVE THE FOLLOWING LIABILITY SIGNED BY THEIR PARENTS OR LEGAL GAURDANS.



We the undersigned parents of__________________________________for and in consideration of our child’s participation in Pacific Penning and Sorting Association activities state that we have read the waiver, release and hold harmless written on reverse hereof and we expressly agree that the terms and conditions of said waiver, release and hold harmless shall apply to and be binding upon us and our minor child so far as it pertains to his or her participation and any injury or damage said minor child or his or her horse my sustain or cause as a result of said participation.  We further warrant we have health and accident insurance on said minor.

I declare under penalty or perjury that the foregoing is true and correct.


Executed this __________________ day of ____________ 20_______  at Santa Clara County.


Age of minor child ___________ .  Children age 10 and under MUST wear a helmet when on horseback of any kind
.

Mothe-------------------r _______________________________________________________ ___________________________


Father  ______________________________________________________ ____________________________


Legal Gaurdian ______________________________________________________ _____________________






I do acknowledge that I have read the foregoing paragraphs and know and understand the content thereof.


Signatures(s)      ________________________________      _________________________________________


Mailing Address _____________________________________________________


City                     __________________________ Zipcode ______________________________


Phone Number (    ) ____________________________________________________


Email Address ________________________________________________________