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        APPLICATION FOR MARE PERFORMANCE TEST         

ATA Mare Performance Test Requirements

Owner's Name: Phone: eMail:

Street: City: State/Province: Zip:

Horse’s Registered Name: ATA Reg#: Foal Date:

Sire: Dam: DamSire:

Breeder:

INSPECTION DATE/SITE YOU WILL BE ATTENDING :

 

Horse has been accustomed to the saddle:  No
Horse has been ridden for:        Months / Years
Horse has competed or been shown under saddle:  No
I agree to allow my horse to be drug-tested at the ATA Mare Performance Test. No

 

 

 

 

Rider’s Information

Name: Address: Date of Birth:

Parent Name / Guardian responsible if rider is under 18: Phone:

Test Fee 

 

 

Please mail a check or call the ATA Office with your credit card # to pay your fees. Note: all fees must be received by office prior to performance test.


Liability Release:                     

            In consideration for being permitted to participate in the Performance Test, the undersigned acknowledges and agrees that he/she is aware of the intrinsic dangers of equine activity which include, but are not limited to: (1) the propensity of equines to behave in ways that result in injury, harm or death to persons on or around them; (2) the unpredictability of an equine’s reaction to such things as sounds, sudden movement, unfamiliar objects, persons or other animals; (3) certain hazards such as surface and subsurface conditions; (4) collisions with other animals, objects or persons; and (5) potential of a participant acting in a negligent manner that contributes to injury to the participant or others, such as failing to maintain control over the equine or not acting within the participant’s ability.

            The undersigned hereby releases, waives, discharges and covenants not to sue the ATA, its promoters, participants, owners, judges, hosts, staff, facility or jury hereinafter referred to as “Releasees” from all liability to the undersigned and the undersigned’s personal representatives, assigns, heirs, and next of kin, for any and all loss or damage, and any claims or demands therefore on account of injury to the person or property of the undersigned, or resulting in death of the undersigned, whether caused by the negligence of the Releasees or otherwise, while participating in the ATA event.

            The undersigned hereby agrees to indemnify and save and hold harmless the Releasees and each of them from any loss, liability, damage or cost they might incur due to the presence of the undersigned in the ATA event, whether caused by the negligence of the Releasees or otherwise.

            The undersigned hereby assumes full responsibility for and risk of bodily injury, death or property damage due to the negligence of Releasees or otherwise, while participating in the ATA event.

            The undersigned has read and voluntarily signs this release and waiver of liability and indemnity agreement and further agrees that no oral representations, statements or inducements apart from the foregoing written agreements have been made.

 

Owner Signature: ____________________________   Rider Signature:_________________________________


Owner Name (printed)   Rider Name (printed):



Owner Parent/Guardian if under age 18:                    Rider Parent/Guardian if under age 18:


Signature: ________________________________      Signature: ______________________________

 

Date signed: ______________________________     Date signed: _____________________________

 


Please note - you must print this form and sign it and fax/mail to the ata office.

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