Headwaters Derby Series Participant Waiver

At Park Lane Horses
5647 6th Line, Erin, ON N0B 1Z0

Participant Waiver

I certify that every horse and rider listed on this form is eligible as entered.

I further certify that the rider will wear a properly fitted ASTM or BSI approved helmet at all times when mounted anywhere on the tournament grounds.

I understand that all equestrian sports involve inherent risk of injury and understand further that no helmet or protective equipment can protect completely against all foreseeable injury.

I accept this risk and hold harmless the Headwaters Derby Series, Park Lane Horses, and each of their staff, volunteers, officials, organizers, agents, directors, officers, employees, representatives, and affiliates against any personal injury, property damage, claims, costs, or loss relating to my participation in this tournament.

I have received and had opportunity to review the Headwaters Derby Series Schedule/Prize List. I understand and agree, for myself and each of my representatives, to be bound by and comply with the rules and regulations set out in the Prize List General Information, including without limitation:

• Equestrian Canada rules and regulations, including but not limited to vaccine requirements for individuals and horses
• The Headwaters Derby Series Code of Conduct
• The Headwaters Derby Series Rules and Regulations
• Biosecurity protocols, understanding that they are based on current regulations and may change with little notice
• The Headwaters Derby Series Liability Clause
• The Headwaters Derby Series recognition of media, intellectual property, and sponsorship rights

Though not an Equestrian Canada sanctioned competition, I understand that the competitions are also governed by the rules and regulations of Equestrian Canada and the Canadian Centre for Ethics in Sport. I am familiar with and agree to comply with these further rules and regulations.

I further understand that all Headwaters Derby Series events will be governed by the laws of Ontario and Canada, and any suspicious activities will be reported to the proper authorities.

In the event that I or the rider listed participates in competition where protective headgear is required for juniors, the rider will wear properly fitted and fastened approved headgear at all times while riding or driving at the event location. It is understood that juniors not meeting this requirement will not be allowed to compete at these competitions.

The person responsible agrees to the release of any information on the entry form to Equestrian Canada.

By checking the waiver agreement box during online registration, the participant, parent/guardian, or person responsible confirms that they have read, understood, and agreed to this waiver.