202 TRACKROCK CAMP RD. BLAIRSVILLE, GA REGISTRATION FORM. Name of Camper: Enrolling for:

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1 TRACKROCK STABLES 2017 HORSE CAMP 202 TRACKROCK CAMP RD. BLAIRSVILLE, GA web: trackrock.com REGISTRATION FORM Name of Camper: Enrolling for: (Indicate choices) April 3 7 April June 5-9 June June June July July July July 31 Aug This week is 4 days. Cost for the week is $360 or $100 per day. Aug 7-11 Aug December 26 30, 2017 January Age Date of Birth Height Weight Riding Experience (check one) Extreme Beginner Has been on a horse less than 5 times Beginner- Walk, stop and able to guide horse vice- Walk and trot -Walk, trot, canter -Walk, trot, canter with balance and control, correct leads Have you attended Trackrock Horse Camp before? yes no How many times? Camp Horse Preferred Parent s Names: Street Address: City: State: Zip:

2 Phone # s: Emergency Contact: Phone: Swimming Ability: Restrictions: Special/Medical Needs? (Please describe, including allergies) Who will be transporting child to/from camp: Phone# s I have read and understand the Participant s Release of Liability Form and the Horse Camp 2017 Important Information Sheet. Signature of Parent/Guardian DATE $450/week; $100/day $25 off if paid in full 30 days in advance If you are under 7 years of age must get special permission to attend camp. Horse Camp T-shirts for sale for $5.00 to students! (limit 1 per child; we ask the your child wear the t-shirt on Friday) ***Each Camper needs to bring their own lunch and sunscreen.*** Spring & Summer Camp Hours 9:00a.m. 5:00 p.m. except Friday 4:00 p.m. Winter Camp Hours 9:00a.m. 4:00 p.m. DEPOSIT INCLUDED: CHECK # AMOUNT DUE:

3 To Whom it May Concern: MEDICAL TREATMENT RELEASE FORM As parent/guardian, I do hereby authorize the treatment of a qualified and licensed physician of any condition which, in the opinion of the physician, is deemed necessary and appropriate. This authority is granted only after a reasonable effort has been made to reach me. Name of Minor Relationship to You: Reason for which release is intended: Address of Minor: City: Emergency Phone(s): Family Physician: Physician Address: Phone: City: List allergies, medication, contract and other pertinent comments: Health Insurance Data: Company: Group: Policy: Contract: I further authorize the person who presents the minor to sign the Acknowledgment of Receipt of tice Privacy Rights that may be presented by the physician or health care facility. This authorization is completed and signed of my own free will with the sole purpose of authorizing medical treatment deemed necessary and appropriate by the treating physician. Date: Signed: (Parent or Guardian) Date CERTIFICATE OF ACKNOWLEDGEMENT OF NOTARY PUBLIC State of County of On this date, personally appeared before me. Please initial one of the following: OR Personally known to me Proved to me on this basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed and acknowledged to me that he/she/they executed the Authorization for Consent to Medical Treatment of Minor. (Signature of tary Public) My Commission Expires: STAMP/SEAL

4 TRACKROCK RIDING ACADEMY, INC. 202 Trackrock Campground Road, Blairsville, GA (706) PARTICIPANT S RELEASE OF LIABILITY I recognize that there is an element of risk and danger in any adventure, sport or activity, including equine activities such as horseback riding. Knowing of such risks, dangers and rigors, I certify that I and each person for whom I have parental or guardianship rights or responsibilities, whose names are listed below, are mentally and physically capable of participating in the riding of horses. I understand that such activities can be dangerous and assume any and all risks of bodily or personal injury, death or damage to property that can result from participating in such activities. WARNING: Under Georgia law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to Chapter 12 of Title 4 of the Official Code of Georgia Annotated. Without limiting the statutory protections offered under the above-referenced Georgia law, each of the undersigned for an on behalf of himself or herself and those for whom he or she has parental or guardianship rights or responsibilities, does hereby, now and forever, unconditionally and irrevocably, release, acquit and discharge Trackrock and its owners, directors, officers, employees and agents, and the real property on which it conducts equine activities and the owners thereof (collectively Trackrock ) from any and all past, present and future claims of any kind or character, and any and all liabilities now accrued or hereafter to accrue, which the undersigned may have, claim to have or may hereafter have or claim to have, against Trackrock on account of or because of, any and all damages, claims, losses, demands, bodily or personal injuries, death, causes of action, or liabilities of any nature whatsoever, in law or in equity, whether known or not known, developed or undeveloped, resulting or to result by reasons of, arising out of, or relating to, the undersigned s (including those for whom he or she has parental or guardianship rights or responsibilities) participation in the equine activities offered by Trackrock. The undersigned hereby agrees to and does hereby indemnify and forever hold harmless and defend Trackrock from and against any and all damages, claims, losses, demands, costs, expenses (including litigation expenses and attorney s fees), or liabilities of any nature whatsoever, which (i) are in any way connected with the claims, or other matters herein released, or (ii) arise out of, or relate to, the undersigned s (including those for whom he or she has parental or guardianship rights or responsibilities) participation in the equine activities offered by Trackrock. I further understand that Trackrock reserves the right to refuse any person it deems in its sole discretion to be incapable of horseback riding. Trackrock recommends that all visitors wear a helmet when participating in equine activities. Name(s) of Participant(s) Official Use Only Initials Date Time 1 Hour 2 Hour # of Horses # of Adults $ # of Children $ Children riding Dbl $ Subtotal Sales Tax Total Credit/Debit Check Cash Lesson Riding Skill Level (circle one) Helmet (circle and initial) Print Name Signature Date Street City State Zip Phone Print Name Signature Date vice vice Name of Participant s Minor Child: Print Name Age vice Name of Participant s Minor Child: Print Name Age vice Name of Participant s Minor Child: Print Name Age vice

5 trackrock riding academy, Inc., d/b/a trackrock stables 202 Trackrock Campground Road, Blairsville, GA (706) participant s release of liability page two nature of horses I/We understand that Trackrock Stables chooses its rental horses for their calm dispositions and sound basic training as is required for use as riding horses for novice and beginning riders. If a horse is frightened or provoked it may divert from its training and act according to its natural survival instincts which may include, but are not limited to, stopping short, changing directions or speed at will, bucking, rearing, kicking, biting or running from danger. conditions of nature Trackrock Stables is not responsible for acts and occurrences, or elements of nature that can scare a horse, cause it to fall, or react in some other unsafe way. Such conditions include thunder, lightening, rain, wind, water, wild and domestic animals, insects, reptiles, which may walk, run or fly near, or bit or sting a horse or person; and irregular footing on out of door groomed or wild land which is subject to constant change in condition according to weather, temperature, and natural and man-made changes in landscape. rider responsibility The rider shall be responsible for his/her own safety. Riders should not carry loose items on rides which may fall, blow away, lap in the wind, bounce, or make sharp noises, possibly scaring a horse. Such items include cameras, video cameras, hats, purses or packs. Riders must not make sharp, loud noises such as screaming or yelling, which may scare a horse. The riders shall also be responsible for the safety of any unborn child if the rider is pregnant. Trackrock Stables advises pregnant women not to ride horses, unless permission is given under advice of her physician. PHOTO RELEASE - For good and valuable consideration, the receipt of which is hereby acknowledged, I hereby authorize Trackrock Riding Academy, Inc. d/b/a Trackrock Stables ( Trackrock ) permission to use my likeness in a photograph in any and all of its publications, including but not limited to all Trackrock s printed and digital publications. I understand and agree that any photograph using my likeness will become property of Trackrock and will not be returned. I acknowledge that since my participation with Trackrock is voluntary, I will receive no financial compensation. I hereby irrevocably authorize Trackrock to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing Trackrock s programs or for any other related, lawful purpose. In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph. I hereby hold harmless and release and forever discharge Trackrock from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization. Do any riders listed on Page 1 have a physical or mental condition, which may affect his/her safety and ability to ride a horse, of which we should be aware? YES NO (circle one) If YES, how can we help this rider with his/her special needs? I hereby acknowledge that I have read and understand the foregoing Participant s Release of Liability and its effect on myself and any and all minor children listed on Page 1. Participant Signature Date Participant Signature Date EMERGENCY CONTACT Name Relationship Telephone How did you hear about us? Internet Brochure Friend Repeat Sign

6 Trackrock Stable Horse Camp General Information Horse Camp Information: Spring Break Horse camp and Summer camp runs from 9:00 am 5pm, Monday Thursday, then Friday 9:00 am 4pm. Christmas camp runs from 9am 4pm. We ask that you plan your drop off in the morning no earlier than 8:30am, and pick up no later than 5:00pm. If you need different hours, please arrange in advance. Children that arrive early to camp need to be supervised by their parents until 8:30 am. Please do not allow the campers to enter the barns or pastures. On Monday Thursday during Summer camp weather permitting, we will take the children that want to swim to the lake at 4pm. Parents can meet their children at the lake and join them for a swim or pick them up at the office at 5pm. Children should bring their sunscreen, swimsuit, towel, and shoes that are easy to put on. THERE IS NOT A CERTIFIED LIFE GUARD ON DUTY. There will be an adult with the kids while they swim. The swimming area is in a manmade lake fed by a mountain stream. Children should wear sunscreen, blue jeans (no shorts) and riding shoes (no crocks, sandals, etc) sneakers are permitted. In Winter and Spring each child should wear a coat, layers (including some type of long johns), gloves, and a winter hat when not wearing a helmet. We supply water and water bottles but remember to pack all your sun protecting items, swimsuits, towels, extra shoes, and lunches (please no sodas)! Children should bring their own lunch including a drink (please no sodas). A refrigerator is available to store the lunches if needed. Snacks will be provided. If your camper cannot have cookies or ice cream, feel free to pack extra snacks for snack times. If your camper has an allergy, please tell us again, even if we already know! Friday mornings we have games on the horses in the large arena starting at 10:30am. All parents and family members and or friends are welcome to watch. It is a lot of fun. Following that is the family picnic and Awards Ceremony. Those who are participating should be at barn by 12:00 noon. Awards Ceremony will be held on Friday afternoon at our Horse Camp picnic area. Parents are invited to participate. Please bring a lunch for you and your child and something to share with the group. Sign up sheet for food/ drinks/ desserts for the luncheon at the award ceremony is on refrigerator in the barn office. Please sign up by Thursday Morning** All parents should meet at the barn office at 12:00 noon. You will be able to drive your own car up to our Horse Camp. It is located at end of the gravel farm road. If you do not want to take your car please let us know ahead of time. Following the awards ceremony on Friday, the campers will ride their horses back to the stables and are expected to take care of their horse and clean their stall before departing. Please let us

7 Trackrock Stable Horse Camp General Information know if you need to leave before 4pm on Friday. Friday the kids are allowed to decorate the horse. Please bring decorations, but no paint please! During the week (on a Tuesday, Wednesday, or Thursday), parents are welcome to join their child on a trail ride for $5.00 off per hour. Please let the staff know and they will help you make a reservation for this. (We do not want parents riding on the camp rides because it takes our attention away from the campers), and your camper can be excused to ride with you for no additional cost. T shirts are also available for our horse camp children for $5 (plus tax). Please, one t shirt per child. We ask that your child wear their Trackrock t shirt on Friday. What happens if it rains? o We have indoor games and activities, but we can also groom our horses, take care of their feet, and we ride when the weather is safe. Our Schedule for the Week: DAILY ROUTINE: 9:00 9:15 Fill waters and go over the days goal. 9:15 9:45 Daily Classroom Education (see below) Break for snack 10:00 10:30 Groom and tack horses. 10:30 11:30 Arena lesson 11:30 12:30 LUNCH 12:30 2:00 or 2:30 Trail ride 2:30 3:00 Unsaddle, rinse, and feed horses. Break for Ice cream and snacks 3:30 4:00 Turn out horses and clean stalls 4:00 5:00 Choice of swimming or activity at the barn. 5:00 Pick up at barn office. DAILY CLASSROOM EDUCATION: Monday: Safety / colors, markings, and breeds. Get to know your horse! Tuesday: Parts of the saddle and horse Wednesday: Horse diseases and illnesses Thursday: Parts of the hoof and hoof care / Bareback riding Friday: Horse decorating! Thank you very much for allowing your children to attend horse camp at Trackrock Stables.