Sharing our love of horses & the outdoors for almost 25 years!

PARTICIPANT CONTACT INFORMATION

Participant's Name
Address

PERSONAL/MEDICAL HISTORY

DOES PARTICIPANT HAVE ANY PHYSICAL OR MENTAL CONDITION(S) that may affect his/her safety and ability to ride a horse?
If “Yes,” how can we help this participant with his or her special needs?
Participant's Date of Birth
WEIGHT OVER 230LBS:
HORSE RIDING EXPERIENCE (Check one that applies)
MEDICAL INSURANCE I/WE AGREE THAT
I do not carry medical insurance
RIDING VOLUNTARILY

RISKS, DEFINITIONS, & WARNINGS

AGREEMENT SCOPE AND TERRITORY AND DEFINITIONS
INHERENT RISKS/ASSUMPTION OF RISKS I ACKNOWLEDGE THAT
WILDERNESS EXPERIENCE PARTICIPATION, CONDITIONS OF NATURE WARNING, UNFAMILIAR AND SUDDEN SIGHTS, SOUNDS, AND MOVEMENTS WARNING, AND INSPECTION OF PREMISES. I/WE ACKNOWLEDGE THAT
CARRY-ON OBJECTS WARNING AND SHARP, LOUD NOISES WARNING I/WE ACKNOWLEDGE THAT
SADDLE GIRTH LOOSENING WARNING I/WE ACKNOWLEDGE THAT

RIDER AGE/PROTECTIVE HEADGEAR/HELMET REQUIREMENT

RIDER AGE/PROTECTIVE HEADGEAR/HELMET REQUIREMENT
PROTECTIVE HEADGEAR/HELMET WARNING AND OFFERING: I/WE AGREE THAT
PROTECTIVE HEADGEAR/HELMET ACCEPTANCE OR REFUSAL SELECTION FOR RIDERS 16 YEARS AND OLDER

LIABILITY RELEASE

LIABILITY RELEASE I AGREE THAT
VIRGINIA WARNING

SIGNER STATEMENT OF AWARENESS

Each participant and parent or legal guardians must sign below after reading and completing this entire document.
SIGNER STATEMENT OF AWARENESS
THIS CONTRACT/AGREEMENT
Clear Signature

Contact Us

North Mountain Outfitter
709 North Mountain Road
Swoope, Virginia 24479 
540.886.7768

North Mountain Outfitter is a permittee
of the George Washington National Forest

Gift Certificates

Give the gift of a memory! Gift certificates to North Mountain Outfitter make the perfect Holiday gift, Wedding present, or Birthday surprise. Let us help plan your gfit today!