1. Acknowledgement and Assumption of Risk. I acknowledge that Barrel racing is an activity being held at
Canterbury Park Holding Corporation (“CPHC”). I understand and agree that there are risks of significant injury,
whether caused by me or someone else, some of which may be inherent, by participating in the Barrel racing,
hereinafter referred to as the “Activity”. I understand and agree that participating in the Activity involves many
risks and hazards, some of which are inherent to the very nature of the Activity itself, others of which may result
from ordinary negligence including but not limited to falling for any reason, including uneven terrain, being
airborne, jumping or collisions with other riders, horses, fixed or moving objects, as well as dangers arising from
excessive speed, ordinary negligence or inexperience of other riders, from equipment failure or inadequate safety
equipment, from uneven trails or changing trail/course conditions, and weather conditions. I agree that if I believe
conditions are unsafe, I will immediately discontinue participating in such Activity. I understand and agree that
these risks may result in injury, harm or damage, including but not limited to economic, property, emotional,
mental, physical or any other type of damage, including but not limited to sprains, torn muscles or ligaments,
broken bones, strokes, heart stress, heart attacks, paralysis, disfigurement, death or other forms of pain or
suffering. I fully understand, voluntarily accept, and specifically assume responsibility for these risks of injury.
2. Waiver of Liability and Indemnification. I agree to release and discharge from all liability, and waive all claims,
demands and actions against CPHC and Extreme Events MN for any and all injuries, harms, or damages sustained
in connection with my participation in the Activity, described above, resulting from the ordinary negligent acts or
omissions of me, CPHC, Extreme Events MN, other participants or any persons encountered while participating in
the Activity. I agree to defend, indemnify and hold CPHC and Extreme Events MN harmless against any and all
claims brought by anyone against CPHC and Extreme Events MN related to such injuries, harms or limited to
payment of CPHC or Extreme Events MN reasonable attorney’s fees and costs incurred in defending a claim
demand or action waived herein.
3. Release of Image and/or likeness. I understand that CPHC and Extreme Events MN will be taking photographs
and making audio and video recordings of the Indian Relay and its related events. I hereby irrevocably consent to
and grant CPHC, Extreme Events MN, and/or anyone authorized by CPHC or Extreme Events MN, the exclusive
right to the ownership and use of (i) any and all photographs taken by CPHC, Extreme Events MN, and/or anyone
authorized by CPHC or Extreme Events MN that contain my person, image and/or likeness; (ii) any and all audio
recordings made by CPHC, Extreme Events MN, and/or anyone authorized by CPHC, that may contain my person,
name or voice; and/or (iii) any and all video recording made by CPHC, Extreme Events MN and/or anyone
authorized by CPHC or Extreme Events MN, that contain my person, image, likeness, name or voice; for any lawful
purpose whatsoever in connection to CPHC, Extreme Events MN and its related events.
________________________________ ______________________
Participant Signature Date
Parent or Guardian Agreement
If participant is under the age of 18, Participant’s parent or guardian does agree and consent as follows:
1. As the legal guardian or parent, I do hereby give my consent and agree that
_________________________________ (hereinafter referred to in this Agreement as the Undersigned) may
participate in the Activity described in the Agreement. My signature below is my affirmation that I have read
the terms of this Agreement, that I understand those terms and conditions, including my duty to provide
adequate medical coverage; to explain to the Undersigned the dangers and risks inherent in the Activity; and
to explain and direct him/her to obey all of the rules of CPHC, and to comply with the directions from CPHC,
Extreme Events MN staff and volunteers.
2. I understand that CPHC and its staff are not physicians or medical practitioners. With this knowledge in mind, I
expressly consent to allow CPHC to provide, through medical staff of its choice, necessary medical treatment,
First Aid and Emergency Medical Assistance and necessary medical transportation, including ambulance
services, to a hospital, health care or treatment facility as deemed necessary with respect to any injury, or
medical condition that may be observed during the course of the Undersigned’s participation in the activity.
3. I, on my own behalf, and to the extent permitted by applicable law, on behalf of the undersigned, hereby
RELEASE CPHC and Extreme Events MN , their respective staff, employees, officers, agents and volunteers
from any liability arising out of any negligent act or action that results in any loss, injury or damage that may
occur as a result of or relates to participation in the Activity. I, on my own behalf, and to the extent permitted
by applicable law, on behalf of the Undersigned, hereby waive all rights and claims for damages that I or the
Undersigned may have against officers, and agents and volunteers.
I affirm that I am authorized to sign this Agreement and Parental Acknowledgement and Consent, and that no
other person or entity is required to give his or her consent.
Animal Entry Requirements
HEALTH CERTIFICATES
All horses (including pony/outrider horses) entering the grounds for the first time must have an original
health certificate (Certificate of Veterinary Inspection) issued within five (5) days of their arrival and a
negative Coggins Test Certificate issued within twelve (12) months of arrival. Equine rhinopneumonitis
(EHV-1 and EHV-4) and Influenza vaccination dates, specific product used, and expiration date and rectal temperatures for each horse should be included on the health certificate.
VACCINATIONS
Every horse entering the enclosure of the racetrack must have been vaccinated by a veterinarian with an FDA approved modified live or killed virus vaccine specific for EHV-1 and EHV-4 and Influenza not less
than 14 days and not more than 180 days prior to date of entry. The specific product used and expiration date as well as the date the horse was vaccinated must appear on the health certificate. Horses must be vaccinated no later than July 5.
ALL OTHER ANIMALS
All other animals will require a health certificate. No specific requirement on those but event hired
veterinarian should know the information needed. Those should be completed by July 18
All health certificates with vaccination information and a negative Coggins test certificate must be
submitted to Andrew Vold no later than July 18. Certificates can be submitted via email or photos of
documents can be sent via text to the information.
Andrew Vold
avold@canterburypark.com
763-234-5966 (cell phone)
