SAVE AND COPY THIS FORM FOR PARTICIPATION IN BVDC ACTIVITIES

Brandywine Valley Driving Club, Inc. Liability Disclaimer

Name of Event:________________________________   (Date)_________________                

Participant:________________________________                 Birthdate ___/___/___.
                                                                                                                        if under 18
Address:_____________________________________________________________
                            street                                                city,                        state     zip
Phone:_________________________________

TO BE SIGNED BY EVERY CLUB MEMBER, PARTICIPANT, GROOM, GUEST, AND/OR ANY
PERSON WHO RIDES WITH A DRIVER ON A CARRIAGE AT ANY TIME. FOR CLUB MEMBERS,
THE TERMS AND CONDITIONS HEREIN APPLY TO EVERY EVENT DURING THE MEMBERSHIP
PERIOD.

        I understand that neither the Brandywine Valley Driving Club, Inc. ("Club"), its officers, directors,
officials, organizers, members, volunteers, trainers, helpers, employees, servants, workers and/or agents, nor the
property owners, accept any responsibility for accidents, damage , injury or illness to me, or any other persons
or property in connection with any event, competition, show, schooling show, pleasure drive, clinic, horse
riding activity, carriage riding activity, or any other participation in any event and/or activity by me while on
any premises used by the Club, or on the premises of an Club member holding a club-related event.

        I hereby expressly agree for myself and my principals, representatives, employees, and agents that horse
sports, including spectators, drivers and/or riders, involves inherent dangerous risk of serious injury or
death and by participating, I do so voluntarily and expressly assume any and all risks of injury or loss, and I
agree to indemnify and hold the Club, its officers, directors, members, volunteers, employees, and agents,
harmless from and against all claims including any injury or loss suffered during, or in conjunction with any
activity on these premises, any premises used by the Club, or any member's premises for a club-related event,
whether or not such claim, injury or loss resulted, either directly or indirectly from the negligent acts or
omissions of the Club, its officers, directors, members, volunteers, trainers, helpers, employees, agents,
officials, and/or organizing committee. I further agree not to commence an action or suit, in this, or any other
jurisdiction, for any such injuries or losses.

I _______________________________ have read this Liability Disclaimer and hereby acknowledge
that I understand and agree to its terms and conditions as expressed herein, and will abide by such terms as set
forth above.

                                        Signature________________________________

                                            (parent or guardian if under 18)

                                        Signature________________________________
                                        Signature________________________________
                                        Signature________________________________

                                                          Dated:_________________