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PISCATAQUOG AREA TRAILWAYS
MOTHER’S DAY RIDE
Sunday May 10, 2015
Tingley’s Gravel Pit, Route 13, New Boston, NH
AFFILIATED WITH NEW ENGLAND HORSE & TRAIL and NEW HAMPSHIRE HORSE & TRAIL
Registration 8:00 a.m.; Rideout 9:00 a.m., Mileage 7 and 12 Please note: light breakfast, no water or toilet, light lunch so you can be home in time to enjoy a Mother’s Day dinner with your family
ENTRY BLANK
Ride Fee = $25.00 per adult, $15.00 youth under 18, riders 16 and under MUST be accompanied by adult rider. Extra meals = $5.00 each # _____@ $5.00 = $_____________ Total Amount $ ______________
RIDER___________________________________________________________________________________________
HORSE__________________________________________________________________________________________
Mailing Address___________________________________________________________________________________
Email_______________________________________________________Phone_______________________________
Member of New Hampshire Horse & Trail? ______ Yes ______ No NHH&T Rider # ________ Horse # ____________
Member of New England Horse & Trail? _____ Yes ______No NEHT Rider#______________Horse#______________
Trail length: ______ 7miles _______ 12 miles (depending on trail conditions at time of ride)
WAIVER OF LIABILITY
Every entry at this trail ride shall constitute an agreement that the person making it, and the horse, agree to hold harmless the PISCATAQUOG AREA TRAILWAYS, Tingley Gravel Pit and their officials, directors and employees for any action taken. I, my party, and my heirs, further agree that if any damage is occasioned by, or injury or loss occur to myself or the horse entered, or to any vehicle or other article or possession that I may send with such horse, that I will make no claims, either now or forever thereafter. I further agree to indemnify, forever, the ride, the Piscataquog Area Trailways Ride Committee, Tingley Gravel Pit and all other property owners and any participants in the event against all claims, demands, suits, and loss or damage to any property or person caused by myself, my horse, my attendants or my vehicle. I understand that trail riding can involve being in remote areas for extended periods of time, far from communications, transportation, and medical facilities; and that these areas may have many natural hazards which ride management cannot anticipate, identify, modify, or eliminate; that horses can be excitable, difficult to control, and unpredictable; and that accidents can happen to anyone at anytime. Further, I agree to abide by the limitations of actions stated in the “NH Equine Liability Law,” RSA 508: 19, effective January 1, 1999.
Signature of Rider__________________________________________________________Date____________________
FOR MINORS signature of parent or guardian____________________________________________________________
RETURN ENTRY BLANK WITH CHECK PAYABLE TO PISCATAQUOG AREA TRAILWAYS. Send to
CHRIS LIPPINCOTT, Treasurer, 438 CLARK HILL ROAD, NEW BOSTON, NH 03070, 6034875168. Email: [email protected]
MEDICAL WAIVERS & INFORMATION
>>>>>FOR MINORS: In case of injury to a minor, this authorizes Piscataquog Area Trailways or its agents to secure whatever emergency medical treatment is needed for my minor child entered in this event, with no liability whatsoever to Piscataquog Area Trailways, the owners of the properties, or anyone involved in this ride.
Signature of Parent/Guardian for minor child______________________________________________________Phone__________________________
>>>>>FOR ALL RIDERS If you desire to give it, this information could be of help in an emergency.
List Allergies or other pertinent information______________________________________________________________________________________
Regular Doctor & Phone_____________________________________________________________________________________________________
Insurance Carrier__________________________________________________________________________________________________________
Name & Phone of nearest relative_____________________________________________________________________________________________
Directions:
From Manchester, N.H.:
Take Rte.114 to Goffstown.
In Goffstown turn left onto Rte. 13 towards New Boston.
In New Boston village turn left at second stop sign following signs to Rte. 13 South. Go past Post Office on left and over bridge. Gravel pit is on right.
From Nashua, N.H.:
From Rte. 3 take exit 8, at third light turn right onto Rte. 101A towards Milford.
At the Milford rotary turn right then continue straight onto Rte. 13 North toward Mount Vernon. Continue through Mount Vernon into New Boston. Go past the Baptist Church and Lyndeborough Road on the left and down a steep, winding hill. At bottom of hill on left is the Gravel pit.
From Keene, N.H.:
Follow Rte. 101 East towards Peterborough. Turn left after lights following signs for Rte. 202 and Greenfield.
1.5 miles turn right onto Rte. 136 towards Greenfield.
Follow Rte. 136 through Greenfield into Francestown.
In Francestown continue on Rte. 136 into New Boston village. Go straight onto Rt. 13 South towards Mont Vernon. Go past the New Boston Post Office on left and over bridge. Gravel pit is on right.
www.PiscataquogAreaTrailways.com