Touch Point Farm Entry

Your Name (required)

Your Email (required)

Coggins Number(s)

Name of Horse

Class Number

Color

Sex

Height

Year Green
 1st 2nd

Owners Name

Owners Address

Rider

Rider Type

Age if Junior

Number of Entry Fees

Total Fees Amount

I hereby agree entry to a Touch Point Farm, LLC competition shall constitute an agreement and
affirmation that the owner, rider and any of their agents or representatives acknowledge that they participate
voluntarily in the competition, fully aware that horse sports involve inherent danger and risk, and by
participating, they expressly assume any and all risks of injury or loss, and they agree to hold the competition,
Touch Point Farm, LLC, Drew Taylor, manager, their officials, directors, employees and agents harmless for
any loss suffered during or in connection with the competition, whether or not such injury or loss resulted
directly or indirectly from the negligent acts or omissions of said officials, directors, employees or agents. I
AGREE that this agreement is given in part under the Virginia Equine Activity Liability Act (3.1-769.130 and
following of the Code of Virginia), which is hereby incorporated by reference.

Trainer

Address

Exhibitor or Agents Signature

Owners Name

Address

Phone

Ring Drew Taylor
Drew Taylor
540.229.6156