CAMP PINNACLE
621 PINNACLE ROAD,
VOORHEESVILLE NY 12186
(518)-872-9100

TODAY'S DATE:

NAME OF HORSE:

HORSE COLOR:

NAME OF RIDER:

DATE OF BIRTH:

ADDRESS:

BEST CONTACT NUMBER:

EMAIL:

EMERGENCY CONTACT NAME & NUMBER:

SIGNATURE:

Parent or Guardian must sign if rider is a Junior under 18 years old

RIDERS MUST WEAR CERTIFIED HELMETS AT ALL TIME WHEN MOUNTED ON COURSE

BY PAYMENT, YOU ARE SIGNING ABOVE, I/WE ACKNOWLEDGE THAT THE PROPERTY OVER WHICH I/WE RIDE IS UNIMPROVED FARM WOODLAND AND CONTAINS BOTH NATURAL AND ARTIFICIAL HAZARDS. INCLUDING, BUT NOT LIMITED TO: WOODCHUCK HOLES, DITCHES, ROCKS, MUD, TREES, EXPOSED ROOTS, WET TERRAIN, WALLS, GATES, WIRE, FARM EQUIPTMENT AND LIVESTOCK. IWE UNDERSTAND AND ACCEPT THAT RIDING OVER SUCH TERRAIN IS INHERENTLY DANGEROUS AND THAT THERE IS RISK OF INJURY FROM FALLS, KICKS, RUNAWAYS, ETC. TO WHICH I WE VOLUNTARILY EXPOSE MYSELF/OURSELVES BY DOING SO. ACCORDINGLY, AS A CONDITION OF BEING ON THE PROPERTY, I/WE AGREE TO HOLD CAMP PINNACLE, OFFICIALS, LANDOWNERS, AND ALL OF ITS SUCCESSORS, ASSIGNS, EMPLOYEES AND AGENTS COMPLETELY HARMLESS AND NOT LIABLE AND RELEASE THEM FROM ANY AND ALL LIABILITY WHATSOEVER ON ACCOUNTOF, OR IN CONJUCTION WITH, ANY CLAIMS, CAUSES OF ACTION, INJURIES, DAMAGES, COSTS, OR EXPENSES ARISING OUT OF MY/OUR USE OF THE FACILITIES OR PRESENCE UPON THE PROPERTY ARISING FROM ANY CAUSE WHATSOEVER.

CAMPPINNACLE.ORG

OUTSIDE HORSE & RIDER TRAIL RIDE PAYMENT 2026