SATURDAY, SEPTEMBER 20, 2025 POLES SIGN UP SHEET

Indemnification & Release Personal Injury: By signing this document and by making entry as a participant, I hereby understand that injury to myself is a possibility no matter how careful the sponsors, officers, directors or participants may be. And, furthermore, I as a participant (or parent/guardian), agree to hold harmless Keystone Horse Center LLC, Keystone Barrel Classic, NBHA, WPRA, OTR, BOTB or any other sanctioning body and its members, show management and it's officers, agents, contractors and employees from any expense, cause of action, damage or claim of damage (including legal fees) of any kind whatsoever which I might assert as a result of my (or my child's) injury, death or claim, property loss or injury and I further agree to hold harmless the aforementioned parties for any injury or death of any animal and/or loss, disappereance, theft or damage to any property while in or upon the premises of Keystone Horse Center. Keystone Barrel Classic does not require helmets for any age group but encourages all riders to wear them. Age Certification / By the appearance of my signature, indicated above, I certify that I am 18 (eighteen) years of age or older, or that I am the parent or legal guardian of the participant/entrant who is under the age of 18 (eighteen Show producers reserve the right to remove attendees, family, friends, etc. for disruptive or dangerous behaivors.

WAIVER OF LIABILITY AND HOLD HARMLESS AGREEMENT

In consideration for receiving permission to BE ON PREMISES at KEYSTONE HORSE CENTER, LLC (hereinafter the “Activity or Activities”), I, on behalf of myself and any minor child/children for whom I have the capacity to contract, hereby acknowledge and agree to the following:

1.         By signing this document and by making entry as a participant, I hereby understand that injury to myself is a possibility no matter how careful the sponsors, officers, directors, facility owners or participants may be.  And, furthermore, I as a participant (or parent/guardian), agree to hold harmless Keystone Horse Center LLC, Keystone Barrel Racing, Keystone Barrel Classic (or any derivative name of Keystone), its members, show management, officers, agents, contractors, sponsors and employees from any expense, cause of action, damage or claim of damage (including legal fees) of any kind whatsoever which I might assert as a result of my (or my child's) injury, death or claim or property loss and I further agree to hold harmless the aforementioned parties for any injury or death of any animal and/or loss, disappearance, theft or damage to any property while in or upon the premises of Keystone Horse Center LLC.  Keystone Barrel Classic does not require helmets for any age group but strongly encourages all riders to wear them.  Age Certification - By the appearance of my signature, whether signed, typed or initialed, indicated below, I certify that I am 18 (Eighteen) years of age or older, or that I am the parent or legal guardian o f the participant/entrant who is under the age of 18 (Eighteen).

2.        I understand the hazards of the novel coronavirus (“COVID-19”) and am familiar with the Centers for Disease Control and Prevention (“CDC”) guidelines regarding COVID-19. I acknowledge and understand that that the circumstances regarding COVID-19 are changing from day to day and that, accordingly, the CDC guidelines are regularly modified and updated and I accept full responsibility for familiarizing myself with the most recent updates.

3.       Notwithstanding the risks associated with COVID-19, which I readily acknowledge, I hereby willingly choose to participate in Activities.

4.       I acknowledge and fully assume the risk of illness or death related to COVID-19 arising from my being on the premises and participating in the Activities and hereby RELEASE, WAIVE, DISCHARGE, AND COVENANT NOT TO SUE (on behalf of myself and any minor children form whom I have the capacity contract) Keystone Horse Center, LLC, Keystone Barrel Racing, NBHA,  WPRA, their owners, officers, directors, agents, employees and assigns (the “RELEASEES”) from any liability related to COVID-19 which might occur as a result my being on the premises and participating in the Activities.

5.       I shall indemnify, defend and hold harmless the RELEASEES from and against any and all claims, demands, suits, judgments, losses or expenses of any nature whatsoever (including, without limitation, attorneys’ fees, costs and disbursements, whether of in-house or outside counsel and whether or not an action is brought, on appeal or otherwise), arising from or out of, or relating to, directly or indirectly, the infection of COVID-19 or any other illness or injury.

6.       It is my express intent that this Waiver and Hold Harmless Agreement shall bind any assigns and representatives, and shall be deemed as a RELEASE, WAIVER, DISCHARGE, AND COVENANT NOT TO SUE the above-named RELEASEES. This Agreement and the provisions contained herein shall be construed, interpreted and controlled according to the laws of the Commonwealth of Pennsylvania. I HEREBY KNOWINGLY AND VOLUNTARILY WAIVE ANY RIGHT TO A JURY TRIAL OF ANY DISPUTE ARISING IN CONNECTION WITH THIS AGREEMENT. I ACKNOWLEDGE THAT THIS WAIVER WAS EXPRESSLY NEGOTIATED AND IS A MATERIAL INDUCEMENT THE PERMISSION GRANTED BY RELEASEES TO BE ON PREMISES AND PARTICIPATE IN THE ACTIVITIES.

IN SIGNING THIS AGREEMENT, I ACKNOWLEDGE AND REPRESENT THAT I have read the foregoing Wavier of Liability and Hold Harmless Agreement, understand it and sign it voluntarily as my own free act and deed; no oral representations, statements, or inducements, apart from the foregoing written agreement, have been made; I am at least eighteen (18) years of age and fully competent; and I execute this Agreement for full, adequate and complete consideration fully intending to be bound by same.

IN WITNESS WHEREOF, I have signed this Waiver and Agreement under seal on this day of