2026 Crocus Hill Fair Gymkhana Registration
Complete your rider details, choose events, review the waiver, and submit your registration—then pay by e-transfer or cash on event day.
Rider and Contact Information
Rider’s Full Name
*
First Name
Last Name
Age Division
*
Open (17+)
Youth (9–16)
Peewee (8 and under)
Parent/Guardian’s Full Name
First Name
Last Name
Email Address
*
example@example.com
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Event Selection and Fees
Select Event(s)
*
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next
( X )
Barrels
$10.00 CAD
$
10.00
CAD
Poles
$10.00 CAD
$
10.00
CAD
Keyhole
$10.00 CAD
$
10.00
CAD
Payment Method
*
E-transfer to valleyviewagsociety@gmail.com
Cash on the day of the event
2026 Valleyview & Districts Agricultural Society Liability Waiver and Release
Warning & Assumption of Risk
I have read, understand, and accept the Warning & Assumption of Risk
*
I have read, understand, and accept the Warning & Assumption of Risk
Release of Liability & Indemnity Agreement
I have read, understand, and agree to the Release of Liability & Indemnity Agreement
*
I have read, understand, and agree to the Release of Liability & Indemnity Agreement
Helmet & Safety Policy
I acknowledge the Helmet & Safety Policy
*
I acknowledge the Helmet & Safety Policy
Medical Treatment Authorization
I authorize emergency medical treatment as described above
*
I authorize emergency medical treatment as described above
Photo/Video Release
Permission granted for promotional use
Do not give permission for promotional use
Event Cancellation & Refund Policy
I have read and agree to the Event Cancellation & Refund Policy
*
I have read and agree to the Event Cancellation & Refund Policy
Code of Conduct / Rules & Regulations
I agree to the Code of Conduct / Rules & Regulations
*
I agree to the Code of Conduct / Rules & Regulations
Acknowledgement & Signature
Typing your name below serves as your electronic signature and means you agree to the terms above.
Type Your Name Here
*
First Name
Last Name
Relationship to Rider
*
Self
Parent
Legal Guardian
Date Signed
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Consent Confirmation
*
By signing and submitting this form, I confirm that the information provided is accurate and that I agree to the terms of this Liability Waiver and Release. If the rider is a minor, I confirm that I am the rider’s parent or legal guardian and am authorized to sign on their behalf.
Submit
Submit
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