Fillable National Racing Experience Application (American Quarter Horse Association)

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National Racing Experience Application (American Quarter Horse Association)

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National Racing Experience Application
October 21-24, 2021
The Downs Racetrack, Albuquerque, NM
Applications for at-large and racing affiliate participants must be
received at AQHA by September 10, 2021.
Applicants MUST also complete the Racing skillathon online
contest for their application to be considered. Study resources
and contest information will be available on aqha.com/youth
under “Youth Racing Experience.”
Racing skillathon online contest available September 13-18, 2021.
Racing affiliates may nominate one representative from their regional race experience. Applicants
must be at least 16 years of age by the first day of the National Racing Experience. In addition,
participants must be current AQHYA members in good standing. Applicants, please fill out this
form completely, attach additional pages as necessary, and submit with a color photograph. The
application and essay should be completed by the youth applicant. The overall quality of your
application will be taken into consideration. Applications must be received by AQHA (not
postmarked) by September 10, 2021.
Applicant Name: ___________________________________ AQHYA I.D. #: ___________________
(Applicants must be current AQHYA members)
Birthdate: ____________________ Age: ____________________ Gender: ❑ M ❑ F
Address: _____________________________________________________________________________
City: _______________________________________ State: _____________ Zip: _______________
Phone #: ____________________________________ Email: _________________________________
Name of parent(s) or guardian(s): _________________________________________________________
Home #: ___________________ Cell #: ___________________ Work #: ___________________
Are you a member of an affiliate Quarter Horse Youth Association? ❑ Yes ❑ No
If yes, please list affiliate: _______________________________________________________________
If yes, do you hold an office in your affiliate association or in AQHYA? ❑ Yes ❑ No
If yes, please list: ______________________________________________________________________
List all other organizations of which you are a member: ________________________________________
_____________________________________________________________________________________
Check all of the following AQHYA programs in which you have been involved.
❑ Youth Excellence Seminar ❑ Horseback Riding Program ❑ Young Horse Development
❑ AQHYA World Show ❑ AQHYA World Show Contest(s) _______________________________
❑ Youth World Cup ❑ Other _____________________________________________________
❑ AQHYA Regional Race Experience held at the following racetrack: __________________________
Are any of your family members involved in American Quarter Horse Racing? ❑ Yes ❑ No
If yes, in what capacity? Please check all that apply. ❑ Trainer ❑ Breeder ❑ Owner
❑ Jockey ❑ Track Employee ❑ Other (explain) _____________________________________
(Continued on next page)
Please attach an additional page (typed, double spaced) with the following information:
1. Describe your hobbies and interests.
2. List your past experience with horses (i.e., rider since I was three, etc.).
3. Describe your future plans or career goals.
4. List any previous knowledge of or experience you have in the horse racing industry.
5. An essay (500 words or fewer) to one of the following questions: “What are your experiences in
the world of racing?” or “What would it mean to you to be a part of the Bank of America
Challenge Championships and the AQHYA National Racing Experience?”
Please read and complete the release form on the following page.
Please complete all requirements and return to
AQHA, Attn: Youth Department, P.O. Box 200, Amarillo, TX 79168.
Youth Department Phone: 806-376-4811 | Fax: 806-349-6409 | E-mail: youth@aqha.org
(Continued on next page)
AQHYA RACING EXPERIENCE ASSUMPTION OF RISK, RELEASE OF LIABILITY AND INDEMNITY AGREEMENT
As a condition of participation in the AQHYA Racing Experience (“Racing Experience”), and in consideration of being allowed to
participate, the Participant and the Parent/Guardian of the Participant does hereby:
1. CERTIFY that Participant agrees to abide by AQHA rules and obey the directions of the AQHA representatives conducting the
Racing Experience.
2. AGREE and represent that Participant understands the nature of the participation and attendance activities associated with the
Racing Experience (“Activities”) and that the Participant is qualified, in good health, and in proper physical condition to participate
in such Activities;
3. FULLY UNDERSTAND THAT THE ACTIVITIES INCLUDE, BUT ARE NOT LIMITED TO, “INHERENT RISKS OF EQUINE
ACTIVITIES” THAT MAY RESULT IN PROPERTY DAMAGE AND BODILY INJURY, INCLUDING, BUT NOT LIMITED TO,
PERMANENT DISABILITY, PARALYSIS, AND DEATH (collectively “RISKS”); that such RISKS may be caused by Participant’s
own action or inaction, the action or inaction of others participating in the Activities, the condition of the premises at which the
Activities take place, and/or the negligence of the “Releasees” named below;
4. UNDERSTAND AND AGREE that “Inherent risk of equine activities” means dangers or conditions that are an integral part of
equine activities, including, but not limited to, any of the following: (a) the propensity of an equine to behave in ways that may result
in injury, death, or loss to persons on or around the equine; (b) the unpredictability of an equine’s reaction to sounds, sudden
movement, unfamiliar objects, persons, or other animals; (c) hazards, including, but not limited to, surface or subsurface conditions;
(d) a collision with another equine, another animal, a person, or an object; and (e) the potential of an equine activity participant to
act in a negligent manner that may contribute to injury, death, or loss to the person of the participant or to other persons, including
but not limited to, failing to maintain control over an equine or failing to act within the ability of the participant;
5. FULLY ACCEPT AND ASSUME ALL SUCH RISKS AND ALL RESPONSIBILITY FOR LOSSES, COSTS, AND DAMAGES
PARTICIPANT INCURS AS A RESULT OF PARTICIPANT’S PARTICIPATION IN THE ACTIVITIES;
6. WARRANT AND REPRESENT that, if the Activities involve horses, Participant is adequately qualified and experienced to both
(a) safely handle and ride a horse in a manner to protect Participant and other third parties, and (b) participate with groups of riders
and horses, such as to take adequate defensive action to avoid injury from third party participants and horses. Furthermore,
Participant understands that it is Participant’s responsibility to ascertain the adequacy of Participant’s training and experience, the
adequacy and training of Participant’s horse, and for Participant conduct himself/herself in a manner such as to make the Activities
safe and enjoyable for all participants;
7. HEREBY RELEASE, DISCHARGE, AND COVENANT NOT TO SUE AQHA, AQHF, AND/OR AQHA CORPORATE
PARTNERS OR THEIR RESPECTIVE ADMINISTRATORS, DIRECTORS, AGENTS, OFFICERS, MEMBERS, VOLUNTEERS,
AND EMPLOYEES, AND, IF APPLICABLE, OWNER AND LESSORS OF PREMISES ON WHICH THE ACTIVITIES TAKE
PLACE, (EACH CONSIDERED ONE OF THE “RELEASEES” HEREIN) FROM ALL LIABILITY, CLAIMS, DEMANDS, LOSSES,
OR DAMAGES WHENEVER OR HOWEVER ARISING AS TO INJURY, DEATH AND/OR PROPERTY DAMAGE OCCURRING
AS A RESULT OF PARTICIPANT’S PARTICIPATION IN THE ACTIVITIES OR CAUSED OR ALLEGED TO BE CAUSED IN
WHOLE OR IN PART BY THE NEGLIGENCE OF THE RELEASEES OR OTHERWISE.
8. AGREE to indemnify, hold harmless and defend RELEASEES from any and all liability, whenever or however arising, from all
third party claims, demands, causes of action, suits, judgments, liabilities, costs and expenses of any nature arising out of (a)
Participant’s negligent act(s) or omissions during or related in any way to the Activities; and/or (b) Participant’s willful act(s) or
omission(s) during or related in any way to the Activities; and/or (c) any misinformation or misrepresentations made by Participant
in this Agreement. Participant agrees to pay any of RELEASEES costs, expenses and reasonable attorney fees incurred, arising
directly or indirectly out of or with respect to any third party claims or associated with the enforcement of the indemnity obligations
referenced above.
9. Should the Participant not abide by the established rules of conduct, understand that the Participant will be returned home, and
Parent/Guardian agrees to pay for the necessary transportation expenses for the Participant and the accompanying chaperone.
Parent/Guardian authorizes those in charge of the delegation to make medical arrangements for the care of the Participant as
deemed necessary. Parent/Guardian further authorizes any licensed medical person/facility to treat the Participant.
Parent/Guardian agrees to assume full financial responsibility for any medical services provided.
10. Agree that AQHA may use any photograph, video or other form of likeness reproductions of Participant to promote AQHA
objectives and activities, including but not limited to use by third parties with AQHA’s authorization.
11. AGREE that this Assumption of Risk/Release of Liability/Indemnity Agreement (“Agreement”) (a) shall bind me, my family, my
heirs, legal representatives, successors and assigns; (b) shall be governed by the laws of the State of Texas; and (c) shall be
subject to the exclusive jurisdiction of the state and federal courts located in Potter County, Texas.
12. Agree that I have read this agreement, fully understand its terms, understand that I am giving up substantial rights by signing
it and have signed it freely and without inducement or assurance of any nature and intend it to be a complete and unconditional
release of all liability to the greatest extent allowed by law and agree that if any provision of this agreement is held to be void,
voidable, invalid or inoperative, the balance, notwithstanding, shall continue in full force and effect as though such provision had
not been contained herein.
Participant Signature: _____________________________________________________ Date: _________________________
Parent/Guardian Signature*: ________________________________________________ Date: _________________________
*If Legal Guardian, court-issued documentation must accompany entry if not already on file with AQHA. NO EXCEPTIONS.
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National Racing Experience Application (American Quarter Horse Association)

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Completed 2 June 2021

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