MONTEZUMA COUNTY FAIR GYMKHANA
Sunday July 31 st 9:00 am at the Montezuma County Fairgrounds Outdoor arena
*Must reside in Montezuma or Dolores Country*
Entries due Friday July 29 th by 5:00 pm to Lindsey Gaasch 23317 Road P Dolores, CO 81323
NO call ins after 5:00pm on the 29th 970-749-7896. Check in 8:00 am on the 31st in the crow’s nest.
NO ENTRIES WILL BE TAKEN AT CHECKIN ONCE RODEO STARTS!
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Contestant Name: ________________________________________________________ Birth date: ____________ Gender: ________
Address: ______________________________________________________________________Phone #: _______________________
Age as of January 1 st, 2022 : _________. Check one age group: 5 & under: ___6-10____ 11-14____ 15-19 ____
Boys and Girls will run together, placing and points will be separated
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5 & Under: $5 per event- May be led 6-10 Age Group: $5 per event
____ Pony Express _____ Pony Express
____ Keyhole Race _____ Keyhole Race
____ Boot Race _____ Boot Race
____ Flag Race _____ Flag Race
11-14 Age Group: $5 per event 15-19 Age Group: $5 per event
_____ Pony Express _____ Pony Express
_____ Keyhole Race _____ Keyhole Race
_____ Boot Race _____ Boot Race
_____ Flag Race _____ Flag Race
Family Fun Events: $5 per event (List partner)
Parent/child Rawhide Race: __________. Parent/child Rescue Race Partner: __________
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TOTAL EVENT FEES $____________
AMIN FEE $ ____$5_____
TOTAL AMOUNT DUE $_______________
I understand that NO DOGS are allowed on the fairgrounds…….… initials________
Montezuma County Fair Family Gymkhana
COLORADO WARNING
Under Colorado Law, an equine professional is not liable for an injury to or death of a participant in equine activities
resulting from the inherent risks of equine activities, pursuant to section 13-21-119, Colorado Revised Statues.
READ THIS DOCUMENT COMPLETELY BEFORE SIGNING. ITS EFFECT IS TO RELEASE MONTEZUMA COUNTY FAIR AND ITS
GOVERNING BOARD, THE COUNTY AND STATE OF COLORADO FROM ANY, AND THE MONTEZUMA COUNTY
FAIRGROUNDS LIABILITY RESULTING FROM YOUR PARTICIPATION IN THE ACTIVITIES DESCRIBED BELOW, AND TO WAIVE
ALL CLAIMS FOR DAMAGES OR LOSSES AGAINST THE COUNTY WHICH MAY ARISE FROM SUCH ACTIVITIES.
PARTICIPANT'S FULL NAME: ________________________________________________________________________
DATE OF BIRTH (MO/DAY/YR): ______________________________________________________________________
ADDRESS: _______________________________________________________________________________________
LOCATION OF ACTIVIY: MONTEZUMA COUNTY FAIRGROUNDS OUTDOOR ARENA
DATE OF ACTIVITY: JULY 31 st , 2022
I, the undersigned participant exercising my own free choice to participate voluntarily in the named above activity, and
promising to take due care during such participation, hereby release and discharge, indemnify and hold harmless
Montezuma County, Board of Commissioners, Montezuma County Fair board, and their members, officers, agents and
employees, Montezuma County Fairgrounds and any other persons or entities acting on their behalf, and the successors
and assigns for any and all claims, demands, and causes of action whatsoever, whether presently known or unknown,
either in law or in equity, relating to injury, disability, death or other harm, to person or property or both, arising from
my participation in and/or presence at the above listed activities.
I acknowledge that I have been informed of the nature of the activities and that I am aware of the hazard and risks
which may be associated with my participation in the above-named activities, including the risk of bodily injury, death or
damage to property which may occur from known or unknown causes. I understand, accept, and assume all such
hazards and risks, and waive all claims against Montezuma County, and any person as set forth above. I understand that
I am solely responsible for any cost arising out of any bodily injury or property damage sustained through my
participation in normal or unusual acts associated with the above-named activities.
I have had sufficient time to review and seek explanation of the provisions contained above, have carefully read them,
understand them fully, and agree to be bound by them. After careful deliberation, I voluntarily give my consent and
agree to this Release from Responsibility, Assumption of Risk, and Waiver.
READ, UNDERSTOOD AND AGREED TO THIS__________ DAY OF ___________20 _____
Signature of Participation whose printed name appears below:
_________________________________________________________________________________________________
If participant is under 18, his or her parent or legal guardian must also sign below:
I, (printed name) ___________________________________________ am the parent or legal guardian of the participant
who has signed above. I have read and I understand the provisions of this document, I consent to the participant taking
part in the activities described above, and I fully enter into and agree to the above Release of Responsibility, Assumption
of Risk, and Waiver.
__________________________________________________________________________________________________
Parent or Guardian must sign
