Maine Driving Club Driving Derby Online Entry Form
Entry form Driving Derby  June14th, 2025  Spurwink Farm
Sign in to Google to save your progress. Learn more
Name (Last, First) *
Maine Driving Club Member *
Required
Junior Driver Date of Birth *
MM
/
DD
/
YYYY
Mailing Address of Driver *
Driver's Phone or Cell Phone Number *
Email *
Navigator Name *
Navigator Phone or Cell phone Number *
Please indicate if you need a navigator *
Required
Name of Horse or Horses(if Pair) you will be competing with: *
Division you will be competing in: *
Turnout *
Required
Equine Size Class you will be competing in: *
Required
Payment OF Entry Fees:

FEES:  $25/MDC and Affiliates    $30/Non-Members 

 No Charge for Junior Drivers

Check Payable to: Maine Driving Club

Mail Check to: Paula Leavitt PO Box 36 Dixmont, ME 04932

PayPal: www.mainedrivingclub.org select “Donation"

How will be paying your entry fees:


*
Required

Please Enter Name at Bottom as Signature of

Include Name & Age of Minor

Permission for Minor to Show: 

I agree to participate in this horse show and certify that I have read and agree to the  representations, disclaimers, and statements contained in this form. I hereby accept full  responsibility thereunder for the participation of said minor. 

Maine Driving Club Event Release, Assumption of Risk and Waiver and Indemnification.  This document waives important legal rights. Read it carefully before signing. 

I agree that I choose to participate voluntarily in this event with my horse as a rider,  driver, handler, groom, owner, lessee, agent, coach, trainer, or as a parent/guardian of a  junior participant. I am fully aware and acknowledge that horse sports and this event  involved inherently dangerous risks of accident, loss and serious bodily injury, including  broken bones, head injuries, trauma, pain, suffering, or death (“Harm”). 

I agree to release the Maine Driving Club and Spurwink Farm,Cape Elizabeth, from all claims for  money damages or otherwise for any harm to me or my horse and for any harm caused  by me or my horse to others, unless due to wanton or willful misconduct or the  negligence of the Maine Driving Club or Spurwink Farm Cape Elizabeth, Maine and to hold them harmless  with respect to claims for harm to me or my horse, and for claims made by others for  any harm caused by me or my horse at the “Event.” 

If I am a parent or guardian of a junior participant, I consent to the child’s participation  and agree to all of the above provisions and agree to assume all of the obligations of  the Release on the child’s behalf. 

I agree that the Maine Driving Club as used above includes all of the officials, officers,  directors, employees, agents, personnel, volunteers, and affiliated organizations. 

By signing below I further agree to be bound by all applicable Maine Driving club  rules. Under Maine law an equine professional has limited liability for an injury or  death resulting from inherent risks of equine activity. 



*
Health Requirements for Horses:
Negative Coggins, Influenza vaccine, Rabies within one year of the date of the competition.
*

Please Enter Name at Bottom as signature of

Maine Driving Club Liability Release

MAINE DRIVING CLUB (MDC) DISCLAIMER and HOLD HARMLESS AGREEMENT:

This form must be signed by every Competition participant or if a minor, their consenting parent, including each person who rides with a driver on a carriage not only during the actual Competition but including any time from arrival at the Competition to departure. I understand and agree that neither the Maine Driving Club (MDC) and its officers, the Driving Event Competition (“ Competition” ), Competition judges, officials, workers, volunteers or organizing committee nor the property owners accept or shall have any responsibility of any nature whatsoever for accidents, damage, injury or illness to the horses,

owners, riders, drivers, grooms, passengers, attendants, spectators or any other person or property in connection with this Competition.

I hereby expressly agree without any limitation or condition for myself and my principals, representatives, employees and agents: (1) to be bound by the rules and by-laws of the MDC and any local rules of this Competition; (2) that every horse, driver, attendant, groom and/or passenger is eligible as entered; and (3) to accept as final any decision of the Competition officials on any question arising under the MDC rules and by-laws or any local rules of the Competition. I also agree, without any limitation or condition, to hold the MDC, its officers, directors, employees and agents, and Competition judges,


officials and organizing committee, harmless from any and all liability, loss, claims or actions, causes of action, judgments or demands of any nature whatsoever. I am fully aware and appreciate that equine sports, including driving in this particular Competition involve inherent dangerous risk of serious injury or death. By participating I do so voluntarily and expressly assume any and all risks of injury to me or loss of my horse(s) or equipment. I agree to release and voluntarily waive the right to sue the MDC, its officers, directors, employees, and agents, stewards, Competition judges, personnel, volunteers,

officials, and organizing committee, including their agents and employees from and against all claims for damages, including money damages, for any action taken or otherwise any harm caused by me or my horse to others, including whether arising from directly or indirectly from the negligence of the MDC or

the Competition.

I agree to indemnify and hold harmless the MDC its officers, directors, employees, clinicians, members, volunteers, coaches, representatives, assigns, Competition judges, officials and organizing committee, their agents and employees from any and all claims for loss or injury caused by me or my horse that

occur during or in conjunction with this Competition.

I also agree that as a condition of and in consideration of acceptance of entry, the MDC and/or the Competition may use or assign photographs, videos, audios, cable - casts, broadcasts, internet, film, new media or other likenesses of me and my horse taken during the course of the Competition for the promotion, coverage or benefit of the Competition, sport, or the MDC. BY SIGNING BELOW, I AGREE to be bound by all applicable MDC rules and all the terms and conditions of this AGREEMENT.


*
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. - Terms of Service - Privacy Policy

Does this form look suspicious? Report