Humboldt Bay Horse Club is proud to host the 3nd annual

Rita Boling Animal Care Fund Benefit Campout at Cuneo Creek

September 25th, 26th, and 27th, 2015
Ride the trails at your leisure or hang out in camp and relax in the sunshine, its your choice, but come and join
us to help raise money for a great cause in the name of a great woman who helped animals in any way she
could. 2013 donation was $500.00, 2014 was $600.00. Lets continue to beat those donations this year!!!
HBHC will be providing a continental breakfast Saturday and Sunday and a barbeque on Saturday night. Then
toast some marshmallows around the campfire and share Rita stories like last year. We have such a great time
and it just gets more fun each year. There will be a silent auction and raffle Saturday during dinner. Reserve
your spot now, horse pens tend to go fast:
Fees:
A) 3 days 2 nights per horse and rider includes 2 continental breakfasts (Saturday and Sunday), Saturday
night barbeque and one horse pen - $100.00
B) Additional family member horse and rider combinations includes all of the above - $ 40.00 (Family as
defined as in living within the same household).
C) 3 days 2 nights per horse and rider includes 2 continental breakfasts (Saturday and Sunday) and
Saturday night barbeque (owner provides own horse pen) - $80.00
D) Single day rider fee includes 1 continental breakfast and Saturday night barbeque - $40.00
E) Additional family members or friends not bringing a horse - $15.00 for all meals or $5.00 per meal.
F) Donation of silent auctions can be turned in for credit towards fees. Receipt or proof of cost must be
included. Up to $30.00 maximum credit limit
G) $10.00 credit if you joined us in 2014.
Sign Up Deadline September 16th, 2015
A)
B)
C)
D)
E)
F)
G)

_______________
X
$ 100.00
=
_______________
_______________
X
$ 40.00
=
_______________
_______________
X
$ 80.00
=
_______________
_______________
X
$ 40.00
=
_______________
_______________
X
$ 15.00 for 3 meals or $ 5.00 per meal = _______________
Donation of silent auction item for credit towards fee
=
2014 return camper credit
<- $10.00> Total Fees: _______________

Name:
Address:
Phone:
Additional family members:

Email:

Rita's family has created the 'Rita Boling Animal Care Fund.' This fund will enable animals to receive lifesaving treatment
when their owners are unable to meet the financial obligations needed for their care. Please visit http://www.ritaboling.com/
to donate or for more information.

Release of Liability
I acknowledge that horseback riding is a sport, carries inherent risk of injury & damage to horses, property & myself. I
knowingly assume all risk, whether known or unknown on horseback riding. Also, I release HBHC & Redwood State
Parks from all liability for any act of negligence or want of the organization or any of their agents, In consideration of my
participation in events organized or sponsored by HBHC & held at Redwood State Parks their representatives, their
executors & assigns from any and all claims of liability of damage to myself or my animals or my property arising out of
my participation. This agreement is binding on my executors, heirs and assigns.
I expressly waive my rights I may have under California Civil Code 1542, which states: A general release does not extend
to claims which the creditor does not know or suspect to exist in his or her favor at the time of executing the release,
which if known by him or her must have materially affected his or her settlement with debtor.
I agree that I will defend, indemnify & hold harmless HBHC, its officers, directors, members & agents against all claims,
demands, & causes of action including court cost & actual attorney fees, arising from any proceeding lawsuit brought by
or prosecuted for my benefits, which this release is upheld.
I acknowledge that I have read the Release of Liability, and understand its contents.

SIGNATURE
ADDRESS

DATE
PHONE

Parents or legal Guardian must sign for minor children. I the undersigned parent or guardian of
In consideration of my childs participation in the event, agree that the terms & conditions of the Release of Liability shall
be binding as to damage or injury to my child, his or her animals & property arising out of his or her participation in the
event. I acknowledge this. I have read this release of Liability, & know & understand its contents.

SIGNATURE
ADDRESS

DATE
PHONE

Please return completed forms, donations and payments to:

Humboldt Bay Horse Club (HBHC)
56197 Highway 101
Fortuna, CA 95540
(707) 407-8548

Additional drop off locations for your convenience:

Dons Rent-All (Eureka) & North Coast Veterinary Hospitals (Arcata or Fortuna)
You can also hand deliver to any HBHC club officer.

For Office Use:

Date Received: ___________________
Amt. Received: ___________________
Check # _____________ Cash_______
Received by:______________________