A Ranch of Light Equine Activities Release AgreementName (adult):_____________________________________________________________________________________
(Minor): ___________________________________________________________________________ (age):_________
Phone: (home) _________________________________________(cell)_________________________
E-mail_________________________________________________
Address:
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Special needs or medication:
____________________________________________________________________________________________________ ____________________________________________________________________________________________________
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Emergency contact:
____________________________________________________________________________________________________ ____________________________________________________________________________________________________
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Activities Release agreement:
1._______While participating in any ranch activity, the participant accepts any and all responsibility for their person and for those persons the participant allows permission to engage in activities, being those under the age of 18. The participant must read, understand and agree to the following terms of the activity agreement.
2._______ The activities agreement for the ranch negates all responsibility to the owner of the ranch, by the participant for any injury or death associated with engaging in activities with the ranch or while engaging in any activities on the owner’s property.
4._______ The participant will be instructed in the proper apparel and equipment for safety.
5._______ The participant will not place their person, those underage children, in any dangerous situation in which they or the children, can be injured or killed. This includes, but not limited to, going outside the specified activity area. The owner cannot be held responsible for any and all injuries or death resulting from the participant placing anyone in a dangerous situation.
6._______ The participant will follow all the ranch rules. These rules are for every person on the property. There are no exceptions. The participant has read and understood all the ranch rules and will abide by them at all times. The owner or instructor cannot be held responsible for any injury or death resulting from disobeying the rules.
The participant and owner have come to an agreement as set forth in this contract. Both parties understand their responsibilities of this ranch activities release agreement. Any changes to the terms as set forth are to be made in writing, signed and dated by both parties.
_____________________________________________________ ______________________
(Signature of parent or guardian) (Date)
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(Signature of manager/leader) (Date)
Please indicate if we can use you or your child’s picture in ranch material or media presentations.
_______ Yes, you have my permission to use pictures taken at the ranch of myself or my child.
_______ No, I do not wish you to use pictures of myself and/or my child in ranch material
All the above named must understand that there are risks inherent in dealing with horses and ponies (equine activity). Some of the inherent risks include:
•The propensity of an equine to behave in ways that may result in injury, death, or loss to persons on or around the equine.
The propensity of an equine to behave in ways that may result in injury, death, or loss to persons on or around the equine.•The unpredictability of an equine's reaction to sounds, sudden movements, unfamiliar objects, persons, or other animals.
The unpredictability of an equine's reaction to sounds, sudden movements, unfamiliar objects, persons, or other animals.•That there may be hazards including, but not limited to, surface or subsurface conditions.
That there may be hazards including, but not limited to, surface or subsurface conditions.•The possibility of a collision with another equine, another animal, a person, or an object.
The possibility of a collision with another equine, another animal, a person, or an object.•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.
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.Participants and spectators further understand the examples of the equine activity taking place at A Ranch of Light include but are not limited to:
•Riding, jumping, trail riding, and the like.
Riding, jumping, trail riding, and the like.•Routine care and feeding of the equine, including veterinary and farrier services.
Routine care and feeding of the equine, including veterinary and farrier services.•Traveling, loading and unloading of equine.
Traveling, loading and unloading of equine.ACKNOWLEDGEMENT OF RISK
1.I, __________________________, the undersigned have read and understand, and freely and voluntarily enter into this Release and Hold Harmless Agreement with Aimee and Jason Palmer and all agents representing A Ranch of Light, understanding that this Release and Hold Harmless Agreement is a waiver of any and all liability(ies).
I, __________________________, the undersigned have read and understand, and freely and voluntarily enter into this Release and Hold Harmless Agreement with Aimee and Jason Palmer and all agents representing A Ranch of Light, understanding that this Release and Hold Harmless Agreement is a waiver of any and all liability(ies).2. I understand the potential dangers that I could incur in mounting, riding, walking, boarding, feeding said horse; including, but not limited to, any interactions with other horses and dogs. Understanding those risks I hereby release that Company, its officers, directors, volunteers, and anyone else directly or indirectly connected with A Ranch of Light from any liability whatsoever in the event of injury or damage of any nature (or perhaps even death) to me or anyone else caused by or incidental to my electing to mount and ride a horse, or be a spectator at such event, at A Ranch of Light.
I understand the potential dangers that I could incur in mounting, riding, walking, boarding, feeding said horse; including, but not limited to, any interactions with other horses and dogs. Understanding those risks I hereby release that Company, its officers, directors, volunteers, and anyone else directly or indirectly connected with A Ranch of Light from any liability whatsoever in the event of injury or damage of any nature (or perhaps even death) to me or anyone else caused by or incidental to my electing to mount and ride a horse, or be a spectator at such event, at A Ranch of Light.3.I understand that there are risks inherent in dealing with equines (including horses, ponies, mules, donkeys, and hinnies) as itemized above.
I understand that there are risks inherent in dealing with equines (including horses, ponies, mules, donkeys, and hinnies) as itemized above.4. I understand and recognize and warrant that this Release and Hold Harmless Agreement, is being voluntarily and intentionally signed and agreed to, and that in signing this Release and Hold Harmless Agreement I know and understand that this Agreement may further limit the liability of equine professionals to include any activity, whatsoever, involving an equine, including death, personal injury and/or damage to property.
I understand and recognize and warrant that this Release and Hold Harmless Agreement, is being voluntarily and intentionally signed and agreed to, and that in signing this Release and Hold Harmless Agreement I know and understand that this Agreement may further limit the liability of equine professionals to include any activity, whatsoever, involving an equine, including death, personal injury and/or damage to property. NOTICE: Wearing an ASTM/SEI approved hard hat is REQUIRED while riding or driving.
I, ____________________, acknowledge that I have read the above statements and d and hereby indemnify and hold harmless, A Ranch of Light, and its volunteers from any liability arising from accident, injury, theft, or damages to myself, my representatives, and helpers, all equipment and property, and all animals under my jurisdiction. This agreement shall continue for each and every visit A Ranch of Light’s property.
The terms of this release form shall be construed as the entire agreement and may not be altered, amended, or modified except in writing and signed by both parties. The terms of this release shall be governed by the laws of the State of California.
In addition, I, _________________________, (student/rider above named for, if minor, parents/guardians) hereby grant permission and authority to A Ranch of Light, its officers and volunteers to act for us in executing verbal instructions of if unable to contact us, to act for us in dealing with physicians, available ambulance companies and hospitals, to obtain prompt medical attention for the participant named above in the event of any perceived medical emergency. I hereby covenant and agree to release A Ranch of Light, it’s officers, volunteers, and owners of any property concerned, and hold harmless from liability for any injury or damage which the rider may sustain while at A Ranch of Light or participating in any activity sponsored by A Ranch of Light, and from any liability connected with obtaining prompt medical attention for the rider named above.
MINORS:
The undersigned declares that the undersigned is the parent or legal guardian of the minor named below. The undersigned has read the foregoing Release and Indemnity Agreement and in consideration of A Ranch of Light allowing such minor entry onto its premises and/or allowing such minor to participate in equestrian activities, hereby agrees that all of the terms and conditions contained herein shall apply to such minor and shall be binding upon the undersigned and the minor.
The undersigned declares under penalty of perjury under the laws of the State of California, that the foregoing is true and correct.
Executed this __________day of _______________, 2_____.
If under 21, the parent or guardian must read and sign the above, indicting his/her acceptance.
Date: _________ Signed: __________________________________________________
Print Participant Name: __________________________________________________
Date: _________ Signed: __________________________________________________
Print Parent/guardian (if minor): __________________________________________
