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Summer Camp Release Forms

RELEASE AND WAIVER AGREEMENT FOR BEST FRIENDS FARM

OWNER EXPRESSLY RELEASES AND WAIVES MANAGER, Equine Kingdom Riding Academy, ITS AGENTS AND EMPLOYEES, PROPERTY OWNERS AND/OR HEIRS FROM ANY AND ALL CLAIMS AND RESPONSIBILITIES FOR BUT NOT LIMITED TO THE FOLLOWING:

                A. ANY SICKNESS, DISEASE, THEFT, DEATH AND OR INJURY OF THE HORSE, WHICH MAY BE SUFFERED BY THE HORSE OR ANY OTHER CAUSE OF ACTION, WHATSOEVER, ARISING OUT OF OR BEING CONNECTED IN ANY WAY WITH THE BOARDING OF SAID HORSE, EXCEPT IF CAUSE IS BY THE WILLFUL AND WANTON NEGLIGENCE OF THE MANAGER

                B. ANY INJURY, DISABILITY AND OR DEATH CAUSED TO THE OWNER AND OR OWNER'S GUEST(S) AND OR ANY LOSS OR DAMAGE TO ANY PERSONAL PROPERTY OF OWNER AND OR OWNER'S GUEST(S) WHILE ON OR OFF BOARDING PREMISES AND IT IS AGREED THAT IT IS THE OWNER'S RESPONSIBILITY TO CARRY FULL INSURANCE, INCLUDING COVERAGE ON SAID HORSE, AND ALL PERSONAL PROPERTY

                C. ANY AND ALL INHERENT RISKS AND ASSUMPTIONS OF RISKS WITH HORSES; THE OWNER ACKNOWLEDGES AND ACCEPTS THAT THERE ARE INHERENT RISKS ASSOCIATED WITH EQUINE ACTIVITIES SUCH AS DESCRIBED BELOW, AND HEREBY EXPRESSLY ASSUMES ALL RISKS ASSOCIATED WITH PARTICIPATING IN SUCH ACTIVITIES; THE INHERENT RISKS INCLUDE, BUT ARE NOT LIMITED TO THE PROPENSITY OF EQUINES TO BEHAVE IN WAYS SUCH AS, RUNNING, BUCKING, BITING, KICKING, SHYING, STUMBLING, REARING, FALLING OR STEPPING ON, THAT MAY RESULT IN AN INJURY, HARM, DISABILITY OR DEATH TO A PERSON ON OR AROUND EQUINES; THE UNPREDICTABILITY OF EQUINE'S REACTION TO SUCH THINGS AS SOUNDS, SUDDEN MOVEMENT AND UNFAMILIAR OBJECTS, PERSONS OR OTHER ANIMALS; CERTAIN HAZARDS SUCH AS SURFACE AND SUBSURFACE CONDITION; COLLISIONS WITH OTHER ANIMALS; THE LIMITED AVAILABILITY OF EMERGENCY MEDICAL CARE, AND THE POTENTIAL OF A PARTICIPANT TO ACT IN A NEGLIGENT MANNER THAT MAY CONTRIBUTE TO INJURY TO THE PARTICIPANT OR OTHERS, SUCH AS FAILING TO MAINTAIN CONTROL OVER THE ANIMAL OR NOT ACTING WITHIN SUCH PARTICIPANT'S ABILITY

D. ANY AND ALL CLAIMS ARISING FROM DAMAGE OR INJURY CAUSED BY OWNER'S HORSE TO ANYONE, AND OWNER WILL DEFEND MANAGER, Equine Kingdom Riding Academy, ITS AGENTS AND EMPLOYEES, PROPERTY OWNERS AND/OR HEIRS FROM ANY SUCH CLAIMS. OWNER AGREES TO DISCLOSE ANY AND ALL HAZARDOUS OR DANGEROUS PROPENSITIES OF THE HORSE BOARDED

E. ANY AND ALL CLAIMS ARISING FROM DAMAGES SUCH AS BUT NOT LIMITED TO PERSONAL INJURY, DEATH, PROPERTY LOSS, OR ANY OTHER LOSS SUSTAINED AS A RESULT OF OWNER'S ACTIVITIES THAT ARE HORSE RELATED.

COMMENCEMENT OF THIS RELEASE AND WAIVER AGREEMENT WILL BEGIN ON ____________________ , 20______.

RELEASE AND WAIVER SIGNATURE:

PRINTED FULL NAME_________________________________

PARTICIPANT'S SIGNATURE(or guardian if student is a minor)____________________________

DATE________________________________________________

CONTACT THE FOLLOWING PERSONS IN CASE OF INJURY, DEATH, OR OTHER EMERGENCY:

________________________________________________________

HOME PHONE:__________________________________________

CELL PHONE:___________________________________________

> Equine Kingdom Riding Academy/Equine Kingdom Day Camp Form

Name of Student:______________________________________________________________

Date of Birth:___/___/____

Address:_____________________________________________________________________

City:__________________________State:___________________ Zip:___________________

Father's Name:____________________Phone: (h)________________(c)_________________

Mother's Name:___________________Phone: (h)________________(c)_________________

Emergency Contact:________________ Phone: (h)________________(c)_________________

Medical Concerns: _____________________________________________________________

Allergies:_____________________________________________________________________

RIDING LEVEL EVALUATION

Previous Student at Best Friends Farm? YES or NO

If no, has your child attended any other riding camps or taken lessons elsewhere (please list)?

___________________________________________________

Riding Level: _______________________________________

Riding Level classifications are:

Beginner: little or no riding experience

Novice: can ride a gentle horse at a walk or trot

Intermediate: can control the horse at a walk/trot and has cantered/loped before

Advanced: can control the horse at a walk, trot, and canter/lope

Number of hours ridden before? _______________________ 0-5, 5-10, 10-15, 15+

Lessons generally run a full hour ' including tacking up, grooming, riding, and untacking. ASTM approved helmets will be used, and all reasonable measures taken to ensure your child's safety.

Rider's Signature_______________________________________________________

Rider's Parent or Guardian (If Rider is a minor)_____________________________________

Sally A. Nolte
equinekingdom@gmail.com
(336) 908-7453

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