Welcome, Equine Kingdom Student!


Please read this entire page carefully. It contains very important information!
This entire packet needs to be filled out to its entirety. Thank you so much!!

Name of Student_______________________________________              

Parents' Names_____________________________________________

There is a weekly/semi weekly newsletter sent out with information about upcoming events, camps, lessons, horse shows, crucial news, exciting stuff, and plenty more! Please write your primary email address (s) so that I can add you to the list


Standard fees:

$25: Private or group 30 minute lesson (please do not ask for a private lesson - that is for new students and up to my discretion, although everyone will get private lessons on a varying basis)

 

There is a $25 applicable fee for missing a lesson without calling, unless it's a life-or-death emergency (then I promise I'll understand), due at the next lesson taken. Instructor reserves the right to cancel or reschedule lessons due to horse problems, injury, or weather up until 30 minutes before the lesson. Lessons are not taught in extreme heat (over 98 degrees) or in extreme cold (under 35 degrees), nor in very rainy/stormy conditions that could prove dangerous to the horses or riders. If your lesson is cancelled, you will be given an opportunity to make up the lesson that week.

 

If you do not hear from me either by phone or email, consider your lesson still on! If you call and cancel, that's fine too ' but if it's raining and you don't show up, and I'm out there teaching, you will owe me for the lesson.

If it's raining, snowy, or other adverse weather conditions are present, lessons will be taught indoors in the barn, with things that students would not normally learn during the course of the lesson program. Please remember that everything having to do with horses is important and the groundwork/barn work is not necessarily 'less important' than riding.

During the summer, lessons will be taught from 7am to 11am, then from 6pm to 8pm, due to heat.

During the winter, lessons will be taught in the warmest hours of the day.


Student's Date of Birth:___/___/____

Address:_____________________________________________________________________

City:__________________________State:___________________ Zip:___________________

Cell Phone #s: :_________________________________________________________________

Home Phone #s: :_______________________________________________________________

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

Medical Concerns: _____________________________________________________________

Allergies
:_____________________________________________________________________


RELEASE AND WAIVER AGREEMENT FOR Equine Kingdom Riding Academy

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 ______________________ ,2008.


RELEASE AND SIGN WAIVER:


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:___________________________________________
 

Release and Waiver Agreement for Equine Kingdom & Sally A. Nolte

NOTICE: Please read this document before signing. Signing this document affirms that you have read it and understand it in its entirety. If you have any questions, please ask before signing.

 The Equine Activity Liability laws of the State of North Carolina, ' 99E-2, require this notice: WARNING: Under North Carolina law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 99E of the North Carolina General Statutes.

 This RELEASE of LIABILITY is made and entered into on this ______ day of _____________, 20 _______, by and between Sally A. Nolte, hereinafter designated Trainer, and _______________________________ hereinafter designated Rider, and if Rider is a minor, Rider's parent or guardian, _______________________. In return for the use, today and on all future dates of the property, facilities and services of Sally A. Nolte, the Rider, his heirs, assigns, and legal representatives, hereby expressly agree to the following:

 1.      Rider agrees to assume ANY AND ALL RISKS INVOLVED IN OR ARISING FROM THE RIDER'S USE OF OR PRESENCE UPON TRAINER'S AND/OR MANAGER'S PROPERTY AND FACILITIES including, without limitation but not limited to, the risks of death, bodily injury, property damage, falls, kicks, bites, collisions with vehicles, horses or stationary objects, fire or explosion, the unavailability of emergency medical care, or the negligence or deliberate act of another person.

 2.      Rider agrees to hold Trainer and/or Manager and all of their successors, assigns, subsidiaries, affiliates, officers, directors, employees and agents completely harmless and not liable and release them from all liability whatsoever and AGREES NOT TO SUE them on account of or in connection with any claims, causes of action, injuries, damages, cost or expenses arising out of Rider's use of or presence upon Trainer's and/or Manager's property and facilities, including without limitation, those based on death, bodily injury, property damage, including consequential damages, except if the damages are caused by the direct, willful and wanton negligence of the Trainer and/or Manager.

 3.      Rider agrees to waive the protection afforded by any statute or law in any jurisdiction whose purpose, substance and/or effect is to provide that a general release shall not extend to claims, material or otherwise, which the person giving the release does not know or suspect to exist at the time of executing the release.

 4.      Rider agrees to indemnify and defend Trainer and/or Manager against, and hold them harmless from, any and all claims, causes of action, damages, judgments, costs or expenses, including attorney's fees, which in any way arise from the Rider's use of or presence upon the Trainer's and/or Manager's property and facilities.

 5.      Rider agrees to abide by all of Trainer's and Manager's rules and regulations.

 6.      If Rider is using his horse, the horse shall be free from infection, contagious or transmissible disease. Trainer and/or Manager reserves the right to refuse horse if not in proper health or is deemed dangerous or undesirable.

 7.      This contract is non-assignable and non-transferable and is made and entered into the State of North Carolina, and shall be enforced and interpreted under the laws of this state.  Should any clause be in conflict with State Law, then that clause is null and void.  When the Trainer, Manager and Rider and Rider's parent or guardian, if Rider is a minor, signs this contract, it will then be binding on all parties, subject to the above terms and conditions.

 _____________________________________          _____________________________________
                    Rider's Signature                                                                                  Trainer's Signature

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

 _____________________________________    

 _____________________________________          _____________________________________
                     Rider's Address                                                                              Rider's Telephone Number