SERIOUS INJURY MAY RESULT FROM YOUR PARTICIPATION IN THIS ACTIVITY
THIS STABLE DOES NOT GUARANTEE YOUR SAFETY
A. REGISTRATION OF RIDERS AND AGREEMENT PURPOSE: In consideration of the payment of a fee and the signing of
this agreement, I, the following listed individual, and parent or legal guardians therof if a minor, do hereby voluntarily request and
agree to participate in riding instruction as a student at THIS STABLE, and that this student will either ride his/her own horse/pony
or school horse/pony provided by THIS STABLE for instructional purpose, today and on all future dates.
RIDER NAME: AGE: WEIGHT: RIDING EXPERIENCE: (Check one that applies)
_____________________________ ___________ Under 240 Pounds _______ Beginner (Under 10 hours) __________
Over 240 Pounds ________ Over 10 hours of riding ____________
B. AGREEMENT SCOPE AND TERRITORY AND DEFINITIONS: This agreement shall be legally binding upon me the registered
student, and the parents or legal guardians, thereof if a minor, my heirs, estate, assigns, including all minor children, and personal
representatives and it shall be interpreted according to the laws of the state of THIS STABLES physical location. If any clause, phrase
or word is in conflict with state law, then that single part is null and void. The term "HORSE" herein shall refer to all equine species.
The term "HORSEBACK RIDING" herein shall refer to the riding or otherwise handleing of horses, whether from the ground or mounted.
The terms "STUDENT" and or "RIDER" shall herein refer to a person who rides a horse mounted or otherwise handles or comes near a
horse from the ground. The terms "I, "ME", "MY",shall herein refer to the above registered student rider and the parents or legal guardians,
therefore if a minor.
C. ACTIVITY RISK CLASSIFICATIONS: I understand that Horseback riding is classified as RUGGED ADVENTURE RECREATIONAL
SPORT ACTIVITY and that there are numerous obvious and non-obvious inherent risks always present in such activity despite all safety
precautions. According to NEISS (National Electronic Injury Surveillance Systems of United States Consumer Products) horse activities rank
64th among the activities of people relative to injuries that result in a stay at U.S hospitals. Related injuries can be severe, requiring more
hospital days and resulting in more lasting residual effects than injuries in other activities.
D: NATURE OF THIS STABLE'S SCHOOL HORSES: I understand that THIS STABLE chooses its school horses for their calm
dispositions and sound basic training as is required for use for STUDENT RIDERS and THIS STABLE follows a rigid safety program.
Yet, no riding horse/pony is completely a safe horse/pony. Horses are 5 to 15 times larger, 20 to 40 times more powerful and 3 to 4 times
faster than a human. If a rider falls from a horse/pony to the ground, it will generally be at a distance of 3 1/2 to 5 1/2 feet and the impact
may result in injury to the rider. Horseback riding is the only sport where one much smaller, weaker predator animal (human), tries to
impose it's will on and become one unit of movement with another, much larger, stronger prey animal with a mind of it's own (horse) and
each has limited understanding of the other. If a horse is frightened or provoked, it may divert from it's training and act according to its
natural survival instinicts, which may include, but not limited to, stopping short, changing directions or speed at will, shifting it's weight,
rearing, bucking, kicking, biting or running from danger.
E. RIDER RESPONSIBILITY: I understand that upon mounting a horse/pony and taking up the reins, the rider is in primary control of
the horse. The rider's safety largely depends upon his/her ability to carry out simple instructions, and his/her ability to remain balanced
and calm aboard the moving animal. I agree that the rider shall be responsible for his/her own safety.
F. CONDITIONS OF NATURE: I understand that THIS STABLE is NOT responsible for total or partial acts, occurrences, or elements
of nature that may scare a horse/pony, cause it to fall or react in some other unsafe way. SOME EXAMPLES ARE: Thunder, lighting, rain,
wind, wild and domestic animals, insects, reptiles, which may walk, run, fly near or bite/sting the horse/pony or rider. Irregular footing on,
out of door groomed or wild land, which is subject to constant change in condition according to weather, temperature and natural and man
made changes in landscape.
G. SADDLE/GIRTHS/NATURAL LOOSING: I understand that a saddle girth (saddle fasteners around horse's/Ponies belly) may loosen
during riding. If a rider notices this, he/she must alert the riding instructor as quickly as possible so action can be taken to avoid slippage of
saddle and potential fall from the animal.
H. ACCIDENT/MEDICAL INSURANCE: I agree that should emergency medical treatment be required, I and/or my own accident/medical
insurance company shall be liable to pay for all such incurred expenses. My accident/medical indurance company is _____________________
and my policy number is____________________.
I. PROTECTIVE HEADGEAR WARNING: I agree that I have been fully warned and advised by THIS STABLE that I should purchase and
wear protective headgear (equestrian riding helment), and do understand that the wearing of such headgear while mounting, riding, dismounting
and otherwise being around horses, may prevent or reduce severity of some head injuries and even prevent death from happening as the result
of a fall or otherwise occurrence.
J. LIABILTY RELEASE: In consideration of THIS STABLE allowing my participation in this activity, under the terms set forth herein, I,
the rider, and the parent or legal guardian, thereof a minor, do agree to hold harmless and release THIS STABLE, it's owners, agents, employees,
officers, members, premises owners, and affiliated organizations from legal liability due to THIS STABLES ordinary negligence, and I do
further agree that, except in the event of THIS STABLE'S gross and willful negligence, I shall bring no claims, demands, actions and causes
of action, and/or litigation against THIS STABLE and IT'S ASSOCIATES as stated above in this clause, for any economic and noneconomic
losses due to bodily injury, death, property damage, sustained by me and /or my minor child or legal ward in relation to the premises and
operations of THIS STABLE, to include while riding, handling, or otherwise being near horses/ponies owned by or in the care custody and
control of THIS STABLE.
All Rider's, paernts or legal guardians must sign below after reading this entire document
SIGNER STATEMENT OF AWARENESS
I/WE THE UNDERSIGNED, HAVE READ AND DO UNDERSTAND THE FOREGOING AGREEMENT, WARNINGS, RELEASE
AND ASSUMPTION OF RISK. I/WE FURTHER A TEST THAT ALL FACTS RELATING TO THE APPLICANTS PHYSICAL
CONDITION, EXPERIENCE AND AGE ARE TRUE AND ACCURATE.
__________________________________________________________________________________________________________________
SIGNATURE OF PARENT/LEGAL GUARDIAN (IF UNDER 18) OR RIDER DATE PLEASE PRINT RIDER'S NAME
__________________________________________________________________________________________________________________
STREET ADDRESS CITY STATE ZIP
______________________________ _______________________________ _______________________________________
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