2021 Family Release Form
2021 Family Release Form
A. REGISTRATION OF PARTICIPANT AND AGREEMENT PURPOSE I, the following listed individual, and the parents or legal guardians thereof if a minor, do
hereby voluntarily agree to participate in horse rental services and / or equestrian services and / or guide and outfitter services provided by THIS STABLE.
1st ADULT PARTICIPANT AGE (If under HEIGHT & HORSE RIDING
NAME 18) WEIGHT EXPERIENCE
(Please Print Name) (Check one that applies)
7. Does participant have any physical or mental condition(s) that may affect his / her safety and ability to ride a horse? YES NO (circle one)
8. If you circled “YES”, how can we help this participant with his / her special needs?
9. MEDICAL INSURANCE I / WE AGREE THAT: Should medical treatment be required, I and / or my medical insurance shall pay for ALL such incurred expenses.
+ My medical insurance company is My policy number is D I do not carry medical insurance.
2nd ADULT PARTICIPANT AGE (If under HEIGHT & HORSE RIDING
NAME 18) WEIGHT EXPERIENCE
(Please Print Name) (Check one that applies)
7. Does participant have any physical or mental condition(s) that may affect his / her safety and ability to ride a horse? YES NO (circle one)
8. If you circled “YES”, how can we help this participant with his / her special needs?
1st MINOR PARTICIPANT AGE (If under HEIGHT & HORSE RIDING
NAME 18) WEIGHT EXPERIENCE
(Please Print Name) (Check one that applies)
7. Does participant have any physical or mental condition(s) that may affect his / her safety and ability to ride a horse? YES NO (circle one)
8. If you circled “YES”, how can we help this participant with his / her special needs?
2nd MINOR PARTICIPANT AGE (If under HEIGHT & HORSE RIDING
NAME 18) WEIGHT EXPERIENCE
(Please Print Name) (Check one that applies)
7. Does participant have any physical or mental condition(s) that may affect his / her safety and ability to ride a horse? YES NO (circle one)
8. If you circled “YES”, how can we help this participant with his / her special needs?
3rd MINOR PARTICIPANT AGE (If under HEIGHT & HORSE RIDING
NAME 18) WEIGHT EXPERIENCE
(Please Print Name) (Check one that applies)
7. Does participant have any physical or mental condition(s) that may affect his / her safety and ability to ride a horse? YES NO (circle one)
8. If you circled “YES”, how can we help this participant with his / her special needs?
7. Does participant have any physical or mental condition(s) that may affect his / her safety and ability to ride a horse? YES NO (circle one)
8. If you circled “YES”, how can we help this participant with his / her special needs?
C. INHERENT RISKS / ASSUMPTION OF RISKS I ACKNOWLEDGE THAT: Horseback riding is classified as RUGGED ADVENTURE RECREATIONAL SPORT
ACTIVITY and that risks, conditions, and dangers are inherent in (meaning an integral part of) horse / equine / animal activities, regardless of all feasible safety
measures which can be taken, and I agree to assume them. The inherent risks include, but are not limited to any of the following: The propensity of an animal to
behave in ways that may result in injury, harm, death, or loss to persons on or around the animal; The unpredictability of an equine’s reaction to sounds, sudden
movement, unfamiliar objects, persons, or other animals; Hazards, including, but not limited to, surface or subsurface conditions; A collision, encounter and / or
confrontation 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, harm, death, or loss to the participant or to other persons, including but not limited to, failing to maintain control over an equine and / or failing
to act within the ability of the participant. 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
horse to ground it will generally be at a distance of from 3 1/2 to 5 1/2 feet, and the impact may result in harm to the rider. Horseback riding is an activity in which
one much smaller, weaker predator animal (the human) tries to impose its will on, and become one unit of movement with, another much larger, stronger prey
animal that has a mind of its own (the horse) and each has a limited understanding of the other. If a horse is frightened or provoked it may divert from its training
and act according to its natural survival instincts which may include, but are not limited to: Stopping short; Spinning around; Changing directions and / or speed at
will; Shifting its weight; Bucking; Rearing; Kicking; Biting; and / or Running from danger. I also acknowledge that these are just some of the risks and I agree to
assume others not mentioned above. I am not relying on THIS STABLE to list all possible risks for me.
D. WILDERNESS EXPERIENCE PARTICIPATION, CONDITIONS OF NATURE WARNING, UNFAMILIAR AND SUDDEN SIGHTS, SOUNDS AND MOVEMENTS
WARNING, AND INSPECTION OF PREMISES I / WE ACKNOWLEDGE THAT: The participant may be taking part in a "WILDERNESS EXPERIENCE" that may
be hazardous to people. I / WE ACKNOWLEDGE THAT The meaning of “WILDERNESS EXPERIENCE” is defined as the pursuit of activity in a natural and / or
wild and / or rugged and / or uncultivated area or region, as of forest and / or hills and / or mountains and / or plains and / or wetlands, which would likely be
uninhabited by people and inhabited by wild animals of many types and species to include, but not limited to, mammals, reptiles, and insects, which are not tame,
may be savage and unpredictable in nature and also wandering at their will. I / WE ACKNOWLEDGE THAT: THIS STABLE is NOT responsible for total or partial
acts, occurrences, or elements of nature and / or sudden and / or unfamiliar sights, sounds and / or sudden movements that can scare a horse, cause it to fall, or
react in some other unsafe way. SOME EXAMPLES ARE: Thunder, lightening, rain, wind, wild and domestic animals, insects, reptiles, which may walk, run, or fly
near, or bite or sting a horse or person; and 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. I also acknowledge that these are just some of the risks and I agree to assume others not
mentioned above. I am not relying on THIS STABLE to list all possible conditions for me. The participant and parent or legal guardian have inspected THIS
STABLE'S facilities and are satisfied that all premise conditions are reasonably safe for this participant’s intended purpose, usage and presence upon
THIS STABLE'S premises.
E. CARRY-ON OBJECTS WARNING AND SHARP, LOUD NOISES WARNING I / WE ACKNOWLEDGE THAT: When approaching, mounting and riding horses, I must
not carry loose items that may fall or blow away or flap in the wind or bounce or make sharp or loud noises, the action of which may scare horses causing them to
react in unsafe ways. SOME EXAMPLES ARE: Cameras, cell phones, hats not securely fastened under chin, toys, purses. When near or riding a horse,
participants must not make sharp or loud noises, such as whistling or screaming or yelling, the sound of which may scare horses causing them to react in unsafe
ways.
F. SADDLE GIRTH LOOSENING WARNING I / WE ACKNOWLEDGE THAT: Saddle girths (fastener straps around the horse's belly) may loosen during riding. Riders
must alert the nearest attendant of any girth looseness so action can be taken to avoid saddle slippage and the potential for the rider to fall from the horse.
G. PROTECTIVE HEADGEAR / HELMET WARNING AND OFFERING: I / WE AGREE THAT: I for myself and on behalf of my child and / or legal ward have been fully
warned and advised by THIS STABLE that protective headgear / helmet, which meets or exceeds the quality standards of the SEI CERTIFIED ASTM STANDARD
F 1163 Equestrian Helmet, should be worn while riding, handling, and / or being near horses, and I understand that the wearing of such headgear / helmet at these
times may reduce severity of some of the wearer's head injuries and possibly prevent the wearer's death from happening as the result of a fall and other occurrences.
I / WE ACKNOWLEDGE THAT: THIS STABLE has offered me, and my child and / or legal ward if applicable, protective headgear / helmet that meets or exceeds
the quality standards of the SEI CERTIFIED ASTM STANDARD F 1163 Equestrian Helmet. I / WE ACKNOWLEDGE THAT: Once provided, if I choose to wear the
protective headgear / helmet offered that I / WE will be responsible for properly securing the headgear / helmet on the participant's head at all times. I am not
relying on THIS STABLE and / or its associates to check any headgear / helmet or headgear / helmet strap that I may wear, or to monitor my compliance
with this suggestion at any time now or in the future.
I. LIABILITY RELEASE I AGREE THAT: In consideration of THIS STABLE allowing my participation in this activity, under the terms set forth herein, I
for myself and on behalf of my child and / or legal ward, heirs, administrators, personal representatives or assigns, do agree to release, hold
harmless, and discharge THIS STABLE, its owners, agents, employees, officers, directors, representatives, assigns, members, owners of
premises and trails, affiliated organizations, and Insurers, and others acting on their behalf (hereinafter, collectively referred to as "Associates"),
of and from all claims, demands, causes of action and legal liability, whether the same be known or unknown, anticipated or unanticipated, due to
THIS STABLE'S and / or ITS ASSOCIATE’S ordinary negligence or legal liability; and I do further agree that except in the event of THIS STABLE'S
gross negligence and / or willful and / or wanton misconduct, I shall not bring any claims, demands, legal actions and causes of action, against
THIS STABLE and ITS ASSOCIATES as stated above in this clause, for any economic and non-economic losses due to bodily injury and / or death
and / or 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 owned by me or owned by THIS STABLE, or in the care, custody or control of THIS
STABLE, whether on or off the premises of THIS STABLE, but not limited to being on THIS STABLE’S premises.
J. EQUINE ACTIVITY LIABILITY ACT [EALA] WARNING OR LANGUAGE: [This clause applies only for operations located in these states: AL, AZ, CO, DE, FL, GA, IL,
IA, IN, KY, KS, LA, ME, MA, MI, MS, MO, NE, NC, OH, OK, OR, RI, SC, SD, TX, TN, UT, VA, VT, WV, and WI.] I acknowledge that I have reviewed this state’s EQUINE
ACTIVITY LIABILITY ACT WARNING OR LANGUAGE, a copy of which is attached hereto and incorporated as if fully set forth herein. INSTRUCTION TO SIGNERS:
DO NOT SIGN UNLESS A COPY OF THE EALA WARNING OR LANGUAGE IS ATTACHED TO THIS AGREEMENT.
SIGNATURE OF ADULT PARENT OR GUARDIAN #1 (Spouses must sign for themselves.) DATE
SIGNATURE OF ADULT PARENT OR GUARDIAN #2 (Spouses must sign for themselves.) DATE
( )
PERSON TO CONTACT IN CASE OF EMERGENCY RELATIONSHIP TO PARTICIPANTS PHONE NUMBER
UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE),
AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH
OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT
RISKS OF EQUINE ACTIVITIES.