|
TRAIL RIDES RELEASE OF LIABILITY, WAIVER OF CLAIMS, EXPRESS ASSUMPTION OF RISK AND INDEMNITY AGREEMENT
Please read and be certain you understand the implications of signing.
Express Assumption of Risk Associated with Trail Rides and Related Activities.
I._____________________________ do hereby affirm and acknowledge that I have been fully informed of the inherent hazards and risks associated with Horse Riding Instructions / Lessons, transportation of equipment related to the activities, and traveling to and from activity sites in which I am about to engage. Inherent hazards and risks but not limited to:
1. Risk of injury from the activity and equipment utilized in Horse Riding is significant including the potential of permanent disability and death.
2. Possible equipment failure and / or malfunction of my own of other’s equipment.
3. My own negligence and / or the negligence of all others, including employees, agents, independent contractors or representatives of ___Cowan Horse Adventures_ LLC__, including but not limited to operator error.
4. The propensity of an equine (horse) to behave in dangerous ways that may result in injury to the participant regardless of the equine’s previous training and past performance.
5. The inability to predict an equine’s (horse’s) reaction to sound, movements, unfamiliar environment, objects, persons, or animals.
6. Natural hazards including but not limited to surfaces or subsurface conditions.
7. Propensity for an equine (horse) to run, buck, bite, kick, shy, stumble, rear, trample, scratch, peck, fall, make unpredictable movement, spook, down, jump, butt, step on a person’s feet, push and shove without warning or apparent cause.
8. Saddles or bridles may loosen or break which may cause the participant to be jolted or fall.
9. The domesticated animal may also react in a dangerous manner when a condition or treatment is considered hazardous to the welfare of the animal.
10. The potential for a participant to fail to exercise reasonable care, take adequate precautions, or use adequate control when engaging in a domesticated animal activity, including failing to maintain reasonable control of the animal or failing to act in a manner consistent with the person’s abilities.
11. Collisions with trees, brush, and other animals or objects.
12. Broken bones, severe injuries to the head, neck, and back which may result in severe impairment or even death.
13. Cold weather and heat related injuries and illness including but not limited to frost nip, frost bite, heat exhaustion, heat stroke, sunburn, hypothermia and dehydration.
14. Exposure to outdoor elements, including but not limited to avalanche, rock fall, inclement weather, thunder and lighting, severe and or varied wind, temperature and all other weather conditions.
15. Attack by or encounter with insects, reptiles, and / or animals.
16. Accidents or illness occurring in remote place where there are no available medical facilities.
17. Fatigue chill, and / or dizziness, which may diminish my/ our reaction time and increase the risk of accident.
18. My sense of balance, physical coordination, and ability to follow instructions.
* I understand the description of these risks is not complete and that unknown or unanticipated risk may result in injury, illness, or death.
Page 1 of 2, continue on reverse side.
----------------------------------------------
Release of Liability, Waiver of Claims and Indemnity Agreement
In consideration for being permitted to participate in any way in Trail Rides and related activities, I herby agree, acknowledge and appreciate that:
1. I HEREBY RELEASE AND HOLD HARMELSS WITH RESPECT TO ANY AND ALL INJURY, DISABILITY, DEATH, or loss or damage to person or property, WHETHER CAUSED BY NEGLIGENCE OR OTHERWISE, the following named persons or entities, herein referred to as releasees.
COWAN HORSE ADVENTURES LLC
Owner ( Company and / or Person )
2. To release the releasees, their officers, directors, employees, representative, agents, and volunteers, and vessels from liability and responsibility whatsoever and for any claims or causes of action that I, my estate, heirs, survivors, executors, or assigns may have for personal injury, property damage, or wrongful death arising from the above activities whether caused by active or passive negligence of the releasees or otherwise. By executing this document, I agree to hold the relaesees harmless and indemnity them in conjunction with any injury, disability, death, or loss or damage to person or property that may occur as a result of engaging in the above activities.
3. By entering in this Agreement, I am not relying on any oral or written representation or statements made by the releasees, other than what is set forth in this Agreement.
This release shall be binding to the fullest extent permitted by law. If any provision of this release is found to be unenforceable, the remaining terms shall be enforceable.
I HAVE READ THIS RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT, AND I FULLY UNDERSTAND ITS TERMS, AND UNDERSTAND THAT I HAVE GIVEN UP LEGAL RIGHTS BY SIGNING IT, AND I SIGN IT FREELY AND VOLUNTARIY WITHOUT ANY INDUCEMENT.
S/____________________________ ______________________ _____
Signature of Adult Participant Name of Adult Participant (Please Print) Date
FOR PARTICIPANTS OF MINORITY AGE: This is to certify that I, as Parent, Guardian, Temporary Guardian with legal responsibility for this participant, do consent and agree not only to his/her release of all Releasees, but also to release and indemnify the Releasees from any and all liabilities incident to his/her involvement in these program for myself, my heirs, assigns, and next of kin.
S/____________________________ _______________________ _____
Signature of Parent or adult legal Guardian if Name of Parent or adult legal Guardian Date
Participant is a Minor, and by their signature, (Please Print)
they on my behalf release all claims that both
they and I have. _____________________________ ______
Minor’s Full Name Date
Page 2 of 2
-------------------------------------
DECLARATION OF FITNESS TO RIDE
I hereby declare that I, and / or the below named minor(s), am/are/is physically fit. I/We/He/She Do/Does Not WEIGH MORE THAN 225 POUNDS AND THE MINOR IS AT LEAST TWELVE (12) YEARS OF AGE. I/We/He/She do/does not, and have not, suffered from any of the following conditions, which I understand may lead to a dangerous situation with regard to other persons or myself/himself/herself during riding activities:
Epilepsy, fits, pregnancy, severe head injury, recurrent blackouts or giddiness, disease of the brain or nervous system, high blood pressure, lung or heart disease, recurrent weakness or dislocation of any limb, diabetes, mental illness, drug or alcohol addiction, recent back injury, arthritis or sever joint sprains, chronic bronchitis, asthma, rheumatic fever, thyroid adrenal or other glandular disorder, recent blood donation or any condition that requires the regular use of drugs. I am currently not impaired by any substance.
I herby declare that I/we/he/she have/has no physical or mental condition that should preclude me/us/he/she from participating in my/our chosen activity, that I/we/he/she am/are/is not participating against medical advice or treatment and that I/we/he/she have/has not been diagnosed by a registered doctor as having terminal illness.
I further declare that in the event that I/he/she feel/feels ill or unwell have/has any physical complaints whatsoever or if an injury is sustained of any kind during the course if riding activities, I/he/she will notify the instructor/ guide/ employee of the insured immediately and before moving away from the immediate vicinity.
I HAVE READ THE ABOVE DECLARATIONS, UNDERSTAND THEM, AND AGREE TO BE BOUND BY THEM.
S/____________________________ ______________________ _____
Signature of Adult Participant Name of Adult Participant (Please Print) Date
_____________________________________ (_____)_____________
Street Address, City, State, Zip Code of Adult Participant Contact Phone Number
S/____________________________ _______________________ _____
Signature of Parent or adult legal Guardian if Name of Parent or adult legal Guardian Date
Participant is a Minor, and by their Signature, (Please Print)
they on my behalf release all Claims that both
they and I have.
_______________________________________ ______
Minor’s Full Name (Please Print) Date
_____________________________________ (_____)_____________
Street Address, City, State, Zip Code of Parent of Guardian Contact Phone Number
****************************************************************************************************
If you cannot sign the above declaration because of any of the above conditions, you must notify the Instructor/Guide/Employee of the insured immediately before you mount the horse or commence any activities.
****************************************************************************************************
Attention of the Authorized Insured Only (Counter-Sign upon full and correct completion)
S/_________________________ _Cowan Horse Adventures LLC_ _____
Counter-Signature of Authorized Insured Name of Authorized Insured (Print) Date
Page 1 of 2 continue on reverse side
----------------------------------------------------
PROTECTIVE EQUESTRIAN HEADGEAR REFUSAL AGREEMENT
Please read and be certain you understand the implications of signing.
I, FOR MYSELF AND/OR ON BEHALF OF MY CHILD OR LEGAL WARD, HAVE BEEN FULLY WARNED AND ADVISED BY Cowan Horse Adventures LLC THAT WE SHOULD WEAR A PROPERLY FITTED “ASTM / SEI” (EQUESTRIAN STANDARD) HELMET WHILE RIDING HORSES IN ORDER TO REDUCE SOME OR ALL OF OUR HEAD INJURIES AS THE RESULT OF A FALL OR ANY OTHER OCCURRENCE ASSOCIATED WITH THIS HAZARDOUS ACTIVITY. WE REALIZE THAT WE ARE SUBJECT TO INJURY FROM THIS ACTIVITY TO WHICH WE ARE EXPOSING OURSELVES PURELY VOLUNTARILY.
AGAINST THIS ADVICE, WE ARE REFUSING THIS CRITICAL SAFETY PRECAUTION.
I / WE THE UNDERSIGNED, HAVE READ THE FOREGOING STATEMENT AND DO UNDERSTAN ITS WARNING AND ASSUMPTION OF RISKS.
S/____________________________ ______________________ _____
Signature of Adult Participant Name of Adult Participant (Please Print) Date
FOR PARTICIPANTS OF MINORITY AGE: This is to certify that I, as Parent, Guardian, Temporary Guardian with legal responsibility for this participant, do consent and agree not only to his/her release of all Releasees, but also to release and indemnify the Releasees from any and all liabilities incident to his/her involvement in these program for myself, my heirs, assigns, and next of kin.
S/____________________________ _______________________ _____
Signature of Parent or adult legal Guardian if Name of Parent or adult legal Guardian Date
Participant is a Minor, and by their signature, (Please Print)
they on my behalf release all claims that both
they and I have.
_____________________________ ______
Minor’s Full Name (Please Print) Date
Page 2 of 2
|
