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RIDING INSTRUCTION AGREEMENT
AND LIABILITY RELEASE FORM
FOR INDIVIDUALS
This form must be completed
by and for each participant
RYMAR RANCH,
INC.
STABLE NAME; hereinafter know
as “This stable”
LOCATION OR ADDRESS
8265 S. LECANTO HWY.
LECANTO, FL 34461
PLEASE READ
CAREFULLY BEFORE SIGNING
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 the parent or legal
guardians thereof 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, or
school horses provided by THIS STABLE for instructional
purpose of horseback riding today and on all future dates:
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RIDERS
NAME
|
AGE
(If under 21) |
WEIGHT
(Over
240#) |
HORSE
RIDING EXPERIENCE
(Check one which applies) |
|
|
|
_______
YES
_______
NO |
_____
BEGINNER (UNDER 10 HRS)
_____ OVER 10 HRS |
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Does
this rider have physical or mental conditions, which may affect his/her
safety and ability to ride a horse of which we should
be aware?
YES NO (Circle One) If "yes”, how can we help this rider with his/her
with special needs?
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B. AGREEMENT SCOPE AND
TERRITORY AND DEFINITIONS -This agreement shall be legally binding upon
me the registered rider,
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 and
county of THIS STABLE'S physical location. Any
dispute by the rider shall
be litigated in and venue shall be the county in which THIS
STABLE
is physically located. 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 riding or otherwise
handling of horses, ponies, mules, or donkeys,
whether from the ground
or mounted. The term '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 rider and
the
parents or legal guardians thereof if a minor.
C. ACTIVITY RISK
CLASSIFICATION- 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 State
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 STABLE
HORSES-I UNDERSTAND THAT: THIS STABLE chooses its rental horses for
their calm dispositions and
sound basic training as is required for use of
STUDENT RIDERS, and THIS STABLE follows a rigid safety program. Yet, no
horse is
a completely safe horse. 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 ½ 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 its will
on another
much larger, stronger prey animal with a mind of his own (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; Changing
directions or speed at will; Shifting its weight; Bucking, Rearing, Kicking,
Biting, or
Running from danger.
E. RIDER RESPONSIBILITY-
I UNDERSTAND THAT: Upon mounting a horse 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 aboard the moving animal. I agree that the rider shall be
responsible for his/her own safety, and that of an unborn child if
the rider is
pregnant. THIS STABLE advises pregnant women not to ride horses.
F. CONDITIONS OF NATURE
AND INSPECTION OF PREMISES-I UNDERSTAND THAT: THIS STABLE is NOT
responsible for total or
partial acts, occurrences, or elements
of nature that can scare a horse, cause it to fall, or react in some other
unsafe way. SOME
EXAMPLES ARE: Thunder, lightning, rain, wind, water, 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. The rider and
parent or legal guardian
have inspected THIS STABLE’S facilities and are
satisfied that all premise conditions are reasonably safe for rider’s intended
purpose,
usage and presence upon THIS STABLE’S PREMISES.
G. SADDLE
GIRTHS-NATURAL LOOSENING- I UNDERSTAND THAT: Saddle girths (saddle
fasteners around horse's belly) may
loosen during a ride. If a rider notices this
he/she must alert the nearest guide or wrangler as quickly as possible so action
can be
taken to avoid slippage of saddle and a 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 pay
for ALL such incurred expenses. My accident/medical insurance company
is
_______________________________ and my
policy number
is ________________________________.
I. PROTECTIVE HEADGEAR
OFFERING- 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 which
meets or exceeds the quality standard of the SEI CERTIFIED AS TM
STANDARD F1163
Equestrian Helmet, should be purchased and worn while riding and
being near horses and I do understand that
the wearing of such headgear 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.
J. LIABILITY RELEASE:
I AGREE THAT: In consideration of THIS STABLE allowing my participation in this
activity, under the terms
set forth herein, I, the rider, for myself and on
behalf of my child and/or legal ward, heirs, administrators, personal
representatives
or assigns, do agree to hold harmless, release, and discharge THIS
STABLE, its owners, agents, employees, officers, members,
promises owners,
insurers, and affiliated organizations, and insurers, and others acting on its
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, unanticipated, due to THIS STABLE’S and/or ITS ASSOCIATES
ordinary negligence; and I do further agree
that except in the event of
THIS STABLE’S gross negligence and will and 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, 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 owned by
or in in case, custody and control of THIS STABLE,
whether on or off premises of THIS STABLE.
All Riders and Parents or
Legal Guardians must sign below after reading this entire document:
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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 ATTEST THAT ALL FACTS RELATING TO THE APPLICANT'S PHYSICAL
CONDITION, EXPERIENCE, AND AGE ARE TRUE AND ACCURATE. |
________________________________________________________________________DATE ___________________________
SIGNATURE OF
RIDER (Spouses must sign for themselves)
______________________________________________ for
_______________________________DATE___________________
SIGNATURE OF PARENT, GUARDIAN AND/OR SPOUSE #1 NAME
(Please Print)
______________________________________________ for
_______________________________ DATE ___________________
SIGNATURE OF PARENT, GUARDIAN AND/OR SPOUSE #2 NAME
(Please Print)
Address
in full: _________________________________________ Home Phone #
______________________________________
_________________________________________ Bus. Phone
# _______________________________________ |