PARTICIPANT’S RELEASE AND WAIVER OF LIABILITY ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

Riverbend Equine Therapy - 4055 S. Wilkins Rd Swanton, OH 43558

BY SIGNING THIS AGREEMENT, YOU ARE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES IN CASE OF INJURY, DEATH OR PROPERTY DAMAGE.

READ THIS AGREEMENT CAREFULLY BEFORE SIGNING IT. YOUR SIGNATURE INDICATES YOUR UNDERSTANDING OF AND AGREEMENT TO ITS TERMS.

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* 1. First Name

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* 2. Last Name

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* 3. Phone Number

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* 4. Email Address

This is an agreement between the Undersigned (or minor in my charge), for Riverbend Equine Therapy Services, Inc. (hereby referred as RETS, Inc.).
On behalf of myself, my personal representatives, heirs, next-of kin, spouse and assigns I HEREBY:
1. Acknowledge that ANY activity involving horses, be it astride or on the ground, has the potential to be dangerous and involves risks that may cause serious
injury and in some cases death, because of the unpredictable nature and irrational behavior of horses, regardless of their training and past performance.
2. Knowing these facts and in consideration of your acceptance of this form, I voluntarily assume the risk and danger of injury or death inherent in horse
related activities. I hereby RELEASE, DISCHARGE AND PROMISE NOT TO SUE RETS, Inc doing business under their own names or any other name and/or any of its owners, officers, employees, agents, sponsors and sanctioning organizations, for any lose, liability, damage or cost whatsoever arising out of or related to any loss, damage or injury (including death) to my person or property.
3. I hereby RELEASE, DISCHARGE AND PROMISE NOT TO SUE RETS, Inc. from any claim that arises such as or may be negligent in connection with my riding experience or ability including but not limited to training or selecting horses, maintenance, care, fit or adjustment of saddles or bridles/halters, stadium/cross country jumps, riding area, trail riding in and around property, instruction on riding skills or supervising riding activities, or any and all ground activities where horses are involved.
4. INDEMNIFY AND SAVE AND HOLD HARMLESS RETS, Inc. and its employees and agents from and against any loss, liability, damage or cost they may incur arising out of or in any way connected with any event, my use of a horse/horses and any equipment or gear provided therewith or any acts or omissions of employees or agents.
5. Agree to abide by and follow any instructions given or rules established by RETS Inc, or any of their employees, agents or volunteers with regard to my participation in any event, use of a horse or any equipment or gear provided therewith. READ AND SIGN YOUR AGREEMENT TO ABIDE BY THE GENERAL RULES POSTED ON THE TACK ROOM AND THE OBSERVATION ROOM DOOR.
6. The Undersigned expressly agrees that the foregoing release and waiver of liability, assumption of risk, and indemnity agreement is governed by the State of Ohio and is intended to be as broad and inclusive as is permitted by Ohio law, and that in the event any portion of this Agreement is determined invalid, illegal or unenforceable, the validity, legality and enforceability of the balance of the Agreement shall not be affected or impaired in any way and shall continue in full legal force and effect.
7. Acknowledge that this document is a contract and agree that if a lawsuit is filed against RETS Inc or its owners, agents,
employees, judges or managers for any injury or damage in breach of this contract, the Undersigned will pay all attorney’s fees and costs incurred by RETS Inc. in defending such an action.

I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A PROMISE NOT TO SUE AND A RELEASE AND INDEMNITY FOR ALL CLAIMS.

Please type your first and last name here along with the date as your Electronic Signature. 

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* 5. Example: Jane Doe 7/25/2012

PARENT/GUARDIAN WAVIER - FILL OUT ONLY IF SIGNING FOR A MINOR. IF THERE IS NO MINOR TYPE "NA".

If the person who is to enter into this agreement (referred to as the “Undersigned” above) is under eighteen (18) years of age, his/her parent must read and sign
the following:

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* 6. Parent or Guardian Name

I declare I am acting as parent, natural or legal guardian of 

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* 7. Minor Name

(hereinafter “the minor”) hereby affirms that he/she has read the Agreement, understands the Agreement and understands that the agreement is a release of all claims for injury, death and property damage and consents to the terms on behalf of him/herself and on behalf of the minor, and agrees to indemnify and save and hold harmless RETS Inc. from any loss, liability, damage or cost they may incur because of any defect in or lack of capacity to act on behalf of minor in executing this agreement.

I HAVE READ AND DISCUSSED THE BARN RULES WITH MY CHILD/WARD AND AGREE TO THEM.

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* 8. Parent/Guardian signature and date (Example: Jane Doe 1/2/2020)

IN CASE OF EMERGENCY PLEASE CONTACT:

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* 9. Emergency Contact Name

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* 10. Emergency Contact Phone Number

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* 11. Relationship

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* 12. Please list any medical conditions or medications that a doctor should know of in the event of an emergency.

MEDIA RELEASE

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* 13. Please select one of these options

In checking the consent box I hereby consent and agree that HOOVES/RIVERBEND EQUINE its employees or agents have the right to take photographs, videotape, or digital recordings of me to use these in any and all media, now or hereafter known, and exclusively for the purpose of furthering or promoting the mission of HOOVES/RIVERBEND EQUINE of me or any minor children listed on this form. I further consent that my name and identity may be revealed therein or by descriptive text or commentary. I do hereby release to HOOVES/RIVERBEND EQUINE its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately and to market and sell copies. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used. I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback. I also understand that HOOVES/RIVERBEND EQUINE is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result. I represent that I am at least 18 years of age, have read and understand the foregoing statement, and am competent to execute this agreement.
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