Waiver and Release of Liability

2008 Horse Farm Student Information Sheet

Name____________________________ DOB_____________ Height_______ Weight________

Address______________________________________City_________________Zip__________

Home Phone ____________________________Work Phone____________________________

Cell____________________________email__________________________________________

What special information should the instructor know for a safe & enjoyable riding experience? (Allergies, conditions that affect the student’s response time or ability to follow instructions, physical limitations etc.)

_____________________________________________________________________________

_____________________________________________________________________________

_____________________________________________________________________________

Student has ridden:..........0-2 times.........3-5 times.........6-8 times..........9+ times

Student has ridden:..........English..........Western..........I don’t know

Student has:..........Walked..........Trotted..........Cantered.........Jumped

Student has previously had riding lessons:..........Yes..........No

If Yes, when and where?______________________________________________________

Responsible Party/Emergency Contact Information
Name____________________________________Relationship_________________________

Phone__________________Address______________________________________________

Medical Release

If an emergency occurs or in the event of an accident, injury or illness and I (we) cannot be contacted, I (we) do allow ourself (our child) to be treated by emergency personnel, a physician, a hospital or other certified medical personnel.

Signature_____________________________________________________Date_____________

2008 WAIVER AND RELEASE OF LIABILITY

This WAIVER and RELEASE of LIABILITY is made and entered into on this ________ day of _____________ , 2008, by and between The Grape Arbor, L.L.C. d/b/a The Horse Farm ("THF") and __________________________________ as Rider, and, if Rider is a minor, Rider’s parent or guardian, __________________________ (collectively "RIDER"). In return for the use, today and on all future dates of the property, facilities and services of the THF, the RIDER, his/her heirs, assigns, and legal representatives, hereby expressly agree to the following:

Inherent Risks. There are significant elements of risk in any adventure, sport or activity associated with horses; horse drawn equipment and/or saddle animals including but not limited to horses, mules and donkeys (referred to herein as “activity”) and the use of any equipment therewith. The undersigned acknowledge(s) there are inherent risks associated with equine activities such as described below, and hereby expressly assumes all risks associated with participating in such activities. The inherent risks include, but are not limited to the propensity of equines to behave in ways such as running, bucking, biting, kicking, shying, stumbling, rearing, falling or stepping on, that may result in an injury, harm or death to persons on or around them; the unpredictability of equine’s reaction to such things as sounds, sudden movement, and unfamiliar objects, persons or other animals; certain hazards such as surface and subsurface conditions, collisions with other animals; the limited availability of emergency medical care; and the potential of a participant to act in a negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the animal or not acting within such participant’s ability.

RIDER acknowledges that horses, by their very nature are unpredictable and subject to animal whim, which may include behavior including, but not limited to their propensity to kick, bite, shy, buck, stumble, bolt, rear or general unpredictability. RIDER assumes all risks in connection therewith, and expressly waives any claims for any injury or loss arising therefrom.

RIDER agrees to abide by and follow THF’s rules and regulations which shall be posted and/or available from time to time.

RIDER further acknowledges that the behavior of any animal is contingent to some extent upon the ability of RIDER. RIDER shall assume risks therefor and warrants that a full and fair disclosure of RIDER’s abilities has been made to THF.

Rider agrees to hold THF and all of its successors, assigns, subsidiaries, affiliates, officers, directors, employees and agents completely harmless and not liable and release them from all liability whatsoever and AGREES NOT TO SUE them on account of or in connection with any claims, causes of action, injuries, damages, cost or expenses arising out of RIDER’S use of or presence upon THF’s property and facilities, including without limitation, those based on death, bodily injury, property damage, including consequential damages, except if the damages are caused by the direct, willful and wanton negligence of THF.
RIDER agrees to indemnify and defend Manager against, and hold it harmless from, any and all claims, causes of action, damages, judgements, costs or expenses, including attorney’s fees, which in any way arise from the Rider’s use of or presence upon the Manager’s property and facilities.

In the event RIDER is using RIDER’s own horse, or a horse(s) not owned by THF, RIDER warrants said horse(s) shall be free from infection, contagious or transmittable diseases. THF reserves the right to refuse access or use of any horse upon the premises that does not appear to THF to be in good health, or is deemed dangerous or undesirable.

Any action brought under this agreements shall be brought within one (1) year of the incident or accident giving rise to said claim. RIDER agrees that damages shall be limited to $250 for property damage, medical or other actual expenses incurred, and a maximum of $10,000 for damages such as pain and suffering.

RIDER agrees to waive the protection of any applicable statutes in this jurisdiction whose purpose, substance and/or effect is to provide that a general release shall not extend to claims, material or otherwise, which the person giving the release does not know or suspect to exist at the time of executing said release.

WARNING

Under Missouri law, 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 pursuant to the Revised Statutes of Missouri.