Horse Rental Agreement and Liability Release Form

BLACKHAWK HORSE CAMP, LLC

20559 S. Paulen Rd, Overbrook, Ks. 785-806-3121 blackhawkhorsecamp.com

Facility Owner: Blackhawk Horse Camp, LLC Facility Owner Agents: Kelley D. Thompson & Judson E. Thompson

Premise Owners: Kenneth B. and Susan G. Johnson Adjacent Property Premise Owners: U.S. Army Corp of Engineers

(Hereinafter Collectively "Released Parties”)

LIABILITY RELEASE

PLEASE READ CAREFULLY BEFORE SIGNING

1. PREMISE ACTIVITIES include but are not limited to the following: Camping; Cabin/Camper or Camping Space Rental; Equine Riding, Clinics, Trail Use, Use of all Horse Corrals, Pens, Stalls and Paddocks; including Electric pens, Arena Usage, Obstacle Course Usage, Round Pen usage, Hitching Post usage, Guided Trail Rides, Lessons, Pony/Horse Rides, Facility Use, Organized Trail Rides, Benefit Trail Rides, Play Set usage, Restroom usage, Educational Day Camps and Clinics and any, and all other activities or facility usage, either on, or directly or indirectly related to, the use of these Premises, including adjacent trail rides on Corp of Engineer properties by Pomona Lake, referred to collectively as “Premise Related Activities”.)

THE RELEASED PARTIES CANNOT AND DO NOT GUARANTEE YOURS OR YOUR ANIMALS SAFETY.

2. Participant’s Name: ______Age:______

Address:______City/zip______

Phone:______Email Address:______

If Participant under 18, name of parents or guardians: ______

Emergency Contact Information: ______

(Name) (Telephone)

3. PLEASE IDENTIFY PARTICIPANT’S RIDING EXPERIENCE:

______Beginner ______Intermediate ______Advanced

4. Facility and Premise Owners recommend that all participants wear ASTM-approved safety helmets while engaging in equine activities.

5. KANSAS STATUTORY DOMESTIC ANIMAL ACTIVITY LIABILITY ACT:

K.S.A. §60-4002 et. seq. (1994) : WARNING

“Under Kansas law, there is no liability for an injury to or the death of a participant in domestic animal activities resulting from the inherent risks of domestic animal activities, pursuant to sections 1 through 4. You are assuming the risk of participating in this domestic animal activity.

Inherent risks of domestic animal activities include, but shall not be limited to:

(1) The propensity of a domesticated animal to behave in ways, i.e. 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;

(2) the unpredictability of a domestic animal’s reaction to such things as sounds, sudden movement and unfamiliar objects, persons, or other animals;

(3) certain hazards such as surface and subsurface conditions;

(4) collisions with other domestic animals or objects; and

(5) 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 domestic animal or not acting within such participant’s ability.”

6. RELEASE:

AS A CONDITION PRECEDENT TO MY PARTICIPATION IN THIS EQUINE AND/OR OTHER "PREMISE RELATED ACTIVITIES", I EXPRESSLY ASSUME THE RISKS OF THESE "PREMISE RELATED ACTIVITIES". I WILL NOT BRING CLAIM OF ANY KIND AGAINST THE RELEASED PARTIES FOR DAMAGES ARISING OUT OF INJURIES OR DEATH RELATING IN ANY WAY TO MY PARTICIPATION IN "PREMISE RELATED ACTIVITIES", OR ANY OTHER ACTIVITY RELATED TO THIS ACTIVITY, WHETHER INCURRED ON OR OFF PREMISES, INCLUDING THOSE INSTANCES INVOLVING THE RELEASED PARTIES’ ALLEGED NEGLIGENCE.

7. In the event of any dispute arising under this lease, I agree that such dispute shall be subject to binding arbitration before a neutral arbitrator selected by agreement of all parties, said proceeding subject to the terms and conditions of the American Arbitration Association Rules of Arbitration.

8. Venue shall be brought in Osage County, Kansas.

9. The Released Parties shall, if deemed "the prevailing parties" on any such dispute, be entitled to recover reasonable costs and expenses, including attorney’s fees.

THE ABOVE AGREEMENT CONTAINS A BINDING ARBITRATION CLAUSE BETWEEN THE PARTIES.

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PARTICIPANT SIGNATURE DATE

______PARENT / GUARDIAN SIGNATURE (if participant is a minor) DATE

READ AND INITIAL THE FOLLOWING TERMS AND CONDITIONS OF THIS LIABILITY RELEASE

_____ 1. ACTIVITY RISK CLASSIFICATIONI UNDERSTAND THAT: Horseback riding is classified as a RUGGED ADVENTURE RECREATIONAL SPORT ACTIVITY, and that there are numerous obvious and nonobvious inherent risks always present in such activity despite all safety precautions. According to NEISS (National Electronic Injury Surveillance Systems of United States 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.

_____ 2. NATURE OF HORSESI UNDERSTAND THAT: Whether riding my own horse or participating in wagon rides or other equine activities, 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 a horse to the ground it will generally be at a distance of from 31/2 to 51/2 feet, and the impact may result in injury to the rider. 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 perceived danger. By utilizing these premises, I expressly assume all risks related to my participation in any activity on Facility or property owned by other Premise Owners.

_____ 3. PARTICIPANT RESPONSIBILITY: I UNDERSTAND THAT: Upon mounting a horse and taking up the reins the Participant is in primary control of the horse, and his/her safety largely depends upon his/her ability to carry out the instructions of this Facility and/or Premise Owners, to adhere to Premise Owners rules, and to remain calm and balanced aboard the moving animal. I/WE agree that the Participant shall be responsible for his/her own safety, and that of an unborn child if the Participant is pregnant. Facility and Premise Owners advise pregnant women not to ride horses unless permission is given under advice of her physician.

_____ 4. CONDITIONS OF NATURE: I UNDERSTAND THAT Facility and Premise Owners are 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 outofdoor groomed or wild land which is subject to constant change in condition according to weather, temperature, and natural and manmade changes in landscape.

_____ 5. CARRYON OBJECTS AND SHARP NOISES: I UNDERSTAND THAT: Participants should not carry loose items on rides which may fall, blow away, flap in the wind, bounce, or make sharp noises, possibly scaring a horse. SOME EXAMPLES ARE: Cameras, hats not securely fastened under chin, toys, and purses. Participants should not make sharp, loud noises, such as screaming or yelling, which may scare a horse.

_____6. SADDLE GIRTHS NATURAL LOOSENING: I UNDERSTAND THAT: Saddle girths (saddle fasteners around horse’s belly) may loosen during a ride. Participant is solely responsible for adjusting these as required to avoid tack slippage and a potential fall from the animal. Participant is solely responsible for adequacy and proper fit of tack.

_____ 7. INDEMNIFICATION. “Participation”, for purposes of this indemnification and release, shall include any activity of Participant while on or adjacent to Facility. Participant and/or Participant’s parents or legal guardians agree to indemnify and hold harmless the Released Parties and their respective Members, Directors, employees or agents (the Released Parties) from any and all liabilities, settlements, expenses and costs, including reasonable attorney’s fees, incurred in defending against any and all claims which arise from participation in "Premise Related Activities", including those on or related to the use of these Premises, and those involving the alleged negligence of the released parties.

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PARTICIPANT SIGNATURE DATE

______PARENT / GUARDIAN SIGNATURE (if participant is a minor) DATE