WC Farms Release and Waiver of Liability,Assumption of Risk,And Indemnity Agreement

Whipple Creek Farms
Emergency Contact and Medical Information
Name / Date ofbirth
Address:
Street / City / State / Zip
Phone(s): / Home / Cell
EmergencyContact: / Phone(s): / Home
Cell
EmergencyContact: / Phone(s): / Home
Cell
Physician / Phone:
Insurance
Carrier / ID#:
Hospital: / Group#:
Allergies:
Bloodtype: / MedicalConcerns
Emergency TreatmentAuthorization
IherebycertifythatIamtheparent/legalguardianoftheparticipantandgivemyconsentforparticipationinthe provided activities. In the event that I cannot be reached in anemergency,
I give permission to any licensed medical professional to secure proper treatment including injectionand anesthesia. I also herby state that my child is free from communicable diseases, has received allrequired immunizations,andhassubmittedinwritingtostaffanyallergiesincaseofemergencymedicaltreatment.
Phone(s): / Home
Name of Rider or Parent/LegalGuardian / Cell
Signature of Rider or Parent/LegalGuardian / Date

WC Farms– Release and Waiver of Liability,Assumption of Risk,and Indemnity Agreement

BYSIGNINGTHISAGREEMENT,YOUANDYOURCHILDAREGIVINGUPCERTAINLEGALRIGHTS,INCLUDINGTHERIGHTTOSUEORRECOVERDAMAGESINCASEOFINJURY,DEATH ORPROPERTYDAMAGES,FORANYREASON,INCLUDINGBUTNOTLIMITEDTO,THE NEGLIGENCE OFTHE STABLE (Whipple Creek Farms);IT’SOWNER,EMPLOYEE, AND AGENTS (“THERELEASEES”).

I, / on behalf of myself (and my minorchild)
[Print First and LastName] / [Print Child'sName]

Inconsiderationforallowingme(ormyminorchild)tohandleandrideahorseandonbehalfofmyself,mychildorourpersonalrepresentatives, heirs, next-of-kin, spouses and assigns, IHEREBY:

Acknowledge that a horse may, without warning or apparent cause, buck, stumble, fall, rear, bite, kick, run,makeunpredictablemovements,spook,jumpobstacles,steponaperson’sfeet,pushorshoveaperson,saddles orbridlesmayloosenorbreak; all of which may cause the rider to fall or be jolted, resulting in serious injury ordeath. –

ACKNOWLEDGE THAT HORSEBACK RIDING IS AN INHERENTLY DANGEROUS ACTIVITY AND INVOLVES RISKSTHATMAYCAUSESERIOUSINJURYANDINSOMECASESDEATH,becauseoftheunpredictablenatureofhorses,regardlessoftheirtraining and past performance.

Voluntarilyassumetheriskanddanger ofinjuryordeathinherentintheuseofthehorse,equipment,andgearprovidedtomebyWhipple Creek Riding Center, hereinafter referred to as theStable.

RELEASE, DISCHARGE AND PROMISE NOT TO SUE the Stable, doing business under its own name or any other nameand/oranyofitsowners,officers,employees andagents(hereinafterthe“Releasees”),foranyloss,liability,damages,orcostwhatsoeverfrom any loss, damage, or injury (including death) to my person orproperty.

ReleasetheReleaseesfromanyclaimthatsuchReleaseesareormaybenegligentinconnectionwithmyridingexperienceorabilityincludingbutnotlimitedtotrainingorselectinghorses,maintenance,care,fitoradjustmentofsaddlesorbridles,instructionorriding skills or leading and supervisingriders.

TheUndersignedexpresslyagreesthattheforegoingreleaseandwaiverofliability,assumptionofrisk,andindemnityagreementisgovernedbytheStateofWashingtonandisintendedtobeasbroadandinclusiveasispermittedbyWashingtonLaw(RIDEATYOUROWNRISK),andthatintheeventanyportionofthisAgreementisdeterminedtobeinvalid,illegal,orunenforceable,thevalidity,legalityandenforceabilityofthebalanceoftheAgreementshallnotbeaffectedorimpairedinanywayandshallcontinueinfull legal force andeffect.

AcknowledgethatthisdocumentisacontractandagreethatifalawsuitisfiledagainsttheStableorits owner,agents, employees,foranyinjuryordamageinbreachofthiscontract,theUndersignedwillpayallattorney’sfeesandcostsincurredby the Stable in defending such anaction.

StatethatIamnotnowpregnantandthatIhavenohistoryofepilepticseizures,heartcondition,oranyothermedicalproblemthatcould be affected by horsebackriding.

IT IS MANDATORY THAT ALL RIDERS WEAR PROTECTIVE HELMET.

IfthepersonwhoistoenterintothisAgreementislessthaneighteen(18)yearsofage,his/herparentorguardianmustreadthisAgreement and sign below on the behalf of theminor.

I have read this entire Release of Liability Document. I understand it is a promise not to sue and to release the stable, itsowners,employees, and agents for all claims. I have made a free and deliberate choice to sign this Release and Waiver as a conditiontoReleasees allowing me or my child to ride or handle a horse.

IndividualSignature / Date
Signature of Parent orGuardian / Date
WitnessSignature / Date