Participant Release

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Name

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Participant Information

Name*

First Last

Date of Birth*

Address*

Street Address City State ZIP Code

Home Phone*

Mobile Phone*

Work Phone

Email*

Please read the following carefully, check beside each statement, and sign at the end.*

I understand that horses are independent living beings and can be unpredictable.

I understand that there are always elements of risk in equestrian activities, including permanent disability or death, that common sense and personal awareness can help reduce.

I am aware that at all times when at Days End Farm Horse Rescue, it is MY RESPONSIBILITY to read and obey all posted information and warnings, and comply promptly with all verbal directions of DEFHR staff and instructors.

I am aware that at all times when riding, it is MY RESPONSIBILITY to practice appropriate handling etiquette, ride with another person, check to ensure integrity of all equipment and tack, ride with proper equipment (regulation helmet with a fastened chin strap and heeled boots).

I am aware that cameras are installed at DEFHR as a measure of security and safety for the horses, people, and property.

I understand that this is only a partial list, and I must be safety conscious and exercise sound judgment AT ALL TIMES. ANYONE found to be endangering themselves, other people, or horses faces immediate revocation of handling/riding privileges WITHOUT EXCEPTION.

I hereby acknowledge and assume the risk of participating in any and all horse related activities, including riding, at DEFHR or in any and all locations where DEFHR activities take place. I do hereby, waive, release and forever discharge, and indemnify and hold harmless DEFHR, its officers, staff members, volunteers, instructors, advisors, and/or agents from any and all claims, suits, actions, damages, losses, liability, cost, and expenses (including attorney fees and court costs) of any kind or nature whatsoever, incurred for injuries and/or damages to person and/or property. I understand that participation in activities at DEFHR are potentially hazardous and can result in serious injury. I release DEFHR from responsibility for accidental physical injury, including death or illness and loss of personal property while at DEFHR.

I agree to remain fully liable and responsible for any such hospital, doctor, ambulance, dental, or medical fees in the event of an injury to me as a result of my participating in any and all activities involving DEFHR. I understand that DEFHR does NOT provide health, accident, or liability insurance to participants.

I acknowledge that there is a valid consideration to executing this release. The invalidity of any statement or waiver of rights above under local, state, or federal law does not invalidate any other statement or waiver of rights above.

Signature*

Date*

Authorization for Treatment (optional)

The undersigned participant, and parents or legal guardian of a minor participant, authorizes members of DEFHR as agent(s), to consent to any x‑ray, anesthetic, medical, or surgical diagnosis or treatment and hospital care deemed advisable and rendered by any licensed physician, licensed emergency medical technician, or surgeon, whether on DEFHR property, in a remote location, in an office, or in a licensed hospital. This authorization is given in advance of any required care to empower the agent(s) to give consent for such treatment as the health caregiver may deem advisable. This authorization shall remain effective indefinitely unless revoked in writing.

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