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Mare Meadows Farm Waiver of Liability and Policy Agreement



 A form must be completed for each participant Release of Liability and Hold Harmless Agreement 



WARNING: Under North Carolina law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 99E of the North Carolina General Statutes. Liability Release, Hold Harmless Agreement, and Express Assumption of Risk



All persons are required in order to be on the grounds, participate, work with the horses, etc. are to have a signed and completed release form/hold harmless agreement. By signing below you agree to and accept all terms stated above and have read and agreed to all terms and agreements stated in this contract. I hereby affirm that I am informed of the inherent hazards of horseback riding, driving, and other horse related activities. 



The undersigned acknowledges 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 such ways 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 an equines 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; 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 participants ability. Owner expressly releases Laney Hardman Equestrian LLC, Mare Meadows Farm, and Brinnwood Farm from any and all claims for personal injury or property damage, even if caused by negligence (if allowed by the laws of this state) by stable or its representatives, agents, or employees



I understand and agree that Laney Hardman Equestrian LLC, Mare Meadows Farm, Brinnwood Farm, Delaney Hardman, Andrea Furnari, Tara Haywood nor any of their respective employees, subcontractors, officers, agents, owners, or assigns (hereinafter referred to as “Released Parties”) may be held liable or responsible in any way for any injury, death , or other damages, to me, my family, or my property, heirs, or assigns that may occur as a result of my participation in this horse-related activity or as a result of the negligence of any party, including the Released Parties, whether active or passive

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First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Emergency Contact's Relation to Participant
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Riders Skill Level
Riding Experience *
Never Rode before
1 month - 1 year
1-3 years
3+ years
Special considerations
Does Rider have any special needs? i.e old injuries, medical conditions, learning disabilities etc.*
No
Yes

If yes, explain
social media and photo release
I grant Mare Meadows Farm or Laney Hardman Equestrian LLC permission to use photos and videos of me and/or my horse(s) taken during lessons, events, or horse-related activities. These may be used for social media, marketing, website content, or educational purposes. I understand I will not receive compensation for the use of this media and that all content remains the property of Laney Hardman Equestrian LLC.*
Yes
No
Parent(s) or Court-Appointed Legal Guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Relationship*
Phone*
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Date of Birth*
Date of Birth
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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