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Golden Isles Riding Academy

HORSE CAMP ENROLLMENT AND RELEASE FORM

ALL CAMP WEEKS ARE MONDAY THRU FRIDAY FROM 9:00 A.M. UNTIL 4:00 P.M. 

IMPORTANT: Please contact our office to make sure your dates are available. A nonrefundable deposit of $100 for week camps or $50 nonrefundable deposit for day camps is required to confirm camp attendance. In the event of cancellation, the deposit will be converted to a barn credit provided a ONE WEEK notice is given for weeklong camps & a 48-hour notice for day camps. Balance for camps are due one week prior to camp start date.

PAYMENT: Call to pay by credit card (4% fee charged), send via Venmo @Kelli-Jordan-16 (phone number confirmation is 3325), send via Zelle to 912-506-3325 Kelli Jordan, or mail your payment to: 

Golden Isles Riding Academy, 264 Galilee Road, Brunswick, GA 31523.

Camp begins at 9:00 a.m. Please do NOT drop your child off before that time unless prior early drop off/late pick up arrangements have been made.Camp pick up and end time is 4pm. Early drop off begins at 8:00 a.m. and is available for an additional $10 and late pick up until 5:00 p.m. for an additional $10. 

Your camper MUST bring these items on the first day of camp, if not received prior to attendance:

___Balance due if anything is owed; ___Enrollment Form; ___Liability Waiver Form 

**Students will not be allowed to ride if Enrollment Form and Liability Waiver are not complete.

We look forward to seeing all the smiles this summer and developing a love of horses for all. 

Kelli Jordan, Owner/Trainer, GIRA

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK AND INDEMNITY AGREEMENT

READ THIS AGREEMENT CAREFULLY BEFORE SIGNING IT. YOUR SIGNATURE INDICATES YOUR UNDERSTANDING OF AND AGREEMENT TO ITS TERMS. BY SIGNING THIS AGREEMENT, YOU (AND YOUR CHILD) ARE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES IN CASE OF INJURY, DEATH OR PROPERTY DAMAGE FOR ANY REASON INCLUDING, BUT NOT LIMITED TO, THE NEGLIGENCE OF THE TRAINER, THE STABLE, ITS OWNERS, EMPLOYEES AND AGENTS.

I, (and my minor child) (hereinafter the “Undersigned”) reside at address listed below.

In consideration for allowing me (or my minor child) to handle and ride a horse and on behalf of myself, my child or our personal representatives, heirs, next-of-kin, spouses and assigns, THE UNDERSIGNED HEREBY:

1. WARNING UNDER GEORGIA 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 FROM THE INHERENT RISKS OF EQUINE ACTIVITIES, PURSUANT TO CHAPTER 12 OF TITLE 4 OF THE OFFICIAL CODE OF GEORGIA ANNOTATED.

2. Acknowledges that a horse or pony may, without warning or any apparent cause, buck, stumble, fall, rear, bite, kick, run, make unpredictable movements, spook, jump, step on a person’s feet, push or shove a person, saddles or bridles may loosen or break – all of while may cause the rider to fall or be jolted resulting in serious injury or death to the Undersigned or any person within close proximity to a horse.

3. ACKNOWLEDGE THAT HORSEBACK RIDING, THE HANDLING OF A HORSE OR BEING IN CLOSE PROXIMITY TO A HORSE IS AN INHERENTLY DANGEROUS ACTIVITY AND INVOLVES RISKS THAT MAY CAUSE SERIOUS INJURY AND IN SOME CASES DEATH because of the unpredictable nature and irrational behavior of horses, regardless of their training or past performance.

4. Voluntarily assume the risk and danger of injury or death inherent in the handling or riding of the horse or being in close proximity to a horse or on the premises of the stable or the failure to wear a protective helmet when riding a horse, and use of saddles, bridles, equipment and gear provided to me by Golden Isles Riding Academy, LLC.

5. RELEASE, DISCHARGE AND PROMISE NOT TO SUE Golden Isles Riding Academy, LLC. for any loss, damage, injury (including death) or cost to me or my child’s arising out of the handling or riding of a horse or being in close proximity to a horse or on the premises of the stable or the failure when riding a horse, and use of saddles, bridles, equipment and gear provided by Golden Isles Riding Academy, LLC.

6. Release Golden Isles Riding Academy, LLC. from any claim that Golden Isles Riding Academy, LLC. was negligent in connection with my or my child’s riding a horse including but not limited to training or selecting horses, maintenance, care fit or adjustment of saddles or bridles, instruction of riding skills or leading and supervising riders or the use of any equipment provided by Golden Isles Riding Academy, LLC. or being on the premises of the stable, which resulted in loss, damage, injury or death.

7. INDEMNIFY, AND SAVE AND HOLD HARMLESS Golden Isles Riding Academy, LLC. from and against any loss, liability, damage or cost that may incur arising out of or in any way connected with either my or my child’s handling or riding the horse or being in close proximity to a horse or on the premises of the stable or the failure to wear a protective helmet when riding a horse and/or use of saddles, bridles, equipment and gear provided therewith from or contributed to by my or my child’s own negligence.

8. Agree to abide by and follow any instructions given or rules established by Golden Isles Riding Academy, LLC. or any of its employees with regard to my or my child’s riding or handling of the horse or being in close proximity to a horse or on the premises of the stable or the failure to wear a protective helmet when riding a horse or any saddles, bridles, equipment and gear provided therewith.

9. Acknowledge that this document is a contract and agree that if a lawsuit is filed against the Stable or its owners, agents, employee guides or wranglers for any injury or damage in breach of this contract, the Undersigned will pay all attorney’s fees and cost incurred by the Stable in defending such action.

10. IT IS RECOMMENDED THAT I, MY CHILD, AND ALL RIDERS WEAR A PROTECTIVE HELMET. IT IS MY UNDERSTANDING THAT A PROTECTIVE HELMET IS AVAILABLE AND HAS BEEN OFFERED FOR MY OWN OR MY CHILD’S SAFETY. I (AND FOR MY CHILD) DECLINE TO WEAR A HELMET


I have read this document. I understand it is a promise not to sue and to release and indemnify the Trainer, the Stable, its owners, employees and agents for all claims. I have made a free and deliberate choice to sign the Release and Waiver as a condition to Golden Isles Riding Academy, LLC. allowing me or my child to ride or handle a horse. I have concluded that the risks involved, and The Release and Waiver of Liability is worth the pleasure of the horseback riding experience and acknowledges that the same is valuable consideration for this Release and Waiver of Liability.

DATE: May 8, 2026

First Participant's Name
First Name*
Middle Name
Last Name*
Phone*
First Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
First Participant's Signature*
Second Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
Third Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
Fourth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
Fifth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
Sixth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
Seventh Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
Eighth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
Ninth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
Tenth Participant's Name
First Name*
Middle Name
Last Name*
Participant's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Participant's Address
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:*
PHOTO RELEASE

I am very proud of my students and their families, and from time to time will use their picture/pictures on our website, FaceBook, Instagram, and other social media / advertising media. At no time will I divulge private information. Please select one of the following:

PHOTO RELEASE*
I/We DO permit G.I.R.A. to use photos or other images of my child as described above.
I/We DO NOT permit G.I.R.A. to use photos or other images of my child as described above.
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*
Phone*
Parent or Guardian's Date of Birth*
Date of Birth
Information
Age:
Does your camper have allergies or other health conditions we need to know about?
Briefly describe your campers horse experience:
Camp Day/s attending:
CHECK LIST:
Pants & closed toe shoes are REQUIRED for riding, please no crocs or western boots unless with tread.
A change of clothes for non-riding time if desired; a light rain jacket or spring jacket if desired.
Sunscreen, bug spray.
Bring a lunch, snacks, water bottles, along with plenty of drinks for the day, please label with campers’ name.
Helmets are REQUIRED for riding and will be provided; however, if you own your own helmet, you may bring it for your own comfort.
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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