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OC Equestrian Vaulting & Riding INDEMNITY AND LIABILITY RELEASE FORM


OC Equestrian Vaulting

905 Arlington Dr.

Costa Mesa, CA 92626





Review OC Equestrian Vaulting Privacy Policy

This agreement is made and entered on April 21, 2024 By and between you, hereinafter referred to as “ I “ and OC Equestrian Vaulting, doing business as OC Vaulting located at 905 Arlington Ave., Costa Mesa, CA 92626, and any and all employees, agents, officers, instructors of same, hereinafter referred to as “ OCV “ hereby agreed to as follows:

 1.     HAZARDOUS ACTIVITY: ACKNOWLEDGE THAT EQUESTRIAN VAULTING, RIDING, THE HANDLING OF ANIMALS OR BEING IN CLOSE PROXIMITY TO ANIMALS 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 animals, regardless of their temperament, training or past performance.

 2.     RELEASE, DISCHARGE AND PROMISE NOT TO SUE for any loss, damage, injury, including death, or cost to me or my child(ren) arising out of the handling of vaulting on, riding, being in close proximity to a horse, on the premises, when handling, vaulting, riding a horse, using of saddles, bridles, equipment or gear provided by me or to me by “OCV”

 3.     I understand that a horse’s natural instincts are to jump forward or sideways, to run away from danger at a trot, canter, or gallop, to kick, to buck, to rear up in front, or to bite.  I understand that helmets, safety equipment, proficiency checks, supervision and/or enforcement of rules DO NOT, AND CANNOT, GUARANTEE my safety. I understand these risks and voluntarily assume these risks and dangers for myself or on behalf of my child or legal ward. 

4.     “RIDING” Defined: when the “rider” is sitting on the back of a horse in a saddle, or bareback and personally controls the movements of the horse with bridle & reins.

5.     “VAULTING” Defined: gymnastic or dance movements performed on American Vaulting Association regulation practice barrel, or on the back of a horse, while being controlled or commanded by a Lunger (handler), on the ground, via a long or lunge line.

6.     RIDING HELMETS: I understand that I can better protect myself against head injuries by wearing protective equestrian head gear while mounting, riding, dismounting and being around horses. OCV does NOT provide helmets to riders. Helmet failure due to manufacturer defects is out of the hands of OCV. OCV REQUIRES all minors riding, (not vaulting), to WEAR helmets.  I accept full responsibility for the increased risk of injury if I decide not to wear a helmet.

7.     PROTECTIVE HEADGEAR AND APPARREL: I have been advised to wear protective footwear at all times while I am grooming or tacking up the horses AND wear a helmet while riding (being in control of the horse as opposed to vaulting on a horse being lunged).  While vaulting, I have been advised that I should wear vaulting slippers/light soled shoes, tight fitting stretchy clothing with no buttons, zippers or strings, have my hair tied back and remove all jewelry.

8.     HELMET WAIVER FOR VAULTING: Vaulting, a gymnastic sport, generally does not employ the use of head gear for safety reasons. Helmets or head gear may become entangled in vaulting equipment, impair balance and cause injury to you or other vaulters. While OCV does NOT PROVIDE helmets, you may still opt to wear one but you will be limited to vaulting solo and only performing certain exercises.

9.     I HEREBY AUTHORIZE & CONSENT TO THE FOLLOWING MEDICAL TREATMENT FOR SAID MINOR(s): Any x-ray examination, anesthetic, medical or surgical diagnosis or treatment, and hospital care which is deemed advisable by, and is to be rendered under the general or special supervision of any physician and/or surgeon licensed under the provisions of the Medical Practices Act, California Business and Professions Code Section 2000 et seq.; or any x-ray examination, anesthetic, dental or surgical diagnosis or treatment, and hospital care to be rendered by a dentist licensed under the provisions of the Dental Practices Act, California Business and Professions Code Section 1600 et seq.   This authorization is given pursuant to the provisions of Section 25.8 of the Civil Code of California. This authorization shall remain effective until my child completes his/her activities in this program unless sooner revoked in writing. I understand that as a parent/guardian, I will be responsible for the cost of any service or treatment provided. 

10. LIABILITY RELEASE: I understand that, except in the event of OCVs’ wanton or willful negligence, I am responsible for bodily injury or property damage that I or my child or legal ward should sustain while riding a horse provided by OCV. I am also responsible for medical expenses or any other expense incurred as a result of such bodily injury or property damage. I am responsible for any time I, or my child or legal ward shall lose in employment or school or other activity. I hereby for myself, my heirs, administrators and assigns release and discharge OCV (the instructor(s) and all of their officers and employees from claims, demands, actions, and causes of action for such injuries sustained to my person, or that of my child or legal ward and/or my property.

11.  INDEMNITY: I agree to indemnify and pay any expenses, loss or damage that is incurred by OCV and all of their officers and employees arising out of my, my child or legal wards participation in any OCV sponsored or related activity.

12.  INDEMNITY / LIABILITY RELEASE:

In the knowledge that a parent by law cannot waive the personal injury rights or other claims of a (their) minor child or legal ward, the undersigned parent or guardian of said minor child or legal ward agrees to indemnify OCV and all of their officers and employees from any financial loss suffered as a result of any claim brought on behalf of said minor child or legal ward. Further, I agree not to bring any claim or other legal action against OCV and all of their officers and employees for personal injuries suffered by said minor alleging negligent acts or acts of omissions by OCV and all of their officers and employees.

 DO NOT SIGN UNLESS YOU HAVE THOROUGHLY READ AND FULLY UNDERSTAND THE ENTIRE CONTENTS OF THIS RELEASE FORM

First participants Name

First Name*

Last Name*

Phone*
First participants Date of Birth*
First participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
First participants Signature*
Second participants Name

First Name*

Last Name*
Second participants Date of Birth*
Second participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
Third participants Name

First Name*

Last Name*
Third participants Date of Birth*
Third participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
Fourth participants Name

First Name*

Last Name*
Fourth participants Date of Birth*
Fourth participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
Fifth participants Name

First Name*

Last Name*
Fifth participants Date of Birth*
Fifth participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
Sixth participants Name

First Name*

Last Name*
Sixth participants Date of Birth*
Sixth participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
Seventh participants Name

First Name*

Last Name*
Seventh participants Date of Birth*
Seventh participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
Eighth participants Name

First Name*

Last Name*
Eighth participants Date of Birth*
Eighth participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
Ninth participants Name

First Name*

Last Name*
Ninth participants Date of Birth*
Ninth participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
Tenth participants Name

First Name*

Last Name*
Tenth participants Date of Birth*
Tenth participants Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
Parent or Guardian's Email Address

Email*

Confirm Email*
YES, please keep me informed of new OCV classes, events & discounts
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Referral source

How did you hear about OC Vaulting? *
PHOTO RELEASE
I authorize the use of photos taken of me/my child on OC Vaulting’s Facebook or webpage, newsletters, articles, etc., ONLY (photos will be images only without identifying/names and will NEVER be shared),*
No
Yes
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*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Weight Range
weight of "largest" participant, (required for safety/"spotting")*
UNDER 100#
101# THRU 135#
OVER 136#
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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