Loading...

Confederate Trails of Gettysburg, Inc.

STATEMENT OF REFUSAL TO WEAR PROVIDED HELMET

Must be 18 years or older to sign

Rider's statement of decision NOT to wear the reccomended Helmet during their trail ride.

READ THIS STATEMENT OF REFUSAL TO WEAR A PROVIDED RIDING HELMET CAREFULLY BEFORE SIGNING IT.

YOUR INITIALS INDICATE THAT YOU ARE 18 YEARS OF AGE OR OLDER AND THAT BEING OF CONSENTING LEGAL AGE YOU UNDERSTAND THE RISK YOU ARE CHOOSING TO TAKE OF YOUR OWN FREE WILL AGAINST THE RECOMMENDATION OF THE RELEASEES. 


   

TO UNDERSTAND AND AGREE TO ITS TERMS BY SIGNING THIS STATEMENT OF REFUSAL TO WEAR A PROVIDED RIDING HELMET ​ YOU ARE ACCEPTING FULL RESPONSIBILITY FOR YOUR CHOICE TO FORGO THE RECOMMENDED SAFETY EQUIPMENT TO PARTICIPATE IN THIS ACTIVITY AND YOU MAKE THIS CHOICE OF YOUR OWN FREE WILL. 

In consideration for allowing me to handle and ride a horse on behalf of myself, my personal representatives, heirs, next-of-kin, spouses and assigns, I HEREBY AGREE: 

  1. It is at my discretion that I have declined, as a rider, to wear a protective helmet.
  2. It is my understanding that a protective helmet has been made available to me by Confederate Trails of Gettysburg for my use during the trail ride.
  3. I understand the risks involved in horseback riding and that declining the use of a helmet is not recommended. 

I HAVE READ THIS DOCUMENT.

IN SIGNING THIS STATEMENT, I AM HEREBY STATING THESE WORDS ARE CONSISTANT OF MY OWN  :

  1.  I UNDERSTAND THAT I AM ACCEPTING FULL RESPONSIBILITY FOR MY DECISION
  2.  I HAVE MADE A FREE AND DELIBERATE CHOICE NOT TO WEAR A HELMET. 
  3.  I UNDERSTAND I AM REQUIRED TO SIGN THIS ‘STATEMENT OF REFUSAL TO WEAR A PROVIDED RIDING HELMET’ AS A CONDITION TO AND A CONDITION FOR THE RELEASEES ALLOWING ME TO RIDE OR HANDLE A HORSE WITHOUT WEARING A HELMET. 

I HAVE CONCLUDED THAT THE RISKS INVOLVED WITH MY CHOICE TO NOT WEAR A HELMET SIGNIFIED BY MY SIGNING THIS ‘STATEMENT OF REFUSAL TO WEAR A PROVIDED RIDING HELMET’ ARE NOT GREAT ENOUGH FOR ME TO WEAR THE HELMET AND FEEL THIS IS BEST FOR THE PLEASURE OF MY INDIVIDUAL HORSEBACK RIDING EXPERIENCE.

I Agree

Date: September 16, 2024   





First Rider’s Name

First Name*

Last Name*
First Rider’s Date of Birth*
First Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
First Rider’s Signature*
Second Rider’s Name

First Name*

Last Name*
Second Rider’s Date of Birth*
Second Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
Third Rider’s Name

First Name*

Last Name*
Third Rider’s Date of Birth*
Third Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
Fourth Rider’s Name

First Name*

Last Name*
Fourth Rider’s Date of Birth*
Fourth Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
Fifth Rider’s Name

First Name*

Last Name*
Fifth Rider’s Date of Birth*
Fifth Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
Sixth Rider’s Name

First Name*

Last Name*
Sixth Rider’s Date of Birth*
Sixth Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
Seventh Rider’s Name

First Name*

Last Name*
Seventh Rider’s Date of Birth*
Seventh Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
Eighth Rider’s Name

First Name*

Last Name*
Eighth Rider’s Date of Birth*
Eighth Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
Ninth Rider’s Name

First Name*

Last Name*
Ninth Rider’s Date of Birth*
Ninth Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
Tenth Rider’s Name

First Name*

Last Name*
Tenth Rider’s Date of Birth*
Tenth Rider’s Information
Do you have any Horseback Riding Experience?*
No
Yes
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
If under eighteen years of age, parent, guardian, or custodian must sign the following indemnification: INDEMNIFICATION: In consideration for the above minor being permitted by Confederate Trails of Gettysburg Inc, to participate in the activities of Confederate Trails of Gettysburg Inc which include, without limitation, the use of its services, animals and equipment, I agree to the following waiver, release and indemnification: The undersigned parent, guardian, or custodian of the above minor, for himself/herself and on behalf of said minor, hereby joins in the foregoing Waiver and Release and hereby stipulates and agrees to save and hold harmless, indemnify and forever defend Confederate Trails of Gettysburg Inc their directors, officers, agents, employees and volunteers from and against any claims, actions, demands, expenses, liabilities (including reasonable attorneys' fees) and NEGLIGENCE made or brought by said minor or by anyone on behalf of said minor, as a result of said minor's participation in the activities of Confederate Trails of Gettysburg Inc. I, for myself and on behalf of said minor, further agree not to sue Confederate Trails of Gettysburg Inc, as a result any injury, paralysis or death that said minor suffers in connection with his/her participation in the activities of Confederate Trails of Gettysburg Inc,


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 Information
Do you have any Horseback Riding Experience?*
No
Yes
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!