Loading...

LEAVITT MEADOWS PACK STATION, INC

STABLE NAME, hereinafter known as “THIS STABLE”

7386 SR HWY 108, BRIDGEPORT CA 93517

Physical Location of THIS STABLE

HORSE RENTAL, EQUESTRIAN, GUIDE & OUTFITTER SERVICES AGREEMENT,
LIBILITY RELEASE, AND ASSUMPTION OF RISK AGREEMENT (FOR INDIVIDUALS)

READ CAREFULLY AND COMPLETE ALL SECTIONS BEFORE SIGNING

A. REGISTRATION OF PARTICIPANT AND AGREEMENT PURPOSE: I, the following listed individual, and the parents or legal guardians thereof if a minor, do hereby voluntarily agree to participate in horse rental services and/or equestrian and/or guide outfitter services provided by THIS STABLE. 

B. AGREEMENT SCOPE AND TERRITORY AND DEFINITIONS: This agreement shall be legally binding upon me the registered participant, and the parents or legal guardians thereof if a minor, my heirs, estate, assigns, including all minor children, and personal representatives; and it shall be interpreted according to the laws of the state and county of THIS STABLE'S physical location. This agreement is intended to be valid and binding at all times now and in the future when THIS STABLE permits me (directly or indirectly) to enter THIS STABLE’S property, be on THIS STABLE’S property, be near any horse, receive instruction or guidance from its associates and/or when I ride and/or am near horses on or off of THIS STABLE’S property. Any disputes by the participant shall be litigated in, and venue shall be the county in which THIS STABLE is physically located. This agreement is intended to be as broad and inclusive as the law permits. If any clause, phrase, or word is in conflict with state law, then that single part is null and void. The terms "HORSE" and “EQUINE” herein shall refer to all equine species. The terms "I", "”WE”, ME", "MY" shall herein refer to the above registered participant and the parents or legal guardians thereof if a minor.

I Agree

C. INHERENT RISKS / ASSUMPTION OF RISKS, I ACKNOWLEDGE THAT: Horseback riding is classified as RUGGED ADVENTURE RECREATIONAL SPORT ACTIVITY: and that risks, conditions, and dangers are inherent in (meaning an integral part of) horse / equine / animal activities, regardless of all feasible safety measures which can be taken, and I agree to assume them. The inherent risks include, but are not limited to any of the following: The propensity of an animal to behave in ways that may result in injury, harm, death, or loss to persons on or around the animal; The unpredictability of an equine’s reaction to sounds, sudden movement, unfamiliar objects, persons, or other animals; Hazards, including, but not limited to, surface or subsurface conditions; A collision, encounter and/or confrontation with another equine, another animal, a person, or an object; The potential of an equine activity participant to act in a negligent manner that may contribute to injury, harm, death, or loss to the participant or to other persons, including but not limited to, failing to maintain control over an equine and/or failing to act within the ability of the participant. Horses are 5 to 15 times larger, 20 to 40 times more powerful, and 3 to 4 times faster than a human. If a rider falls from horse to ground it will generally be at a distance of from 3 1/2 to 5 1/2 feet, and the impact may result in harm to the rider. Horseback riding is an activity in which one much smaller, weaker predator animal (the human) tries to impose its will on, and become one unit of movement with, another much larger, stronger prey animal that has a mind of its own (the horse) and each has a limited understanding of the other. If a horse is frightened or provoked it may divert from its training and act according to its natural survival instincts which may include, but are not limited to: Stopping short; Spinning around; Changing directions and/or speed at will; Shifting its weight; Bucking; Rearing; Kicking; Biting; and/or Running from danger. I also acknowledge that these are just some of the risks and I agree to assume others not mentioned above. I am not relying on THIS STABLE to list all possible risks for me.

I Agree

D. WILDERNESS EXPERIENCE PARTICIPATION, CONDITIONS OF NATURE WARNING, UNFAMILIAR AND SUDDEN SIGHTS, SOUNDS AND MOVEMENTS WARNING, AND INSPECTION OF PREMISES I/WE ACKNOWLEDGE THAT: The participant may be taking part in a "WILDERNESS EXPERIENCE" that may be hazardous to people. I/WE ACKNOWLEDGE THAT The meaning of “WILDERNESS EXPERIENCE” is defined as the pursuit of activity in a natural and/or wild and/or rugged and/or uncultivated area or region, as of forest and/or hills and/or mountains and/or plains and/or wetlands, which would likely be uninhabited by people and inhabited by wild animals of many types and species to include, but not limited to, mammals, reptiles, and insects, which are not tame, may be savage and unpredictable in nature and also wandering at their will. I/WE ACKNOWLEDGE THAT: THIS STABLE is NOT responsible for total or partial acts, occurrences, or elements of nature and/or sudden and/or unfamiliar sights, sounds and/or sudden movements that can scare a horse, cause it to fall, or react in some other unsafe way. SOME EXAMPLES ARE: Thunder, lightning, rain, wind, wild and domestic animals, insects, reptiles, which may walk, run, or fly near, or bite or sting a horse or person; and irregular footing on out-of-door groomed or wild land which is subject to constant change in condition according to weather, temperature, and natural and man-made changes in landscape. I also acknowledge that these are just some of the risks and I agree to assume others not mentioned above. I am not relying on THIS STABLE to list all possible conditions for me. The participant and parent or legal guardian have inspected THIS STABLE'S facilities and are satisfied that all premise conditions are reasonably safe for this participant’s intended purpose, usage and presence upon THIS STABLE'S premises.

I Agree

E. CARRY-ON OBJECTS WARNING AND SHARP, LOUD NOISES WARNING I/WE ACKNOWLEDGE THAT: When approaching, mounting and riding horses, I must not carry loose items that may fall or blow away or flap in the wind or bounce or make sharp or loud noises, the action of which may scare horses causing them to react in unsafe ways. SOME EXAMPLES ARE: Cameras, cell phones, hats not securely fastened under chin, toys, and purses. When near or riding a horse, participants must not make sharp or loud noises, such as whistling or screaming or yelling, the sound of which may scare horses causing them to react in unsafe ways. 

I Agree

F. SADDLE GIRTH LOOSENING WARNING: I/WE ACKNOWLEDGE THAT: Saddle girths (fastener straps around the horse's belly) may loosen during riding. Riders must alert the nearest attendant of any girth looseness so action can be taken to avoid saddle slippage and the potential for the rider to fall from the horse. 

I Agree

G. PROTECTIVE HEADGEAR/HELMET WARNING AND OFFERING: I/WE AGREE THAT: I for myself and on behalf of my child and/or legal ward have been fully warned and advised by THIS STABLE that protective headgear/helmet should be worn while riding, handling, and/or being near horses, and I understand that the wearing of such headgear/helmet at these times may reduce severity of some of the wearer's head injuries and possibly prevent the wearer's death from happening as the result of a fall and other occurrences. I/WE ACKNOWLEDGE THAT: THIS STABLE makes headgear/helmets available for me and my child and/or legal ward if applicable, protective headgear/helmet. I/WE ACKNOWLEDGE THAT: Once provided, if I choose to wear the protective headgear/helmet offered that I/WE will be responsible for properly securing the headgear/helmet on the participant's head at all times. I am not relying on THIS STABLE and/or its associates to check any headgear/helmet or headgear/helmet strap that I may wear, or to monitor my compliance with this suggestion at any time now or in the future. 

I Agree

H. THIS STABLE’S PROTECTIVE HEADGEAR/HELMET POLICY: I understand that I have the choice whether or not me or my child/or legal ward wear protective headgear/helmet. If I would like protective headgear/helmet I will notify my trail guide.

I Agree

I. DRUG AND ALCOHOL POLICY:  I agree not to be under the influence of drugs or alcohol during my horseback ride. This includes any form of marijuana, illegal street drugs, or misuses of prescription drugs.  I agree that use of these substances creates an unsafe environment for myself, other riders, the animals, employees and residents. I understand that intoxication of any kind will not be tolerated and THIS STABLE reserves the right to refuse service if they suspect any intoxication from the above drugs or alcohol.  Furthermore, I agree to be financially responsible for injury to myself, other riders, property damage, injury to animals, injury to employees or residents due to intoxication.

I Agree

J. LIABILITY RELEASE I AGREE THAT: In consideration of THIS STABLE allowing my participation in this activity, under the terms set forth herein, I for myself and on behalf of my child and/or legal ward, heirs, administrators, personal representatives or assigns, do agree to release, hold harmless, and discharge THIS STABLE, its owners, agents, employees, officers, directors, representatives, assigns, members, owners of premises and trails, affiliated organizations, and Insurers, and others acting on their behalf (hereinafter, collectively referred to as "Associates"), of and from all claims, demands, causes of action and legal liability, whether the same be known or unknown, anticipated or unanticipated, due to THIS STABLE'S and/or ITS ASSOCIATE’S ordinary negligence or legal liability; and I do further agree that except in the event of THIS STABLE'S gross negligence and/or willful and/or wanton misconduct, I shall not bring any claims, demands, legal actions and causes of action, against THIS STABLE and ITS ASSOCIATES as stated above in this clause, for any economic and non-economic losses due to bodily injury and/or death and/or property damage, sustained by me and/or my minor child or legal ward in relation to the premises and operations of THIS STABLE, to include while riding, handling, or otherwise being near horses owned by me or owned by THIS STABLE, or in the care, custody or control of THIS STABLE, whether on or off the premises of THIS STABLE, but not limited to being on THIS STABLE’S premises.

Date: July 16, 2018

First Rider's Name

First Name*

Last Name*

Phone*
First Rider's Date of Birth*
I certify that I am 18 years of age or older
First Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
First Rider's Signature*
Second Rider's Name

First Name*

Last Name*
Second Rider's Date of Birth*
Second Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
Third Rider's Name

First Name*

Last Name*
Third Rider's Date of Birth*
Third Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
Fourth Rider's Name

First Name*

Last Name*
Fourth Rider's Date of Birth*
Fourth Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
Fifth Rider's Name

First Name*

Last Name*
Fifth Rider's Date of Birth*
Fifth Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
Sixth Rider's Name

First Name*

Last Name*
Sixth Rider's Date of Birth*
Sixth Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
Seventh Rider's Name

First Name*

Last Name*
Seventh Rider's Date of Birth*
Seventh Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
Eighth Rider's Name

First Name*

Last Name*
Eighth Rider's Date of Birth*
Eighth Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
Ninth Rider's Name

First Name*

Last Name*
Ninth Rider's Date of Birth*
Ninth Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
Tenth Rider's Name

First Name*

Last Name*
Tenth Rider's Date of Birth*
Tenth Rider's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
Rider'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:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
I/WE, THE UNDERSIGNED, REPRESENT THAT I/WE HAVE READ AND DO UNDERSTAND THE FOREGOING AGREEMENT, LIABILITY RELEASE AND ASSUMPTION OF RISK AGREEMENT. I/WE UNDERSTAND THAT BY SIGNING THIS DOCUMENT I/WE AM GIVING UP RIGHTS TO SUE TODAY AND IN THE FUTURE. I/WE ATTEST THAT ALL FACTS ARE TRUE AND ACCURATE. I AM SIGNING THIS WHILE OF SOUND MIND AND NOT SUFFERING FROM SHOCK, OR UNDER THE INFLUENCE OF ALCOHOL, DRUGS OR INTOXICANTS.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
Weight*
HORSE RIDING EXPERIENCE:*

Does this rider have a special need or disability that we should be aware of so that we can provide a safe horseback riding experience?
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.

Agree To This Document



Powered by  Smartwaiver