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Wings of Hope Ranch 

13280 Tower Road

Doswell, VA 23047







RELEASE OF LIABILITY AND HOLD HARMLESS AGREEMENT

In consideration for allowing me (and my minor child) to participate in activities and programs at Wings of Hope Ranch, Inc. (“Ranch”) including, but not limited to, working with and riding a horse and on behalf of myself, my child or our personal representatives, heirs, next-of-kin, spouses and assignees, I Hereby:

1.    RELEASE, DISCHARGE AND PROMISE NOT TO SUE the Ranch, doing business under its own name or any other name, any parent or subsidiary company, and/or any of its board of directors, officers, instructors, volunteers, employees and agents (hereinafter the “Releasees”), for any loss, liability, damages, or cost whatsoever arising out of or related to any loss, damage, or injury (including death) to my person or property.

2.    INDEMNIFY, AND SAVE AND HOLD HARMLESS the Releasees from and against any loss, liability, damage or cost they may incur arising out of or in any way connected with any of programs and activities at the Ranch, including, but not limited to, interacting with the horses and any equipment or gear provided therewith or any acts or omissions of volunteers or other employees or agents located at 13280 Tower Road, Doswell, VA 23047.

3.    EQUINE ACTIVITIES. The equine activities in which I may participate may directly or indirectly engage, whether mounted or un-mounted, to include but not be limited to: horseback riding, groundwork and liberty work, training, or otherwise being a passenger upon an equine; and also petting, handling, leading, grooming, feeding and otherwise attending to the equine, are activities and events which pose potentially serious risks of injuries or death to the participants.

a.    I understand that I may be injured or die as a result of my negligence, the negligence of others, or through no fault of me or anyone else but because of the nature of the activity in which I am going to be engaged. I also understand that horses, even the most well-trained animals, are unpredictable and may be difficult to control. At any time, a horse may, without warning or any apparent cause, buck, stumble, fall, rear, bite, kick, run, make unpredictable movements, spook, jump obstacles, step on a person’s feet, push or shove a person, saddles, girths, or bridles may loosen, or break – all of which may cause the rider to fall or be jolted, resulting in serious injury or death.

b.    I ACKNOWLEDGE THAT HORSEBACK RIDING 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 and past performance. I represent that I voluntarily assume the risk and danger of injury or death inherent in the use of the horse, equipment and gear provided to me by the Ranch.

c.    I release the Releasees from any claim that such Releasees are or may be negligent in connection with my riding experience or ability, including but not limited to, training or selecting horses, maintenance, care, fit or adjustment of saddles or bridles, instruction or riding skills or leading and supervising riders. While on the Ranch property I will abide by all rules and guidelines imposed by the Ranch. I understand that refusal to abide by these rules my result in being asked to leave for my safety and the safety of others.

d.    If I wish to participate in ranch activities such as equine riding, I understand that it is my sole responsibility to discuss any contraindicated medical conditions with Ranch staff, and that in the Ranch’s sole discretion, I may not be able to participate in certain activities such as equine riding for safety reasons. At the Ranch’s sole discretion, I may be required to obtain a medical release from my doctor to participate in certain activities such as equine riding. 

                                     i.    I do not have any known medical condition, including but not limited to, atlantoaxial instability, epileptic seizures, heart condition, pregnancy, or any other medical diagnoses or symptoms related thereto that could be affected by equine riding activities.

e.    With this waiver, I accept notice of the provisions of the Equine Activity Liability Act, Sections 3.2-6200 through 3.2-6203 of the Code of Virginia, 1950, as amended, which states in part, the intrinsic dangers or conditions that are an integral part of equine activities, including but not limited to (i) the propensity of an equine to behave in ways that may result in injury, harm or death to persons on or around them; (ii) the unpredictability of an equine's reaction to sounds, sudden movements, and unfamiliar objects, persons or other animals; (iii) certain hazards such as surface and subsurface conditions; (iv) collisions with other animals or objects; and (v) the potential of a participant acting in a negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the equine or not acting within the participant's ability. This waiver shall remain valid unless expressly revoked by me, or if a minor, by a parent or guardian, in writing, with receipt acknowledged in writing by an agent/director of the Ranch.

Wings of Hope Ranch COVID-19 Waiver and Policy

I am aware that COVID-19 is an infectious virus that spreads easily through person-to-person contact and could cause serious illness to individuals who have certain medical risk factors. Federal and state public health authorities and the Ranch have issued basic health and safety guidance aimed at mitigating the spread of the virus. I understand that my participation in any activities or accessing facilities owned or managed by the Ranch could increase the risk of contracting COVID-19. The Ranch in no way warrants that the protective measures prescribed for the activities or in order to access the facilities will completely prevent exposure to the COVID-19 virus. I agree to follow all public health and safety guidelines for the activities and freely and voluntarily assume the risk of COVID-19 exposure.

I agree that if I am experiencing any COVID-19 symptoms (as described in CDC guidelines as of March 22, 2022): Fever or chill, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea, that I will follow the quarantine guidelines below or get tested to confirm that I do not have COVID-19.

If I am diagnosed with COVID-19 or anyone in my immediate household is diagnosed with COVID-19, I shall notify Ranch Staff immediately via phone (804) 485-4045. This aids the Ranch in informing anyone who has been in contact and allows appropriate measures to be taken to help mitigate the spread.  The Ranch will follow its internal protocols based on the current CDC guidelines regarding quarantine and isolation.

If you cannot complete your assigned shift at the Ranch, notify our staff immediately at 804-485-4045, and find a substitute for your shift. If you are a session volunteer, notify the program director and your session supervisor (gatekeeper) immediately. If you are a barn volunteer, contact the Barn Manager at 804-485-4045. It is your responsibility to find a substitute for your shift(s).

BY SIGNING THESE WAIVERS AND RELEASE, I UNDERSTAND THAT I AM GIVING UP, WAIVING AND RELEASING, ANY RIGHT I MIGHT HAVE TO SUE OR MAKE A CLAIM AGAINST THE RANCH, any parent or subsidiary company, and/or any of its board of directors, officers, instructors, volunteers, employees and agents, FOR ANY INJURIES THE I MIGHT SUSTAIN TO MY PERSON OR MY PERSONAL PROPERTY, WHILE HORSEBACK RIDING OR OTHERWISE PARTICIPATING, EITHER DIRECTLY OR INDIRECTLY, MOUNTED OR UNMOUNTED, IN ANY EQUINE ACTIVITY AT THE RANCH, AND

THAT I AM INDEMNIFYING AND HOLDING HARMLESS THE RANCH, any parent or subsidiary company, and/or any of its board of directors, officers, instructors, volunteers, employees and agents, FOR INJURIES TO ANYONE ELSE OR ANY HORSE RIDDEN BY ANOTHER WHILE I AM ENGAGED IN EQUINE ACTIVITIES OR ANY OTHER ACTIVITIES AT THE RANCH. 

IT IS MY INTENT TO GIVE UP THOSE RIGHTS AND PROVIDE THIS HOLD HARMLESS AGREEMENT. I DO SO KNOWINGLY AND VOLUNTARILY BECAUSE I HAVE CONCLUDED THAT THE RISKS INVOLVED AND THE RELEASE AND WAIVER OF LIABILITY IS WORTH MY, AND/OR MY CHILD’S, PARTICIPATION IN THE RANCH’S PROGRAMS AND SERVICES.

I acknowledge that this document is a contract and agree that if a lawsuit is filed against the Ranch or its affiliates, parent or subsidiary companies, agents, volunteers, employees, officers or directors, for any injury or damage in breach of this contract, the Participant will pay all attorney’s fees and costs incurred by the Ranch in defending such an action.


First Volunteer Name

First Name*

Last Name*

Phone*
First Volunteer Date of Birth*
First Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
First Volunteer Signature*
Second Volunteer Name

First Name*

Last Name*

Phone*
Second Volunteer Date of Birth*
Second Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
Third Volunteer Name

First Name*

Last Name*

Phone*
Third Volunteer Date of Birth*
Third Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
Fourth Volunteer Name

First Name*

Last Name*

Phone*
Fourth Volunteer Date of Birth*
Fourth Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
Fifth Volunteer Name

First Name*

Last Name*

Phone*
Fifth Volunteer Date of Birth*
Fifth Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
Sixth Volunteer Name

First Name*

Last Name*

Phone*
Sixth Volunteer Date of Birth*
Sixth Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
Seventh Volunteer Name

First Name*

Last Name*

Phone*
Seventh Volunteer Date of Birth*
Seventh Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
Eighth Volunteer Name

First Name*

Last Name*

Phone*
Eighth Volunteer Date of Birth*
Eighth Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
Ninth Volunteer Name

First Name*

Last Name*

Phone*
Ninth Volunteer Date of Birth*
Ninth Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
Tenth Volunteer Name

First Name*

Last Name*

Phone*
Tenth Volunteer Date of Birth*
Tenth Volunteer Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
Volunteer 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.
I/We am/are the parent(s) or guardian of a minor, and on the minor's behalf and on my/our own behalf as the parent or guardian of the minor, I/we accept the release and waiver of liability contained within this form as an inducement for allowing my/our child, or this minor, to participate in equine activities which may occur at Wings of Hope Ranch. I/We have carefully read and understand the provisions as stated above, particularly, the INTRINSIC DANGERS associated with all equine activities. I/We further authorize emergency medical care which may be necessary. I/We represent and warrant that I/we have the legal authority to give this release.


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 Visit Details

The DATE you are coming to Wings of Hope. *

Click to customize text


Wings of Hope Volunteer or Group you are coming with. *
Reason for coming to Wings of Hope Ranch
Tour and Orientation
Work Day and/or Group Work day
Special Event
Other

Parent/Guardian, if you're not a biological parent of the minor, please provide the COURT JURISDICTION which granted you legal custody of the minor(s) and the DATE legal custody granted.
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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