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UNITY STABLES LLC
3805 MILL ST
BINGHAMTON, NY 13903

RIDING INSTRUCTION AGREEMENT AND LIABILITY RELEASE FORM

SERIOUS INJURY AND/OR DEATH MAY RESULT FROM YOUR PARTICIPATION IN THIS ACTIVITY.
THIS STABLE DOES NOT GUARANTEE YOUR SAFETY.
SIGNING OF THIS AGREEMENT, I, THE FOLLOWING LISTED INDIVIDUAL, AND THE PARENT OR LEGAL GUARDIANS THEREOF IF A MINOR,

DO HEREBY VOLUNTARILY REQUEST AND AGREE TO PARTICIPATE IN RIDING AND/OR RIDING INSTRUCTION AS A STUDENT AT THIS STABLE, AND THAT THIS STUDENT WILL EITHER RIDE HIS/HER OWN HORSE, WHETHER OWNED OR LEASED, OR SCHOOL HORSES, OWNED OR PROVIDED BY THIS STABLE, FOR INSTRUCTIONAL PURPOSE, TODAY AND ON ALL FUTURE DATES.

AGREEMENT SCOPE AND TERRITORY AND DEFINITIONS: THIS AGREEMENT SHALL BE LEGALLY BINDING UPON ME, THE REGISTERED STUDENT, 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 STABLES PHYSICAL LOCATION. ANY DISPUTES BY THE RIDER SHALL BE LITIGATED IN, AND VENUE SHALL BE IN THE COUNTY IN WHICH THIS STABLE IS PHYSICALLY LOCATED. IF ANY CLAUSE, PHRASE, OR WORD IS IN CONFLICT WITH STATE LAW, THEN THAT SINGLE PART IS NULL AND VOID. THE TERM "HORSE" HEREIN SHALL REFER TO ALL EQUINE SPECIES. THE TERM "HORSEBACK RIDING" HEREIN SHALL REFER TO RIDING OR OTHERSWISE HANDLING OF HORSES OR PONIES, WHETHER FROM THE GROUND OR MOUNTED. THE TERMS "STUDENTS AND/OR RIDER" SHALL HERIN REFER TO A PERSON WHO RIDES A HORSE MOUNTED OR OTHERWISE HANDLES OR COMES NEAR A HORSE FROM THE GROUND. THE TERMS "I", "ME", "MY" SHALL HEREIN REFER TO THE ABOVE REGISTERED STUDENT RIDER AND THE PARENTS OR LEGAL RUARDIANS THEREOF IF A MINOR.

ACTIVITY RISK AND NATURE OF THE HORSE: I UNDERSTAND THAT HORSEBACK RIDING IS CLASSIFIED AS A RUGGED ADVENTURE RECREATIONAL SPORT ACTIVITY AND THAT THERE ARE NUMEROUS OBVIOUS AND NON-OBVIOUS INHERENT RISKS ALWAYS PRESENT IN SUCH ACTIVITY DESPITE ALL SAFETY PRECAUTIONS. RELATED INJURIES CAN BE SEVERE, REQUIRING MORE HOSPITAL DAYS AND RESULTING IN MORE LASTING RESIDUAL EFFECTS THAN INJURIES IN OTHER ACTIVITIES. I UNDERSTAND THAT THIS STABLE CHOOSES ITS SCHOOL HORSES FOR THEIR CALM DISPOSITIONS AND SOUND BASIC TRAINING, AS IS REQUIRED FOR USE FOR STUDENTS RIDERS AND THIS STABLE FOLLOWS A RIGID SAFETY PROGRAM, YET, NO RIDING HORSE IS COMPLETELY A SAFE HORSE. HORSES ARE 5 TO 15 TIMES LARGER, 20 TO 40 TIMES MORE POWERFUL, AND 3-4 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 INJURY OR DEATH TO THE RIDER. HORSEBACK RIDING IS THE ONLY SPORT WHERE ONE MUCH SMALLER, WEAKER PREDATOR ANIMAL (HUMAN) TRIES TO IMPOSE ITS WILL ON, AND BECOME ONE UNIT OF MOVEMENT WITH ANOTHER, MUCH LARGER, STRONGER PREY ANIMAL (HORSE) WITH A MIND OF ITS OWN. AND EACH HAS A LIMITED UNDERSTANDING OF THE OTHER. IF A HORSE IS FRIGHTENED OR PROVOKED IT MAY DIVERT FROM IT'S TRAINING AND ACT ACCORDING TO ITS NATURAL SURVIVAL INSTINCTS WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO: STOPPING SHORT, CHANGING DIRECTIONS OR SPEED AT WILL, SHIFTING IT'S WEIGHT, BUCKING, REARING, KICKING, BITING OR RUNNING FROM PERCEIVED DANGER.

STUDENT RIDER RESPONSIBILITY: I UNDERSTAND THAT UPON MOUNTING A HORSE AND TAKING UP THE REINS, THE RIDER IS IN PRIMARY CONTROL OF THE HORSE. THE RIDER'S SAFETY LARGELY DEPENDS UPON HIS/HER ABILITY TO CARRY OUT SIMPLE INSTRUCTIONS, AND HIS/HER ABILITY TO REMAIN BALANCED ABORD THE MOVING ANIMAL. I AGREE THAT THE RIDER SHALL BE RESPONSIBNLE FOR HIS/HER OWN SAFETY, INCLUDING THAT OF AN UNBORN CHILD, IF THE RIDER IS PREGNANT. PREGNANT WOMEN SHOULD RIDE HORSES ONLY UNDER THE ADVICE OF THEIR PHYSICIAN. THIS STABLE ADVISES PREGNANT WOMEN NOT TO RIDE HORSES.

CONDITIONS OF NATURE AND INSPECTIONS OF PREMISES: I UNDERSTAND THAT THIS STABLE IS NOT RESPONSIBLE FOR TOTAL OR PARTIAL ACTS, OCCURRENCES, OR ELEMENTS OF NATURE 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 HROSE OR PERSON: AND IRREGULAR FOOTING, WHICH IS SUBJECT TO CONSTANT CHANGE IN CONDITION ACCORDING TO WEATHER, TEMPERATURE, AND NATURAL AND MAN-MADE CHANGES IN LANDSCAPE. THE RIDER AND PARENT OR LEGAL GUARDIAN HAVE INSPECTED THIS STABLE'S FACILITIES AND ARE SATISFIED THAT ALL PREMISE CONDITIONS ARE REASONABLY SAFE FOR RIDER'S INTENDED PURPOSE, USAGE AND PRESENCE UPON THIS STABLES PREMISES.

ACCIDENT/MEDICAL INSURANCE: I AGREE THAT SHOULD MEDICAL TREATMENT BE REQUIRED, I AND/OR MY OWN ACCIDENT/MEDICAL INSURANCE COMPANY SHALL PAY FOR ALL SUCH INCURRED EXPENSES.

PROTECTIVE HEADGEAR WARNING: I AGREE THAT I, FOR MYSELF AND ON BEHALF OF MY CHILD AND/OR LEGAL WARD, I HAVE BEEN FULLY WARNED AND ADVISED BY THIS STABLE THAT PROTECTIVE HEADGEAR WHICH MEETS OR EXCEEDS THE QUALITY STANDS OF THE SEI CERTIFIED ASTM STANDARD SHOULD BE PURCHASED AND WORN WHILE RIDING AND BEING NEAR HORSES AND I DO UNDERSTAND THAT THE WEARING OF SUCH HEADGEAR 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.

LIABILITY RELEASE:

HAVING READ THE PREVIOUS STATEMENTS, I AGREE THAT, IN CONSIDERATION OF THIS STABLE ALLOWING MY PARTICIPATION IN THIS ACTIVITY, UNDER THE TERMS SET FORTH HERIN, I, THE RIDER, FOR MYSELF AND ON BEHALF OF MY CHILD AND/OR LEGAL WARD, HEIRS, ADMINISTRATORS, PERSONAL REPRESENTATIVES OR ASSIGNS, DO AGREE TO HOLD HARMLESS, RELEASE, AND DISCHARGE UNITY STABLES LLC, IT'S OWNERS, AGENTS, EMPLOYEES, OFFICERS, DIRECTORS, REPRESENTATIVES, ASSIGNS, VOLUNTEERS, MEMBERS, OWNERS OF PREMISES AND TRAILS, AFFILIATED ORGANIZATIONS, AND INSURERS, AND OTHERS ACTING ON IT'S BEHALF (HEREIN AFTER, 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 UNITY STABLES LLC AND/OR IT'S ASSOCIATES ORDINARY NEGLIGENCE: AND I DO FURTHER AGREE THAT EXCEPT IN THE EVENT OF UNITY STABLES LLC AND/OR IT'S ASSOCIATES GROSS NEGLIGENCE AND WILLFUL AND WANTON MISCONDUCT, I SHALL NOT BRING ANY CLAIMS, DEMANDS, LEGAL ACTIONS AND CAUSES OF ACTION AGAINST UNITY STABLES LLC AND IT'S ASSOCIATES AS STATED ABOVE IN THIS CLAUSE, FOR ANY ECONOMIC AND NON-ECONOMIC LOSSES DUE TO BODILY INJURY, DEATH, PROPERTY DAMAGE, SUSTAINED BY ME AND/OR MY MINOR CHILD OR LEGAL WARD IN RELATION TO THE PREMISES AND OPERATION OF UNITY STABLES LLC, TO INCLUDE WHILE RIDING, HANDLING, OR OTHERWISE BEING NEAR HORSES OWNED BY OR IN THE CARE, CUSTODY AND CONTROL OF UNITY STABLES LLC, WHETHER ON OR OFF THE PREMISES OF THIS STABLE.

ALL STUDENT RIDERS & PARENTS OR LEGAL GUARDIANS (OF MINORS) MUST SIGN BELOW AFTER READING THIS ENTIRE DOCUMENT.

SIGNER STATEMENT OF AWARENESS:

 I/WE THE UNDERSIGNED, HAVE READ AND DO UNDERSTAND THE FOREGOING AGREEMENT, WARNINGS, RELEASE AND ASSUMPTION OF RISK.

I/WE FURTHER ATTEST THAT ALL FACTS RELATING TO THE APPLICANT'S PHYSICAL CONDITION, AND AGE ARE TRUE AND ACCURATE.

Agree

I Agree
 

 

First Participant/Spectator Name

First Name*

Last Name*

Phone*
First Participant/Spectator Date of Birth*
First Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
First Participant/Spectator Signature*
Second Participant/Spectator Name

First Name*

Last Name*
Second Participant/Spectator Date of Birth*
Second Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
Third Participant/Spectator Name

First Name*

Last Name*
Third Participant/Spectator Date of Birth*
Third Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
Fourth Participant/Spectator Name

First Name*

Last Name*
Fourth Participant/Spectator Date of Birth*
Fourth Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
Fifth Participant/Spectator Name

First Name*

Last Name*
Fifth Participant/Spectator Date of Birth*
Fifth Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
Sixth Participant/Spectator Name

First Name*

Last Name*
Sixth Participant/Spectator Date of Birth*
Sixth Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
Seventh Participant/Spectator Name

First Name*

Last Name*
Seventh Participant/Spectator Date of Birth*
Seventh Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
Eighth Participant/Spectator Name

First Name*

Last Name*
Eighth Participant/Spectator Date of Birth*
Eighth Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
Ninth Participant/Spectator Name

First Name*

Last Name*
Ninth Participant/Spectator Date of Birth*
Ninth Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
Tenth Participant/Spectator Name

First Name*

Last Name*
Tenth Participant/Spectator Date of Birth*
Tenth Participant/Spectator Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
Participant/Spectator 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*
Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
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.
Parent or Guardian's Name

First Name*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
DOES THIS STUDENT HAVE ANY PHYSICAL CONDITIONS, WHICH MAY AFFECT HIS/HER ABILITY TO SAFELY RIDE AND/OR HANDLE A HORSE, OF WHICH WE SHOULD BE AWARE:*
No
Yes

IF YES, PLEASE EXPLAIN:
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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