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Haile Equestrian 2020 Online Camp Registration Form

Haile Equestrian 2020 Camper Registration Form

 

 

Parent and Camper Statement of Understanding of Haile Equestrian Policy

The following is Haile Equestrian LLC policy information for the safety and protection of each child.

I am the parent or legal guardian of a camper at Haile Equestrian LLC. Understanding that certain activities have a degree of risk and uncertainty involved, and understanding that all reasonable efforts will be made by the staff of Haile Equestrian LLC to see that these activities are carried out and supervised in a competent and responsible manner, permission is hereby given, as indicated below, for the camper above named to participate in horseback riding and other activities. To ensure safety while horseback riding, all campers are required to wear ASTM approved riding helmets (provided by camp if needed) and closed-toe, heeled shoes (preferably boots) that come up to at least the camper’s ankle. If you have any questions regarding the suitability of footwear, please do not hesitate to contact Haile Equestrian LLC.

Nature of Horses

(a) Haile Equestrian follows a rigid safety program. Horses are selected and tested to ensure their safety and suitability for our program. However, no horse is a completely safe horse. Horses are 5 to 10 times larger and 20 to 40 times more powerful than a human. If a rider falls from a horse to the ground, it will typically be at a distance of 3.5 to 5.5 feet and can result in injury to the rider. Horseback riding is one of the only sports where a smaller, weaker predator (human) imposes its will on a much larger, stronger prey animal (horse).

(b) 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, changing directions or speeds at will, shifting its weight, rearing, bucking, bolting, kicking, biting, or running from danger.

Client understands the nature of horses and their unpredictability as described above

We (camper and parent) understand that it is the responsibility of each camper to participate in the whole program, including activities of work, play, and values sharing. We understand and support camp policies prohibiting campers from bringing weapons to camp, and from possessing or using tobacco products, alcoholic beverages or non-prescription drugs while at camp. We recognize that campers must follow safety instructions, remain in areas designated by staff and refrain from behavior that is harmful to themselves or others. Failure to adhere to camp policies may cause the Camp Director to dismiss a camper, without refund of camp fees.

I (parent) understand that I am not to leave my child at Haile Equestrian LLC unless a camp staff member
is there to receive and supervise my child. I understand that my child will not be allowed to leave the camp or camp activities with an unauthorized person. Any person other than a parent will not be allowed to pick up the camper unless prior arrangements have been made by calling the Haile Equestrian LLC office to inform them. Campers may bring electronic devices such as MP3 players or cell phones. These are to be
used only during limited times designated by the camp staff. Failure to adhere to this policy may result in the Camp Director taking and holding the device in safekeeping until the camper departs. Haile Equestrian LLC is not responsible for lost or stolen items.

I am aware that my child will have the opportunity to participate in camp activities which may involve a degree of risk, and I approve his/her participation in such activities. I understand that accidents can occur.

Recognizing that the camp will do its best to ensure a safe and enjoyable camping experience, I hereby release Haile Equestrian LLC, its officers, directors, shareholders, employees and anyone else directly or indirectly connected with Haile Equestrian LLC from any liability whatsoever in the event of injury or damage of any nature (or perhaps even death) to me or anyone else caused by or incidental to my electing to mount and ride a horse owned or operated by Regina Esterman, Plantation Community Club LLC, or Haile Equestrian LLC. I have read and understand FLORIDA STATUTES for EQUINE ACTIVITIES, Fla. Stat. § 773.01 (1993).

I understand that my child will be photographed, and consent to the photographs being used for camp promotional purposes. Haile Equestrian LLC uses only campers’ first names in photo captions and articles.

Ride & Excursion Camps Only:

I consent to our child’s/children’s participation in the offsite excursions facilitated by Haile Equestrian. I further consent to allow Haile Equestrian, its teacher or other volunteers, or whomever any of these so delegate to transport my child/children to and from any such offsite excursions. I further release and hold harmless Haile Equestrian LLC, Plantation Community Club LLC, Regina Esterman, Mauricio Cazanova, and any and every of its  subsidiaries or affiliates, and any and every of the teachers, delegates, drivers, volunteers, agents, employees, officers or directors of these entities from any liability or claim of liability, including negligence, and for any personal injury, including death, (and especially including, but not limited to, bodily injury or death from any motor vehicle accident) and for any other damages (including actual, compensatory, consequential, or incidental), arising from or relating to activities which take place during the offsite excursion or in the travel to and from said excursion. 

 

Payments

Registration fee of $175 per session must accompany application (this portion of the fee is non-refundable). Balance of all fees is due one month in advance of the camp start date. If spaces remain, registration will continue after this date. 

Please make checks payable to “Haile Equestrian”. Credit cards accepted with 4% fee. Please fill out, sign, and return this form with payment to Haile Equestrian digitally, or you can print and mail to 7680 SW 46th Blvd., Gainesville, FL 32608.  Online payments can be made at haileequestrian.com by clicking on the "Pay Online" tab.

Client or Parent/Guardian Signature

 Date: February 22, 2020

 

Haile Equestrian LLC
Liability Release & Hold Harmless Agreement

WARNING

Under Florida law, an equine activity sponsor or equine professional is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities. FLORIDA STATUTES 1993, Title XLV TORTS, CHAPTER 773 EQUINE ACTIVITIES, Fla. Stat. § 773.01 (1993).

1. I, the undersigned, signing as the legal parent or guardian of the minor listed, have read and understand, and freely and voluntarily enter into this Release and Hold Harmless Agreement with Regina Esterman and Plantation Community Club LLC, their agents and employees, collectively known as Haile Equestrian LLC (“Farm”), understanding that this Release and Hold Harmless Agreement is a waiver of any and all liability(ies).

2. I have read and fully understand the “WARNING” posted above.

3. I understand the potential dangers that I could incur in mounting, riding, walking, boarding, feeding said horse; including, but not limited to, any interactions with other horses. Understanding those risks I hereby release that Farm, its officers, directors, shareholders, employees and anyone else directly or indirectly connected with that Farm from any liability whatsoever in the event of injury or damage of any nature (or perhaps even death) to me or anyone else caused by or incidental to my electing to mount and ride a horse owned or operated by Regina Esterman, Plantation Community Club LLC, or Haile Equestrian LLC. I have read and understand FLORIDA STATUTES for EQUINE ACTIVITIES, Fla. Stat. § 773.01 (1993).

4. I understand and recognize and warrant that this Release and Hold Harmless Agreement, is being voluntarily and intentionally signed and agreed to, and that in signing this Release and Hold Harmless Agreement I know and understand that this Release and Hold Harmless Agreement may further limit the liability of equine professionals beyond that statutorily provided by the above referenced Florida Statutes; to include any activity, whatsoever, involving an equine, including death, personal injury and/or damage to property.

5. I recognize and agree that I know which equine professional(s) I will be working with, and acknowledge that I agree said equine professional(s) has/have made reasonable and prudent efforts to determine my ability to engage in the equine activity, and has/have sufficient knowledge of my equine and horseback riding skills as to relieve, release and hold harmless said equine professional(s) from any continuing duty to monitor my equine activities.

6. I further voluntarily agree and warrant to Release and Hold Harmless this (these) equine professional(s) from any liability whatsoever, including, but not limited to, any incident caused by or related to said equine professional’s (s’) negligence, relating to injuries known, unknown, or otherwise not herein disclosed; including, but not limited to, injuries, death or property damage from: mounting; riding; dismounting; walking; grooming; feeding; use of horse barn, paddock, trails or horse ring, in any capacity; falling off horse whether horse is bucking, flipping, spooked; or my failure to understand any equine professional’s directions relating to my riding or otherwise use and control, or lack thereof, of my horse or the horse I have been assigned to.

NOTICE: Wearing an ASTM/SEI approved hard hat is REQUIRED for ALL independent riders. Wearing an ASTM/SEI approved hard hat is HIGHLY RECOMMENDED, but not required for leadline horse or pony rides.

By signing this agreement, you certify that you are at least 18 years of age.

Person voluntarily entering into this Release and Hold Harmless Agreement:
Signature:

 Date: February 22, 2020

First Camper's Name

First Name*

Middle Name

Last Name*

Phone*
First Camper's Date of Birth*
First Camper's Signature*
Second Camper's Name

First Name*

Middle Name

Last Name*
Second Camper's Date of Birth*
Third Camper's Name

First Name*

Middle Name

Last Name*
Third Camper's Date of Birth*
Fourth Camper's Name

First Name*

Middle Name

Last Name*
Fourth Camper's Date of Birth*
Fifth Camper's Name

First Name*

Middle Name

Last Name*
Fifth Camper's Date of Birth*
Sixth Camper's Name

First Name*

Middle Name

Last Name*
Sixth Camper's Date of Birth*
Seventh Camper's Name

First Name*

Middle Name

Last Name*
Seventh Camper's Date of Birth*
Eighth Camper's Name

First Name*

Middle Name

Last Name*
Eighth Camper's Date of Birth*
Ninth Camper's Name

First Name*

Middle Name

Last Name*
Ninth Camper's Date of Birth*
Tenth Camper's Name

First Name*

Middle Name

Last Name*
Tenth Camper's Date of Birth*
Camper'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*
Insurance

Insurance Carrier*

Insurance Policy Number*
Camper Information

Camper Name *
Age*
Grade Level Completed*

School
Does your child have any health impairments or serious illness which may affect your child's participation in horse/outdoor activities (i.e. asthma, diabetes, allergies)*
No
Yes

If yes, please explain

Are there any other personal characteristics that you would like us to know about your child?
Horseback Riding Ability/Experience
Previous Riding Experience *
None (no experience is required to enjoy half and full day camps at Haile Equestrian)
Beginner
Novice
Intermediate
Advanced

Please describe previous horse experience
Special Instructions or Notes

Please let us know if there are any special instructions or notes about your camper
Special Requests

Horse preferences, friends attending same session that would like to ride in the same group, etc
How did you hear about us?
Advertising *
From a friend
Haile Equestrian Website
Facebook Ad
Fun4GatorKids.com
Alachua County School Notes
Flyers
Craigslist
Other

If Other, where did you hear about us?
Registration Information

Full Day Camps $375/week

Half Day Camps $275/week

Advanced Camps $375/week

Ride & Field Trip Camps $475/week

Camp fees include $175 registration deposit

Please select the 2020 camp sessions you wish to register for: *
Spring Break Camp - March 23-27 Full Day Camp
June 1 - 5 - Full Day Camp
June 1 - 5 - Half Day Camp (5 & 6 year olds permitted)
June 8 - 12 - Full Day Camp
June 8 - 12 - Ride & Excursion Camp*
June 15 - 19 - Full Day Camp
June 15 - 19 - Advanced Camp**
June 22 - 26 - Full Day Camp
June 22 - 26 - Half Day Camp
June 29 - July 3 - Full Day Camp
June 29 - July 3 - Half Day Camp
July 6 - 10 - Half Day Camp (5 & 6 year olds permitted)
July 13 - 17 - Full Day Camp
July 13 - 17 - Advanced Camp**
July 20 - 24 - Full Day Camp
July 27 - 31 - Half Day Camp
July 27 - 31 - Ride & Excursion Camp*
August 3 - 7 - Full Day Camp
August 3 - 7 - Half Day Camp (5 & 6 year olds permitted)

*Campers registering for Ride & Excursion Camp sessions must be registered in another full, half, or advanced camp session to be eligible to participate in these special sessions.

**Campers must be able to walk, trot, canter, and jump small fences to attend Advanced Camp sessions. If you are unsure if your camper is ready for these sessions, ask your instructor or give us a call. If you are not a regular student at Haile Equestrian, please schedule a lesson for an evaluation ride or submit a brief video of your camper riding.

Early Drop Off & Late Pickup
Do you need early drop off?*
No
Yes

If yes, what time will you drop off:
Do you need late pickup?*
No
Yes

If yes, what time will you pickup?
I understand that Haile Equestrian's Summer Camp runs from 9 am - 4 pm on Full Day camp days and 9 am - 1 pm on Half Day camp days. Campers arriving before camp begins or staying beyond when camp ends will incur additional fees. Early drop off (8:00 am) OR late pickup (5:00 pm) are available for $50/week. Additional extended hours are available at $10/hour.*
Yes
No
T-shirts
One t-shirt is included per camper in the camp fee (summer camps only, full week registrations only). Additional shirts available for $15/shirt. Number of shirts requested (select total number of shirts if you are registering multiple campers): *
1
2
3
Size *
Youth Small
Youth Medium
Youth Large
Adult Small
Adult Medium
Adult Large
Adult X-Large
I understand that my child's registration is not complete without payment of the camp deposit.
I will make my camp payment by: *
I will use the online payment system at HaileEquestrian.com (4% fee added to credit card payments)
Please send me an invoice for payment to my email address (4% fee added to credit card payments)
I will mail a check
I will drop off payment to the Haile Equestrian farm.
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*

Middle Name

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
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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