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Shamrock “T” Ranch

Horse Riding/Handling agreement and Liability Release Form

Intended for individuals handling/riding their own animals, as well as, individuals riding horses owned by or in the care and custody of the Shamrock T Ranch. This form must be completed by and for each participant.

Shamrock T Ranch/Craig and Cindy Tognazzini, hereinafter known as “Shamrock T Ranch” Located at 8927 Hierba Rd. Agua Dulce, Ca 91390 661-268-0422.

A. Registration of riders and agreement purpose: I, the following listed individual hereinafter know as the “RIDER”, and the parents or legal guardians thereof if a minor, do hereby voluntarily request and agree to participated in horseback riding on The Shamrock T Ranch’s premises, and that the rider will ride his/her own horse or one borrowed or leased by Rider’s own arrangement, today and on all future dates:

B. Agreement Scope and Territory definitions: This agreement shall be legally binding upon me the registered RIDER, and the parents or legal guardians thereof if a minor, my heirs, estates, 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 an venue shall be in the county in which this stable is physically located. The term HORSE herein shall refer to all equine species. The term HORSEBACK RIDING or RIDING shall hereinafter refer to a person who rides a horse mounted or otherwise handling of horses, ponies, mules or donkeys whether from the ground or mounted. The term RIDER shall herein 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 rider and the parents or legal guardians thereof if a minor.

C. Activity Risk Classification: I UNDERSTAND THAT: Horseback riding is classified as RUGGED ADVENTRURE RECREATIONAL SPORTS ACTIVITY, and that there are numerous obvious and non-obvious inherent risks always present in such activity despite all safety precautions. According to the NEISS(National Electronic Injury Surveillance Systems of United States consumer products) horse activities rank approximately 64th among the acitvites of people relative to injuries that result in a stay at US hospitals. Related injuries CAN BE SEVERE UP TO AND INCLUDING DEATH, requiring more hospital days and resulting in more lasting residual effects that injuries in other activities.

D. Nature of Riding Horses: I UNDERSTAND THAT: No horse is a completely safe horse. Horses are 5 to 15 times larger, 20-40 times more powerful and 3-4 times faster that a human. If a rider falls from horse to ground it will generally be at a distance of from 31/2 to 51/2 feet, and the impact may result in injury 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 with a mind of its own (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, changing directions or speed at will, shifting its weight, bucking, rearing, kicking, biting, or running from danger.

E. 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 on his/her ability to carry out simple instructions, and his/her ability to remain balanced aboard the moving animal. The RIDER shall be responsible for his/her own safety, and that of an unborn child, if the rider is pregnant. Pregnant women should ride horses only under the advice of their physician. Shamrock T Ranch advises pregnant women do not ride horses.

F. Conditions of Nature: Shamrock T Ranch 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, lightening, rain, WIND, wild and domestic animals, insects, reptiles which may walk, run, fly near, bite and or sting a horse or a person, and irregular footing on out of door groomed or wild land which is subject to change in condition according to the weather.

G. Inspection of Premises: I UNDERSTAND THAT: Rider has inspected the Shamrock T Ranch facilities and trails and is satisfied that all the premises conditions are reasonably safe for RIDERS intended purpose, usage, and presence upon Shamrock T Ranch’s premises.

H. Accident/Medical and Personal Liability 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. Should my actions or that of my horse cause injury or damage of any kind I and/or my personal liability shall pay for such damages.

I. Protective Headgear Warning: I AGREE THAT: I for myself and on behalf of my child and/or legal ward have been fully warned and advised by Shamrock T Ranch that protective headgear which meets or exceeds the quality standards of the SEI Certified ASTM Standard F 1163 Equestrian Helmet, 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 the severity of some of the wearer’s head injuries and possibly prevent the wearer’s death from happening as a result of a fall and other occurrences.

J. Liability Release: I AGREE THAT: In consideration of Shamrock T Ranch allowing my participation in this activity, under the terms set forth herein, 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 Shamrock T Ranch, its owners, agents, employees, officers, directors, representatives, assigns, members, owners of premises and trails, affiliated organizations, and insurers, and others acting on behalf (hereinafter collectively referred to as “Associtates”) of and from ALL claims, demands, causes of action and legal liability, whether the blame be known or unknown, anticipated or unanticipated, due to Shamrock T Ranch’s and/or its Associates ordinary negligence; and I do further agree that except in the even of Shamrock T Ranch’s gross negligence and willful and wanton misconduct, I shall not bring any claims, demands, legal actions and causes of action, against Shamrock T Ranch and its Associates as stated in the above 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 operations of Shamrock T Ranch, to include while riding, handling or otherwise being near horses owned by or in the care and custody and control of Shamrock T Ranch whether on or off the premises of the Shamrock T Ranch.

All Riders and Parents or legal Guardians must sign below after reading this ENTIRE document:

SIGNER STATEMENT OF AWARENESS

I/WE HAVE READ THE ENIRE DOCUMENT AND HAVE HAD THE OPPORTUNITY TO HAVE ALL MY QUESTIONS ANSWERED. I/WE THE UNDERSIGNED DO UNDERSTAND THE FOREGOING AGREEMENT, WARNINGS, RELEASE AND ASSUMPTION OF RISK. I/WE FURTHER ATTEST THAT ALL FACTS RELATING TO THE APPLICANT ARE TRYE AND ACCURATE.

Date: July 4, 2020 

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
Participant'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*
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*

Phone*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information
Check here if you will be riding at your own risk without a helmet.
Agree

Age (if under 21)

2nd phone:
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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