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Southern Belle Riding
Ammie and Shawn Lords
6245 W 10400 N, 

6273 W 10400 N,

6311 W 10400 N
Highland Ut 84003
(801) 995-8012

⚠️ WARNING:

Under Utah law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant due to the inherent risks of equine activities, pursuant to Utah Code Ann. §78B-4-201 through §78B-4-203.


I fully understand that horseback riding and working around horses can be dangerous. I understand that riding or working around horses may result in serious injury, permanent disability, or death. I voluntarily assume these inherent risks.


I understand and agree that Southern Belle Riding, Shawn and Ammie Lords, Samuel and Cheryl Eggleston, and their agents, employees, successors, and assigns ("the Released Parties") are not liable for injuries, death, or damages resulting from the inherent risks of equine activities.


I understand that liability under Utah law is not limited if an equine professional:

  • Knowingly provides faulty tack or equipment,
  • Fails to make reasonable and prudent efforts to determine my ability to safely participate in the equine activity,
  • Owns or lawfully possesses land or facilities with a known dangerous latent condition, or
  • Commits an act or omission that constitutes willful or wanton disregard for my safety or intentionally injures me.


I fully understand that I am required to wear long pants, a properly fitted safety helmet, and boots while riding or working around horses. All equipment and safety gear must be supplied by me.


I understand that while every reasonable precaution has been taken to provide safe horses and facilities, horses are large, powerful animals that may be easily frightened and unpredictable. I am participating at my own risk and accept full responsibility for my safety and the safety of my property.


I agree not to make any claims now or in the future against any of the Released Parties for injuries sustained while riding, working near horses at Southern Belle Riding, or participating in any off-site trips organized by Southern Belle Riding.


Business Policies:

Cancellation Policy:

I understand that if I must cancel a lesson, I must provide at least 24 hours’ notice.

  • If I cancel with less than 24 hours’ notice, I agree to pay half of the lesson fee.
  • If I fail to provide any notice, I agree to pay the full lesson fee.


Acknowledgment:

By signing separately below, I acknowledge that I have carefully read this Waiver for Horse/Facility Use, understand its terms, and voluntarily agree to be bound by it.

I understand that this agreement is intended to be a complete release of all liability to the greatest extent allowed by law.




First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Participant's Signature*
Second Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
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*
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Photo and Video Release Authorization
I hereby grant Southern Belle Riding, its representatives, employees, agents, and assigns, the irrevocable right and permission to use photographs and/or video recordings of me (and/or my minor child, if applicable) taken during activities at Southern Belle Riding for promotional purposes. This includes, but is not limited to, use on websites, social media (such as Instagram and Facebook), printed marketing materials, and advertising. I understand that: I will not receive compensation for the use of these images or videos. I waive any right to inspect or approve the finished products or advertising materials in which my likeness appears. I release and hold harmless Southern Belle Riding from any claims, demands, and causes of action arising out of or related to the use of my image or likeness. *
YES-I grant permission for use of photographs/videos.
NO-I do not grant permission for use of photographs/videos.

Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (under 18 years of age).

By signing, the parent(s) or legal guardian(s) acknowledge and agree that they and the minor participant are subject to all terms, conditions, releases, and waivers set forth in this document.



By signing below, the parent or court-appointed legal guardian acknowledges and agrees that they are also subject to all the terms, conditions, releases, and waivers set forth in this document.

Parent or Guardian's Name
First Name*
Last Name*
Relationship*
Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you consent to the use of your electronic signature in lieu of an original, handwritten signature on paper. You have the right to request to sign a paper copy instead. By checking here, you are waiving that right. After providing your consent, you may request a paper copy of any electronic record at any time by submitting a written request to us. No fee will be charged for providing a paper copy, and no special hardware or software is required to view electronic records. Your agreement to use an electronic signature with us will remain in effect until you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You are responsible for keeping us informed of any changes to your current email address so that we can contact you regarding any necessary updates.


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