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ACTIVITY PARTICIPATION WAIVER

STEVENS CREEK FARM
“the Organizer”

Completed waivers must be submitted prior to participating in, and/or attending, the Organizer’s Activity. This form is mandatory for all visitors to Stevens Creek Farm, including all riders, officials, family members, spectators, volunteers, grooms, coaches, and anyone wishing to attend clinics, camps, lessons or competitions at SCF.

WAIVER OF LIABILITY FOR ALL CLAIMS AND RELEASE OF LIABILITY

PLEASE READ CAREFULLY BEFORE SIGNING.

By signing below, the Participant (named below) and/or the Participant’s Guardian represents that the Participant:

  1. Has nottravelled, or will nottravel, internationally during the 14 days preceding the start of the Activity;
  2. Has not visited, or will not visit, a COVID-19 high risk area, region or location in Canada during the 14 days preceding the start of the Activity;
  3. Does not knowingly have COVID-19;
  4. Is not experiencing known symptoms of COVID-19, such as fever, cough, or shortness of breath, and if experiences such symptoms during the Activity will immediately withdraw from the Activity and depart from the premises;
  5. Will not, in the 14 days leading up to the Activity knowingly come into contact with someone who has COVID-19, who has known symptoms of COVID-19, or is selfquarantining after returning to Canada; and,
  6. For the duration of the Activity, will abide by the Organizer’s policies, procedures, and protocols, including physical distancing, and all federal, provincial, and municipal laws, regulations, by-laws and orders as they may exist from time to time. The Participant and/or the Participant’s Guardian understands, acknowledges, and assumes the potential for bodily injury or illness(including contraction of COVID-19) and contact or interaction with others who may have been exposed to COVID-19.

The Participant and/or the Participant’s Guardian further understands and acknowledges that horseback riding is a dangerous sport and assumes the inherent risks in participating in activities that involve horseback riding, handling and grooming of horses and other stable activities, including, but not limited to: permanent disability, paralysis, or loss of life; collision with natural or manmade objects; dangers arising from adverse weather conditions; imperfect venue or field of play conditions; equipment failure; participants of varying skill levels; inadequate safety measures; circumstances known, unknown or beyond the control of the Organizer, its owners/operators (Andy de Ste. Croix and Estelle [Teddie] Laframboise), its partners, sponsors, agents, affiliates, directors, employees, officers, therapists, adjoining landowners (where neighboring property is used) or volunteers (together, the “Organization”); negligence or omission of the Organization (collectively, the “Risks”).

In consideration for allowing the Participant to participate in the Activity, the Participant and/or the Participant’s Guardian: (a) release, discharge and forever hold harmless the Organization from any and all liability for damages or loss arising as a result of the Risks of participation in or in connection with the Activity; (b) waive any right to sue the Organization in respect of all causes of action (including for injuries or illness caused by their own negligence), claims, demands, damages or losses of any kind that may arise as a result of the Risks of participation in or in connection with the Activity, including without limitation the right to make a third party claim or claim over against the Organization arising from the same; and (c) freely assumes all risks associated with the Risks, anything incidental to the risks which may arise as a result of participation in/or connection with the Activity. YOU ARE GIVING UP LEGAL RIGHTS TO ANY AND ALL FUTURE CLAIMS AGAINST THE ORGANIZATION.

I confirm that I have read and fully understand this waiver and release of liability. I sign this waiver and release of liability voluntarily without any inducement, assurance, or warranty being made to me.

Date: September 25, 2020

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
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.
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*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
The "Activity" (please select one):*

Other

Date(s) of Activity *
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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