Loading...

GENERAL RELEASE, LIABILITY WAIVER AND ASSUMPTION OF ALL RISK AND LIABILITY

PLEASE READ CAREFULLY

WARNING: UNDER FLORIDA LAW, AN EQUINE ACTIVITY SPONSOR, EQUINE PROFESSIONAL, OR ANY OTHER PERSON OR LEGAL ENTITY IS NOT LIABLE FOR AN INJURY TO, OR THE DEATH OF, A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES. 

Proper execution of the following General Release, Liability Waiver and Assumption of All Risk and Liability by the undersigned is a prerequisite to the undersigned or the undersigned’s minor child or legal ward (“Participant”) being able to take part in any and all equine and related activities as a rider, driver, trainer, boarder, groomer, guest, visitor, spectator, vendor, volunteer or participant in any equine event or otherwise in connection with lessons, boarding clinics, driving or riding club meets, horse training shows, stall rentals, apartment or cottage rentals, RV camping, carriage rides, special events or any other horse, recreational or farm-related activities (“Equine Activities”) sponsored by or taking place at the Black Prong Equestrian Village (“Black Prong Equestrian Village”) and/or by all related or affiliated organizations including but not limited to Black Prong Equestrian Village LLC and 6851 LLC, all of which entities together with their respective members, managers, representatives, volunteers, agents and employees are hereinafter referred to herein as the “Releasees.”

In consideration of the Participant electing to use the Black Prong Equestrian Village, including but not limited to use of the fields, trails, tracks, rings, courses, fences, water hazards, barns, paddocks, stables, buildings, roadways, facilities, and equipment, and to participate in Equine Activities, the undersigned, as or on behalf of said Participant, his or her heirs, next of kin, dependents, representatives, executors, administrators, successors or assigns, HEREBY FOREVER RELEASES, INDEMNIFIES AND HOLD HARMLESS the Releasees from any cause of action, claims or demands of any nature whatsoever (including, but not limited to actions for costs and/or attorney’s fees) which the undersigned and/or the Participant, his or her representatives, heirs, next of kin, dependents, executors, administrators, or any other person or entity on his or her behalf, may now have, or have in the future, against the Releasees on account of personal injury, loss, property damage, or accident of any kind, including death, arising out of the participation in or observation of Equine Activities by the undersigned and/or the Participant, including without limitation, participation in or observation of Equine Activities sponsored by one or all Releasees.

The undersigned and/or Participant further understand that by signing this Release, he/she covenants and agrees that he/she, as well as his/her heirs, next of kin, dependents, representatives, executors, administrators, successors or assigns, will never institute any suit or action at law of otherwise against the Releasees or in any way aid in the institution or prosecution of any claim, demand, action or cause of action for damages, costs, loss of services, expenses or compensation for or on account of any damage, loss or injury either to the Participant’s person or property or both, or Participant’s death, which may result from the Participant’s attendance at or participation in Equine Activities. Participant is hereby given notice of risk intrinsic and inherent in equine activities, including Equine Activities, including (i) the propensity of an equine to behave in dangerous ways which may result in injury to the Participant; (ii) the inability to predict an equine's reaction to sound, movements, objects, persons, or animals; and (iii) hazards of surface and subsurface conditions - and specifically assumes this risk and the risk of acts or omissions that constitute negligence for the safety of the Participant by the Releasees, whether or not related to the preceding enumerated intrinsic dangers and inherent risks.

The undersigned and/or Participant further understand that participation in Equine Activities involves substantial risk of injury - including death - and fully understands, accepts and assumes that risk. The undersigned and/or Participant verify that the Participant is in good health and that he/she has no physical limitations which would preclude his/her safe participation in Equine Activities. The undersigned and/or the Participant agree that prior to participating he/she will inspect the facilities and mounts for suitability and safety and related equipment to be used, and if they believe anything is unsafe, they will immediately advise a Black Prong Equestrian Village representative of such condition and refuse to participate. The undersigned and/or Participant hereby specifically assume the risk of his/her own negligence in any Equine Activities and any negligence of the Releasees.

The undersigned and/or Participant hereby acknowledge that no medical emergency services are or will be provided by the Releasees during Equine Activities, and if he/she is unable to timely do so for himself/herself or his/her child or legal ward’s behalf, he/she hereby consents, directs and authorizes the Releasees to contact an emergency medical care provider on himself/herself to engage any emergency medical care, diagnosis or transportation as they may deem appropriate for himself/herself or his/her child or legal ward, as the case may be, inclusive of necessary treatment, diagnosis or transportation, whether surgical or otherwise, and that this General Release, Liability Waiver and Assumption of All Risk and Liability extends to any and all liability arising out of, or in any way connected to such provision or emergency medical treatment, diagnosis or transportation. The undersigned and/or Participant hereby agrees to assume all risk and to pay all costs in connection with or associated to such treatment, diagnosis or transportation.

The undersigned and/or the Participant understand that the Releasees did not undertake to provide medical or hospitalization insurance for Participants. The undersigned certifies that the Participant will be covered by his/her own medical and hospitalization insurance while participating in Equine Activities. The undersigned and/or the Participant further states that he/she is cognizant of all of the intrinsic dangers and inherent risks of participation in Equine Activities including the dangers of participating in and observing Equine Activities; that he/she is of lawful age and legally competent to sign this General Release, Liability Waiver and Assumption of All Risk and Liability which he/she has fully read and completely understands; he/she understands the terms herein are contractual and legally binding and not a mere recital; and that this General Release, Liability Waiver and Assumption of All Risk and Liability has been signed as his/her own free act by the Participant or on behalf of the Participant by the parent or legal guardian with whom the undersigned has discussed the nature of the Equine Activities described herein. 

COVID-19 SAFETY INFORMATION:
In order to reduce the risks of exposure to COVID-19, all participants, employees and guests participating in events held at Black Prong Equestrian Village LLC (“Black Prong”) are expected to maintain at least 10 feet of social distance at all times and must wear face coverings, that cover both the nose and mouth in a secure fashion, inside of all buildings and at all times when 10 feet of distance is unable to be maintained. Black Prong has put numerous preventative measures in place to reduce the spread of COVID-19. However, Black Prong cannot guarantee that its guests, participants,volunteers, or others in attendance will not become infected with COVID-19.In light of the ongoing spread of COVID-19, individuals who are experiencing or have experienced symptoms within the previous 72 hours, (including fever, cough, and shortness of breath, among others), who may have been exposed to a confirmed or suspected case of COVID-19 within the previous 14 days, or who have been diagnosed with COVID-19 within the previous 10 days and have not yet been cleared as non-contagious, should not attend events and/or other face
to face group activities. Your signature below and your attendance at the event certifies that you do not fall into any of these categories.
DUTY TO SELF-MONITOR AND SELF-QUARANTINE:
I agree to self-monitor for signs and symptoms of COVID-19 (including fever, cough, and shortness of breath, among others) and to contact Black Prong at (352) 486-1234 if I experience symptoms of COVID-19 or am confirmed to be infected with COVID-19 within 14 days after participating in the event on Black Prong property. If I experience symptoms of COVID-19 during the event I will immediately self-quarantine either in rented space on the property or at an offsite location.
LIABILITY WAIVER AND RELEASE OF CLAIMS:
I hereby forever release and waive my right to bring suit against Black Prong and its affiliates, subsidiaries, owners, officers, directors, managers, officials, trustees, agents, employees, or other representatives (“Released Parties”) in connection with exposure, infection, and/or spread of COVID-19 related to attending an event on Black Prong property and/or utilizing Black Prong’s services. I understand that this waiver means I give up my right to bring any claims including for personal injuries, death, disease or property losses, or any other loss, including but not limited to claims of
negligence and give up any claim I may have to seek damages, whether known or unknown, foreseen or unforeseen.
ASSUMPTION OF THE RISK:
I acknowledge and understand that participation includes possible exposure to and illness from infectious diseases including but not limited to COVID-19. While particular rules and personal discipline may reduce this risk, the risk of serious illness and death does exist; I knowingly and freely assume all such risks related to illness and infectious diseases, such as COVID- 19, even if arising from the negligence or fault of the Released Parties; and I hereby knowingly assume the risk of injury, harm and loss associated with the event, including any injury, harm and loss caused by the
negligence, fault or conduct of any kind on the part of the Released Parties.

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE:

Today's date: May 18, 2021

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 Signature*
Second Participant's Name

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

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

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email
Check to receive information, news, and discounts by e-mail.
A signed copy of this waiver will be sent to the email address you provide.
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 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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!