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2021 Wichita Riding Academy, Inc. RELEASE FORM

Please fill all information out completely before signing.

WARNING

Under Kansas law, there is no liability for an injury to or the death of a participant in domestic animal activities resulting from the inherent risks of domestic animal activities, pursuant to sections 1 through 4, Chapter 290, 1994 Session Laws of Kansas. You are assuming the risk of participating in this domestic animal activity.
Inherent risks of domestic animal activities include, but shall not be limited to:

  1. the propensity of a domestic animal to behave in ways i.e., running, bucking, biting, kicking, shying, stumbling, rearing, falling or stepping on, that may result in an injury, harm or death to persons around them;
  2. the unpredictability of a domestic animal’s reaction to such things as sound, sudden movement and unfamiliar objects, persons or other animals;
  3. certain hazards such as surface and subsurface conditions;
  4. collisions with other domestic animals or objects; and
  5. the potential of a participant to act in a negligent manner that may contribute to injury to the participant of others, such as failing to maintain control over the domestic animal or not acting within such participant’s ability.

RELEASE-ASSUMPTION OF RISK
PLEASE READ CAREFULLY AND FILL OUT COMPLETELY BEFORE SIGNING

I acknowledge that there is the possibility of injury when riding or working with horses. I hereby release WICHITA RIDING ACADEMY, INC., its executives, owners, employees and all their heirs from any and all liability for any injuries that I may receive while preparing to ride; mounting; riding; dismounting; or returning the horse; and any other activities not enumerated, but which may pertain to my “riding” a horse and/or visiting WRA, Inc. This release is total and without reservation on my part.

I fully understand the danger of this activity and the possible harm which may result. I further understand that by signing this document that I am releasing my rights to seek recovery from the WICHITA RIDING ACADEMY, INC., its owners, executives, employees and their heirs. I also acknowledge that this total waiver shall operate to prevent my spouse, or my heirs from pursuing any such action arising out of this activity. 

By signing this form, I acknowledge that I have read this form and understand it.

PHOTOGRAPHY CONSENT FORM / RELEASE

I, ("participant"), hereby grant permission to Wichita Riding Academy, Inc. representatives, to take and use: photographs and/or digital images of me or my minor child for use in news releases and/or educational materials. These materials might include printed or electronic publications, Web sites or other electronic communications. I further agree that my name and identity may be revealed in descriptive text or commentary in connection with the image(s). I authorize the use of these images without compensation to me. All negatives, prints, digital reproductions shall be the property of Wichita Riding Academy, Inc.

Barn Rules

  • NO Smoking —NO Drugs—NO Alcohol
  • Use common sense.
  • No pets.
  • Do not feed or pet horses through the stall fronts. A A release form must be signed to ride.
  • Boarders are responsible for friends they bring to WRA. They must have a signed release form on file and comply with barn rules.
  • Hard hats are required for all riders Under 18 yr. of age.
  • Adults wishing to ride without a hard hat must be signed an additional release. 
  • WRA strongly recommends the use of hard hats at all times.
  • Children under 7 must have adult supervision at all times. A Practice safe behavior around horses at all times.
  • No running, screaming or playing in or around the stall area.
  • Do Not use Cell phones/ipods/electronic devices when working with or around horses.
  • Please keep gates, stall and office doors closed.
  • No gum or candy in your mouth while riding.
  • You must provide written permission to ride or handle another person’s horse or tack.
  • Riders are required to ride in long pants and boots.
  • Do not ride horses in halters or leads-except in round pens.
  • Do not ride on grass areas when wet.
  • Do not ride or tie horses in areas with loose horses
  • Do not tie horses up in the barn aisle.
  • Accidents or injuries must be reported to Instructors immediately.
  • Pick up after yourself and label all your tack.
  • WRA horses are not allowed off WRA property.
  • Customers are asked to please comply with barn hours and rules.
  • Each customer is responsible for family & guests, ensuring rules are followed for their safety.

I have read and agree to abide by the WRA Barn Rules and Lesson Handbook.

Barn Hours Monday-Friday 8:00 a.m. - 8:00 p.m. Saturday 8:00 a.m. - 6:00 p.m. Sunday Noon - 6:00 p.m.

Welcome to our barn and enjoy the horses!

Today's Date: November 29, 2021

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

Riding Experience *
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

Riding Experience *
Third Participant's Name

First Name*

Middle Name

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

Riding Experience *
Fourth Participant's Name

First Name*

Middle Name

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

Riding Experience *
Fifth Participant's Name

First Name*

Middle Name

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

Riding Experience *
Sixth Participant's Name

First Name*

Middle Name

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

Riding Experience *
Seventh Participant's Name

First Name*

Middle Name

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

Riding Experience *
Eighth Participant's Name

First Name*

Middle Name

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

Riding Experience *
Ninth Participant's Name

First Name*

Middle Name

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

Riding Experience *
Tenth Participant's Name

First Name*

Middle Name

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

Riding Experience *
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

Emergency Contact's Name*

Emergency Contact's Phone Number*
Additional Information

Alternate Contact:

Phone:

Family Physician:

Phone:

Additional Important Information:

Please ask to join our Facebook page just for WRA Customers to stay up to date on all the happenings at Wichita Riding Academy, Inc. Our page is "Customers at Wichita Riding Academy, Inc."

The undersigned declares that the undersigned is the parent or legal guardian of the minor named below. The undersigned has read the foregoing Release and Indemnity Agreement and in consideration of Wichita Riding Academy, Inc. allowing such minor entry onto its premises and/or allowing such minor to participate in equestrian activities, hereby agrees that all of the terms and conditions contained herein shall apply to such minor and shall be binding upon the undersigned and the minor. The undersigned declares under penalty of perjury under the laws of the State of Kansas, that the foregoing is true and correct.
Parent or Guardian's Name

First Name*

Middle Name

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information

Riding Experience *
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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