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Lesson Registration Form

 

Release Form for Media Recording

I, the undersigned, do hereby consent and agree that Erin Valley Riding Stables/Doug Mills Horsemanship, its employees, or agents have the right to take photographs, videotape, or digital recordings of me beginning on June 26, 2022 and ending on (date specified by business) and to use these in any and all media, now or hereafter known, and exclusively for the purpose of advertising. I further consent that my name and identity may be revealed therein or by descriptive text or commentary.

I do hereby release to Erin Valley Riding Stables/Doug Mills Horsemanship, its agents, and employees all rights to exhibit this work in print and electronic form publicly or privately. I waive any rights, claims, or interest I may have to control the use of my identity or likeness in whatever media used.

I understand that there will be no financial or other remuneration for recording me, either for initial or subsequent transmission or playback.

I also understand that Erin Valley Riding Stables/Doug Mills Horsemanship is not responsible for any expense or liability incurred as a result of my participation in this recording, including medical expenses due to any sickness or injury incurred as a result.

I represent that I am at least 19 years of age, have read and understand the foregoing statement, and am competent to execute this agreement. 

Waiver will be valid from January 1st 2022 - January 1st 2023

You are not required to sign photo/video consent.

 

 

ASSUMPTION OF RISKS, RELEASE OF INTEREST, WAIVER OF CLAIM AND INDEMNITY AGREEMENT BY SIGNING THIS DOCUMENT YOU WILL WAIVE CERTAIN LEGAL RIGHTS INCLUDING THE RIGHT TO SUE PLEASE READ CAREFULLY!

Participants under the age of 19 must have a parent or guardian sign below.

TO: DOUG MILLS & LYNETTE MILLS DBA ERIN VALLEY RIDING STABLE & TRAINING THRU TRUST (REFERED TO IN THIS AGREEMENT AS THE “PROVIDER”)

AND TO: ALL PROPERTY OWNERS (PRIVATE, FEDERAL, PROVINCIAL, REGIONAL AND MUNICIPAL)

ASSUMPTION OF RISKS: I am aware and understand that activities involving these horses involve many risks, dangers and hazards, including, but not limited to the following:

  1. Horses, which are powerful and potentially dangerous animals, may change their behavior at any time and may, without warning, jump, run wildly, buck, kick, bite or step on people or things;
  2. Horses may collide with other horses or objects or trip, stumble or fall even if being led, ridden, or attended to;
  3. Negligence (which means, in general terms, a failure to exercise ordinary or proper care) of other riders or my or my child’s own failure to ride safely within my or my child’s ability or within designated areas and trails;
  4. Equipment may fail;
  5. Weather conditions can change and can sometimes be dangerous;
  6. The nature of the terrain can change and has certain risks associated with it including, but not limited to, exposed natural objects, trees, streams and creeks;
  7. The activities can sometimes be in remote areas and injuries or illness may occur and it may be a considerable distance to doctors, hospitals, or any other type of assistance; and Customer Witness
  8. Negligence on the part of A PROPERTY OWNER AND/OR THE PROVIDER OR THEIR STAFF. 

I am also aware that the risks, dangers and hazards referred to above exist throughout the trail, stable, practice and
other areas and many are unmarked. I understand and acknowledge that no amount of caution, experience and
instruction can eliminate all of the risks involved and I freely accept and fully assume all such risks, dangers and hazards and the possibility of personal injury, death, property damage and damages or loss resulting there from.

 

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND INDEMNITY AGREEMENT: In consideration of the Provider providing me or my child with their horses or sleigh riding and other services and permitting my or my child’s use of their equipment, and other facilities and the Property Owners providing me or my child with the use of their property (hereinafter collectively referred to as “the Services”), I hereby agree as follows:

  1. TO WAIVE ANY AND ALL CLAIMS that I or my child have or may in the future have against a Property Owner or the Provider, and their directors, officers, employees, agents, representatives, and volunteers (all of whom are hereinafter collectively referred to as (“THE RELEASEES”) and TO RELEASE THE RELEASEES from any and all liability for any loss, damage, injury or expense that I or my child may suffer, or that my or my child’s next of kin may suffer as a result of my or my child’s use of the services or due to any cause whatsoever, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OR CARE INCLUDING ANDY DUTY OF CARE OWED UNDER THE “OCCUPIERS LIABILITY ACT” ON THE PART OF THE RELEASEES;
  2. TO HOLD HARMLESS AND INDEMNIFY THE RELEASEES from any and all liability for any damages to the property of or personal injury to any third party resulting from my or my child’s use of the services;
  3. This Agreement shall be effective and binding upon my or my child’s heirs, next of kin, executors, administrators, assigns the representativesin the event of my or my child’s death or incapacity;
  4. This Agreement shall be governed by and interpreted in accordance with the laws of the province of B.C. and;
  5. Any litigation involving the parties to this Agreement shall be brought within the Province of B.C.

PROTECTIVE HEAD GEAR & RIDING BOOTS: Only students over the age of 19 can decline a helmet

  1. Proper riding footwear is required by all persons, regardless of age, participating in any horse related activities;
  2. ALL MINORS (horseback riders under 19 years of age) are required to wear protective head gear in the form of a high impact helmet and proper footwear;
  3. IT IS HIGHLY RECOMMENDED THAT ALL HORSEBACK RIDERS 19 YEARS OF AGE WEAR A HIGH IMPACT HELMET;
  4. I (we) decline to wear a helmet(s)
    Signature of Customer

In entering into this Agreement, I am not relying upon any oral or written representations or statements made by the 

Releasees other than what is set forth in this Agreement.

I HAVE READ AND UNDERSTOOD THIS AGREEMENT AND I AM AWARE THAT BY SIGNING THIS AGREEMENT, FROM THIS DAY FORWARD, I AM WAIVING CERTAIN LEGAL RIGHTS WHICH I, MY CHILD, MY HEIRS, NEXT OF KIN, EXECUTORS, ADMINISTRATORS, ASSIGNS AND/OR REPRESENTATIVES MAY HAVE AGAINST THE RELEASEES.

Waiver will be valid from January 1st, 2022- January 1st, 2023

Today's Date: June 26, 2022

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

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

First Name*

Middle Name

Last Name*
Tenth Participant's 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*
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Emergency Contact

Emergency Contact's Name*

Emergency Contact's Phone Number*
Additional Information
Sex:
Female
Male
Other

Work Number:

Care Card (MSP) Number:
Does the participant have any allergies we need to know about?*
Yes
No

If yes, please specify:
Does the participant require any medication?*
Yes
No

If yes, please specify:

Goals for lesson:
Please check this box if you would like to be added to our email list!

How did you hear about us?
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 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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