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WAIVER, RELEASE AND INDEMNIFICATION AGREEMENT WITH COVENANT NOT TO SUE

To induce Birchview Stables, LLC, Alexandra Binetti, Pasquale Binetti, John Flowers, Pixshire, LLC and their agents, servants and employees (all of said parties are hereinafter collectively called the “Indemnified Parties”) to allow the use of the facilities at the property located at 2420 Conns Creek Rd., Ball Ground, GA 30107 and known as Birchview Stables (the “Property”) and in consideration of the use of the same, the undersigned, by executing this writing, agrees to hold harmless, discharge, release, and indemnify the Indemnified Parties with respect to any and all claims, causes of action, injuries, damages, costs, expenses and losses of any one or more of the Indemnified Parties (including, but not limited to, reasonable attorneys’ fees) arising out of or in any way connected with any activities at the Property or use of the facilities at the Property or use of the facilities at the Property by myself, my spouse, my family, my children, my friends, the rider indicated at the end of this form and/or guest spectators accompanying any of said persons to the Property. The foregoing indemnity includes, but is not limited to, any and all damage, loss, or injury of any kind to any horse or other property or person (whether on or off the facilities of the Property and whether or not any such liability, damage, cost or loss shall be due to acts or omissions of any one or more of the Indemnified Parties) and for all losses, costs, claims, injuries, damages, expenses and causes of action arising out of any use of the facilities of the Property, of riding horses on or off the facilities of the Property, and of boarding horses with or at the Property.

The undersigned acknowledges the inherent risks associated with the sport of equestrian without limitation including serious bodily injury, sickness and disease (including communicable diseases), pain and suffering, permanent disability, paralysis and death arising out of the unpredictable behavior of horses.

If the participant is under 18 years of age, I, the undersigned, as the parent or legal guardian of the minor, hereby consent to the minor’s participation in activities at the Property. I acknowledge the risks associated with equestrian activities and agree to all terms set forth in this Waiver, Release, and Indemnification Agreement on behalf of the minor. I further agree to indemnify and hold harmless the Indemnified Parties for any claims or liabilities that may arise from the minor’s participation, even if caused by the ordinary negligence of the Indemnified Parties.

In the event of an injury or medical emergency involving myself or my child while on the Property, I authorize the Indemnified Parties to secure any necessary medical treatment, including transportation to a medical facility. I understand that I am solely responsible for any costs incurred for such treatment and transportation, and I agree to indemnify and hold the Indemnified Parties harmless from any liability relating to such medical care.

I grant permission to Birchview Stables, LLC and its representatives to take photographs and/or video recordings of myself and/or my child while on the Property. I understand these images may be used for promotional purposes, including but not limited to websites, social media, flyers, and newsletters. I waive any rights to compensation or ownership of such materials.

Further, the undersigned AGREES NOT TO SUE or pursue any legal or equitable action against anyone or more of the Indemnified Parties with respect to any claims, causes of action, injuries, damages, costs or expenses, or losses to myself, my spouse, my family, my children, my friends, the rider indicated at the end of this form and/or guest spectators accompanying any of the above persons to the Property arising out of or in any way connected with the use of the facilities of the Property. Said covenant not to sue shall include, but not be limited to, any and all damage, loss or injury of any kind to my horse(s) or other property or persons (whether on or off the facilities of the Property, and whether any such liabilities, damage, cost or loss shall be due to acts or omissions of one or more of the Indemnified Parties). In addition, the Indemnified Parties shall not be liable for any loss due to accident, illness, fire, or theft. It is the responsibility of the undersigned to carry full and complete insurance coverage on his horse, personal property and himself.

If any provision of this Agreement is found to be invalid or unenforceable under applicable law, such provision shall be ineffective to the extent of such invalidity only, without affecting the remaining provisions of this Agreement, which shall remain in full force and effect.

Further, the undersigned acknowledges and agrees that the activities on and about the Property include horses which may, from time to time, become “spooked” and cause damage or injury to the rider, other persons and property. The undersigned hereby acknowledges that he or she is knowledgeable about the risks of such animals and assumes the risk of any injury or damage caused by any horse on or about the Property.  

WARNING
UNDER GEORGIA LAW, AN EQUINE ACTIVITY SPONSOR OR EQUINE PROFESSIONAL IS NOT LIABLE FOR ANY INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES PURSUANT TO CHAPTER 12 OF TITLE 4 OF THE OFFICIAL CODE OF GEORGIA ANNOTATED.

First Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Phone*
First Owner/Rider/Participant Age Acknowledgment*
First Owner/Rider/Participant Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Owner/Rider/Participant Signature*
Second Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Owner/Rider/Participant Date of Birth*
Date of Birth
Third Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Owner/Rider/Participant Date of Birth*
Date of Birth
Fourth Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Owner/Rider/Participant Date of Birth*
Date of Birth
Fifth Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Owner/Rider/Participant Date of Birth*
Date of Birth
Sixth Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Owner/Rider/Participant Date of Birth*
Date of Birth
Seventh Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Owner/Rider/Participant Date of Birth*
Date of Birth
Eighth Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Owner/Rider/Participant Date of Birth*
Date of Birth
Ninth Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Owner/Rider/Participant Date of Birth*
Date of Birth
Tenth Owner/Rider/Participant Name
First Name*
Middle Name
Last Name*
Owner/Rider/Participant Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Check to receive information, news, and discounts by e-mail.
Owner/Rider/Participant 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:*

PARENTAL/LEGAL GUARDIAN [IF PARTICIPANT IS UNDER 18 YEARS OF AGE]:

I hereby certify that I am the parent or legal guardian of the child whose signature appears above.



By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name
First Name*
Middle Name
Last Name*
Relationship*
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 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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