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FAR WEST FARMS

CALABASAS, CA

(818) 591-2180

Rider Information & Agreements Form


LIABILITY RELEASE, PLEASE READ CAREFULLY *

The undersigned recognizes that horse boarding, riding, training, breeding and related activities are by their nature hazardous and enters into such activity voluntarily and agrees to assume the risks inherent in such activities.


I/We hereby agree to assume all responsibility and risk from the participation in equestrian activities at Far West Farms and further agree to hold Far West Farms and its teachers, counselors, trainers and employees free from all damages or liability for any injury to person or property arising as a result of this participation.

May 8, 2024

MEDICAL RELEASE, PLEASE READ CAREFULLY *

The undersigned, parents of students, a minor, do hereby consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital service that may be rendered to said minor under the general or specific instructions of any physician or hospital. It is understood that this consent is given in advance of any specific diagnosis or treatment which may be required, but is given to encourage the Far West Farms’ staff, and such physician to exercise their best judgment as to the requirements of such diagnosis or treatment. The undersigned shall pay all fees for doctors, hospitals, ambulances and other medical charges reasonable and necessarily incurred.

May 8, 2024


ACKNOWLEDGEMENT OF AGREEMENT *

I WAS GIVEN AND HAVE READ THE FAR WEST FARMS POLICY ON RIDING LESSONS, CANCELLATIONS, RESCHEDULING & THE LATE POLICY, WEIGHT HEIGHT & AGE RESTRICTION, AND THAT RIDING SCHOOL HALF LEASES ARE AVAILABLE.




INSTRUCTIONS:

Important! For families, please put all members on the same waiver. If the adult in the family is not riding, simply select "minors". If the adult in the family is riding, please select "Adult" and "Minors".





First Rider's Name

First Name*

Last Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
First Rider's Signature*
Second Rider's Name

First Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
Third Rider's Name

First Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
Fourth Rider's Name

First Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
Fifth Rider's Name

First Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
Sixth Rider's Name

First Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
Seventh Rider's Name

First Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
Eighth Rider's Name

First Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
Ninth Rider's Name

First Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
Tenth Rider's Name

First Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
Parent or Guardian's Email Address

Email
A signed copy of this waiver will be sent to the email address you provide.
Rider'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:*
Photo Release - Please Read Carefully
Far West Farms requests permission to display photos/images/videos of you and/or your child on the Far West Farms website - farwestfarms.com, as well as our Youtube and social media accounts. In granting this permission you understand that Far West Farms may use photos/images/videos of you and/or your child for purposes such as celebrating achievements and publicizing events, as deemed appropriate by Far West Farms staff. You further understand that you and/or your child’s name or other personally identifiable information will not be used with any photo/image/video. You sign this release form with the knowledge that any photos/images/videos posted on the Far West Farms website and social media can be downloaded and reprinted by various news organizations, including print, electronic and broadcast media, and therefore, release Far West Farms from any liability arising from use of you and/or your child’s photos/images/videos in Far West Farms web and social media postings. You further understand that if you wish to not consent to this agreement, you may do so by selecting the "I Do Not Grant Permission" checkbox below. *
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.


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*

Last Name*

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

Rider's Height *

Rider's Weight *

Riders Experience Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both) *

Riders Allergies Please List All Allergies Separated by Commas *
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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