Loading...

Liability Release for Equine Activities with Stable Space, LLC

IN CONSIDERATION OF the risk of injury that exists due to inherent risks of participating in equine activities as part of Stable Space Women's Retreat, "Whoa Girl" (hereinafter the "Activity") by Stable Space LLC; and

IN CONSIDERATION OF my desire to participate in said Activity and being given the right to participate in same; 

I HEREBY, for myself, my heirs, executors, administrators, assigns, or personal representatives (hereinafter collectively, "Releasor," "I" or "me", which terms shall also include Releasor's parents or guardian if Releasor is under 18 years of age), knowingly and voluntarily enter into this WAIVER AND RELEASE OF LIABILITY and hereby waive any and all rights, claims or causes of action of any kind arising out of my participation in the Activity; and

I HEREBY release and forever discharge Stable Space LLC, located at 4914 N Kenwood Ave, Indianapolis, IN 46208, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns (collectively "Releasees"), from any physical or psychological injury that I may suffer as a direct result of my participation in the aforementioned Activity.

WARNING: Under Indiana Law, an equine professional is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities.

I am voluntarily participating in the aforementioned activity and i am participating in the activity entirely at my own risk. I am aware of the inherent risks of equine activities associated with participating in this activity, which may include, but are not limited to:

  • the propensity of an equine to behave in ways that may result in injury or harm to persons on or around the equine;
  • the unepredictability of an equine's reaction to such things as sound, sudden movement, unfamiliar objects, people, or other animals
  • hazards such as surface and subsurface conditions;
  • collisions with other equines or objects; and
  • the potential of a participant to act in a negligent mannger that may contribute to injury to the participant or others

I FURTHER AGREE to indemnify, defend and hold harmless the Releasees against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney's fees and any related costs. 

I FURTHER ACKNOWLEDGE that Releasees are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Releasees. In the event that I should require medical care or treatment, I authorize to provide all emergency medical care deemed necessary, including but not limited to, first aid, CPR, the use of AEDs, emergency medical transport, and sharing of medical information with medical personnel. I further agree to assume all costs involved and agree to be financially responsible for any costs incurred as a result of such treatment. I am aware and understand that I should carry my own health insurance. 

I HEREBY ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS "WAIVER AND RELEASE" AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY. I EXPRESSLY AGREE TO RELEASE AND DISCHARGE STABLE SPACE LLC AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST FOR PERSONAL INJURY OR PROPERTY DAMAGE.

To the extent that statute or case law does not prohibit releases for ordinary negligence, this release is also for such negligence on the part of Stable Space LLC, its agents, and employees.

I agree that this Release shall be governed for all purposes by law, without regard to any conflict of law principles. This Release supersedes any and all previous oral or written promises or other agreements.

In the event that any damage to equipment or facilities occurs as a result of my or my family's or my agent's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any such actions of neglect or recklessness.

THIS WAIVER AND RELEASE OF LIABILITY SHALL REMAIN IN EFFECT FOR THE DURATION OF MY PARTICIPATION IN THE ACTIVITY, DURING THIS INITIAL AND ALL SUBSEQUENT EVENTS OF PARTICIPATION.

Cornerstone Equestrian Services

CORNERSTONE EQUESTRIAN SERVICES, LLC WAIVER, AGREEMENT, AND LIABILITY RELEASE

 

I agree to this agreement with Cornerstone Equestrian Services, LLC, Emma Meeks, Matthew Meeks, and any other instructor or individual with Cornerstone Equestrian Services (hereafter referred to as “stable”) as a condition for his/her/its/their allowing me and the persons identified below (if any), to do any or all of the following at any time and any location: enter Stable’s premises, land, facilities, barns, arenas, paddocks, pastures, and surrounding land; be near horses, ponies, mules, donkeys (hereafter “equines”), work with, handle, ride, drive, and/or receive instruction or guidance related to riding, driving, handling and/or working with equines. (All of these activities individually and collectively will be referred to as “the activities”).

All parts of this document apply to me and each of the children or legal wards included in this document

IT IS AGREED AS FOLLOWS:

1.        Consideration/Binding Effect. I have voluntarily requested to engage in any or all of the activities and I am signing this document in consideration for being allowed to engage in any or all of the activities now and in the future. I understand that although I am signing this document today, I intend it to be valid and binding when I engage in any or all of the activities at any time in the future and at any location.

2.        Risks of equine activities. I understand that anyone riding, driving, handling, working with, or even near an equine can suffer bodily and other injuries. Among other things, equines are unpredictable by nature. For example, when frightened, angry, or under stress, the natural instincts of an equine are to jump forward or sideways, back up quickly, or run away from real or perceived danger by trotting or galloping. Equines also have the ability to kick, buck, rear up, spin around, strike or bite. I know that equines can do these and other things without warning. I also understand that equines, even if they have no history of hurting anyone, are powerful and have the potential to be dangerous to people, equines, and other animals. I also understand that riding, driving, handling, working with or even being near equines can expose me to numerous hazards, which could include dangers or conditions which are an integral part of equine activities, including, but not limited to: (1) The propensity of an equine to behave in ways that may result in injury, harm, or death to persons on or around the equine; (2) The unpredictability of an equine’s reaction to such things as sound, sudden movement, unfamiliar objects, people, or other animals; (3) Hazards such as surface and subsurface conditions; (4) Collisions with other equines or objects; (5) The potential of a participant to act in a negligent manner that may contribute to injury to the participant or others such as failing to maintain control over the animal or not acting within the participant’s ability. I understand these risks and dangers that are inherent in equine-related activities, and I agree to assume all of them. I also understand that these are just some of the risks, and I agree to assume others that are not mentioned in this document. I am NOT relying on Stable to list all possible equine-related risks in this document or any time now or in the future.

 

3. WAIVER AND LIABILITY RELEASE: As consideration for being allowed to engage in any or all of The Activities, now and in the future and at any location, I (on behalf of myself and my spouse, parents, heirs, representatives, assigns, minor child/ren or legal wards) am voluntarily agreeing to each of the following: (a) Stable and his/her/its/their respective officers, directors, members, managers, employees, agents, heirs, family members, assigns, representatives, affiliated persons, and others acting on their behalf (hereafter referred to collectively as “The Released Parties”) shall not be liable for any losses, injuries, or damages that I (which includes the signer and signer’s minor child/children or legal wards) may sustain as a result of engaging in any of The Activities at any time or at any location; and (b) I fully and forever release, waive, agree not to sue, and discharge all claims, demands, damages, legal actions, omissions, causes of action, or rights of action (whether they occur now or in the future, and whether they are known or unknown, anticipated or unanticipated) against The Released Parties, whether caused by their ordinary negligence, a violation of a provision of the Indiana Activity Liability Act, or other legal liability resulting from or arising out of my/our engaging in The Activities at any time and at any location. The term "damages" means, for example, medical expenses all claims or losses because of bodily injuries, mental/emotional injuries, or property damages, death, expenses, and/or personal property damages. This document is intended to apply and be binding regardless of whether I am riding, driving, handling, or near equines. (However, it is understood that I am not releasing any of these parties from liability for injuries that are directly caused by their gross negligence, willful and wanton misconduct, willful negligence, reckless conduct, or intentional wrongdoing.)

 

4. INDEMNIFICATION. To the fullest extent permitted by law, I also agree to indemnify and hold harmless The Released Parties against any and all claims, demands, actions, liabilities, losses, or suits that are brought against The Released Parties (or either of them) which are in any way connected with my/our participation in any of The Activities at any time and at any location, including claims that allege acts or omissions of The Released Parties that are negligent or in violation of a state Equine Activity Liability Act. This indemnification shall also include reimbursement of reasonable attorney fees incurred by Stable or by others on its behalf.

 

5. Helmets. I understand that, for my own protection, I should purchase and wear properly fitted and secured ASTM-standard/SEI-certified protective headgear that is designed for use when riding, driving, or near equines. I am NOT relying on Stable to provide headgear, to check headgear I may wear, or to monitor my compliance with this suggestion at any time.

 

6. Indiana law applies to this document, and I agree that this document shall be enforced to the greatest extent permitted by law. If any clause conflicts with applicable law, only that clause will be null and void, but the remainder shall stay in full force and effect. This document can only be modified in writing and signed by me and Cornerstone Equestrian Services, LLC (on behalf of Stable). I agree to pay any attorney fees and costs for The Released Parties (or either of them) to enforce this Agreement, and I agree to indemnify and hold harmless The Released Parties for such fees and costs. I acknowledge that I have carefully read this “waiver and release” and fully understand that it is release of liability. I expressly agree to release and discharge Cornerstone Equestrian Services, LLC from any and all claims or causes of action and I agree to voluntarily give up or waive any right that I may otherwise have to bring a legal action against Cornerstone Equestrian Services, LLC for personal injury or property damage. To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence. If any portion of this release from liability shall be deemed by a Court of competent jurisdiction to be invalid, then the remainder of this release from liability shall remain in full force and effect and the offending provision or provisions severed here from.

First Participant's Name
First Name*
Last Name*
Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
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*
Participant's Date of Birth*
Date of Birth
Third Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fourth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Fifth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Sixth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Seventh Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Eighth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Ninth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Tenth Participant's Name
First Name*
Last Name*
Participant's Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email*
Confirm Email*
Participant's phone number
Phone number
Photo Release

During activities, we take photographs involving participants to share with the community, by which incidentally, some photographs may capture your participation, directly or indirectly.

These photos may be published through our website, social media pages, news bulletins, and ads.

With this, we seek for your consent in allowing us to publish photos to above platforms.

Do you give consent to be photographed and or videoed?*
Yes
No
Payment/Cancellation

Financial Commitment

I agree to submit the full payment of $175 via the Square link that Stable Space sends to my email. Registration is not final until the payment is made. Please contact kathleen@stablespace.org if needing to make a special arrangement.

Cancellation Policy

In order to honor the time and commitment of our facilitators, clients, and equine partners, we ask that you provide at least 1 week notice if you need to cancel. In this case, you will receive a 50% refund.

Cancellations made with less than 1 week's notice will not receive a refund, except in the case of emergencies.

We appreciate your understanding and cooperation in helping us maintain a respectful and reliable schedule for all participants.

I understand the above information regarding payment and cancellation*
No
Yes
Have you ever been investigated for, charged with, or convicted of animal cruelty or neglect?"
The safety of our animals is of utmost importance*
No
Yes
Emergency Contact
First Name*
Last Name*
Emergency Contact's Phone Number*
Emergency Contact's Relation to Participant
Pronouns

We honor each individual's identity and strive to foster safety and belonging for all.

Pronouns
Pronouns if not listed above
Participant's Occupation/Vocation
Occupation or Vocation
Allergies
Please list any allergies or answer N/A *
Describe your previous experience with horses, if any:
Horse experience
Health
Physical limitations or health conditions that may impact participation in retreat activities (optional)
What are your personal strengths?
Strengths
What are your personal challenges?
Challenges
I would like to grow in the following areas:
communication
confidence
decision making
emotional boundaries
emotional regulation
exploring a life dream
independence
leadership
mindfulness
navigating a life transition
positive relationships
self-awareness
self-belief
self-care
Other
What else would you like us to know about you?
What's important for us to know?
How did you hear about Stable Space?
Referral from teacher
Facebook
Instagram
Friend or family member
Referral from therapist, doctor, or teacher
Referral from social agency
Other
If other, please list here
Please describe any dietary restrictions or preferences
Dietary restrictions or preferences
I understand that this retreat is not therapy nor intended to be therapy
Click to customize question*
No
Yes
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*
Relationship*
Phone*
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.


One or more problems exist. Please scroll up.




Powered by  Smartwaiver - TRY IT FREE!