2024 FHC Waiver and Release (Updated Aug 2023)

Firefly Horse Co. Wellness Retreat Center

Waiver and Release for Equine & Animal Related Activities

Please read the following carefully and indicate your understanding and agreement to these statements by signing below.

I understand and believe that the use, handling, or riding of a horse & other animals involves a risk of physical injury. I further know that any horse and/or animals upon the property, regardless of its training and usual past behavior may act or react unpredictably at any time. With full awareness of the foregoing, I am knowingly and voluntarily engaging in equine activities and/or other animal activities sponsored by Firefly Horse Co. (FHC), their employees, or any of its’ subcontractors. The possibility of injury to myself is accepted as a risk inherent in work with or activities around horses and other animals present; this includes but is not limited to any equipment or arenas / property used in activities with horses and animals that may be present.

I understand that safety in working with horses and misc. animals, whether riding or on the ground, requires mental alertness and a moderate degree of physical fitness.

I agree to abide by and follow facility rules and regulations which are posted on site.

It is recommended that all riders wear protective helmets, which are provided onsite for your convenience. It is REQUIRED that any child younger than 18 years of age MUST wear a helmet when riding. It is my understanding that a helmet is available and has been offered for my own or my child’s safety.

I also understand that I must and will use my own judgement where the situation demands it. I understand that all equine & all animal activities are entirely voluntary and that I may elect not to comply with any suggested act. FHC, any of its’ subcontractors, and other participants, are entitled to my good faith efforts to respond to the exercise directives, but are not entitled to nor expect absolute obedience. It is expected that I will be alert and thinking at all times while engaged in equine & all animal activities.

I have read and understand Montana Code Annotated for Horse Use.

TITLE 27. CIVIL LIABILITY, REMEDIES, AND LIMITATIONS

CHAPTER 1. AVAILABILITY OF REMEDIES -- LIABILITY

Part 7. Liability - Equine Activity Liability Limitations

27-1-727. Equine activity liability limitations. (1) Except as provided in subsections (2) and (3), an equine activity sponsor or an equine professional is not liable for an injury to or the death of a participant engaged in an equine activity resulting from risks inherent in equine activities.

(2) An equine participant shall act in a safe and responsible manner at all times to avoid injury to the participant and others and to be aware of risks inherent in equine activities.

(3) Subsection (1) does not apply:

(a) if the equine activity sponsor or the equine professional:

(i) provided the equipment or tack and the equipment or tack caused the injury because the equine activity sponsor or equine professional failed to reasonably and prudently inspect or maintain the equipment;(ii) provided the equine and failed to make reasonable and prudent efforts to determine the ability of the participant to safely engage in the equine activity and the participant's ability to safely manage the particular equine based on the participant's representations as to the participant's ability;

(iii) owned, leased, rented, or otherwise was in lawful possession and control of the land or facilities upon which the participant sustained injuries caused by a dangerous latent condition that was known or should have been known to the equine activity sponsor or the equine professional;

(iv) committed an act or omission that constituted willful or wanton disregard for the safety of the participant and the act or omission caused the injury; or

(v) intentionally injured the participant; or

(b) in a products liability action.

In consideration of the potential learning and growth value of equine & other animal activities, I the undersigned expressly and voluntarily assume the unavoidable risks inherent in horse related activities mounted and dismounted, as well as other misc. animal related activities. I do hereby release, discharge and hold harmless Firefly Horse Co., LLC and any of its’ subcontractors, including but not limited to Firefly Healing Arts, LLC and Firefly Equestrian Center, LLC from any and all claims which I, the undersigned, or my assigns, may assert as a result of physical injury or loss of property incurred while using, handling or riding a horse, as well as other animal interactions as part of equine & other animal activities on this date or other dates as part of continuing horse & animal use.

My signature on this form constitutes expression of my understanding and agreement to all statements above and my total and unconditional release of Firefly Horse Co and any of its’ subcontractors along with any co-workers or assignsassociated with equine activities.

Date: July 26, 2024

All guests upon Firefly Horse Co. property will need to sign a waiver regardless of their participation in activities. Please select who will be sigining:

Adult Minor(s)Adult and Minor(s)
1 Minor 2 Minors 3 Minors 4 Minors 5 Minors More Minors 6 Minors 7 Minors 8 Minors 9 Minors 10 Minors

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First Name

First Name*

Middle Name

Last Name*

Phone*

First Date of Birth*

First Media Use Agreement

My photo or video may be taken and used for any media, advertising, or marketing associated with Firefly Horse Co. and/or Firefly Healing Arts including but not limited to; social media platforms, websites, online advertisements, paper advertisements, etc.

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

First Signature*

Type Signature

Draw Signature

Click to Sign

Second Name

First Name*

Middle Name

Last Name*

Second Date of Birth*

Second Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Third Name

First Name*

Middle Name

Last Name*

Third Date of Birth*

Third Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Fourth Name

First Name*

Middle Name

Last Name*

Fourth Date of Birth*

Fourth Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Fifth Name

First Name*

Middle Name

Last Name*

Fifth Date of Birth*

Fifth Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Sixth Name

First Name*

Middle Name

Last Name*

Sixth Date of Birth*

Sixth Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Seventh Name

First Name*

Middle Name

Last Name*

Seventh Date of Birth*

Seventh Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Eighth Name

First Name*

Middle Name

Last Name*

Eighth Date of Birth*

Eighth Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Ninth Name

First Name*

Middle Name

Last Name*

Ninth Date of Birth*

Ninth Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Tenth Name

First Name*

Middle Name

Last Name*

Tenth Date of Birth*

Tenth Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Parent or Guardian's Email Address

Email*

Confirm Email*

Check to receive information, news, and discounts by e-mail.

Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

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*

Middle Name

Last Name*

Relationship*

Phone*

Parent or Guardian's Date of Birth*

Parent or Guardian's Media Use Agreement

Please select "I decline" if you do not agree with your photo being used for advertising or marketing. 

Do you agree to let Firely Horse Co. use any photos or videos of you for any media/marketing purposes?*

Parent or Guardian's Signature*

Type Signature

Draw Signature

Click to Sign

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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