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Participant Release, Waiver, and Assumption of Risk

EQUINE RELATED ACTIVITIES

PLEASE READ CAREFULLY

WARNING: UNDER FLORIDA LAW, AN EQUINE ACTIVITY SPONSOR, EQUINE PROFESSIONAL, OR ANY OTHER PERSON OR LEGAL ENTITY IS NOT LIABLE FOR AN INJURY TO, OR THE DEATH OF, A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES.

In consideration for participation in activities, to include trail riding and/or carriage riding (“Equine Activities”) provided by Black Prong Adventures LLC taking place at the Black Prong Equestrian Village, I, on my own behalf or on behalf of my minor child (“Participant”), our respective heirs, next of kin, dependents, representatives, executors, administrators, successors or assigns, HEREBY FOREVER Release, IndemnifY and Hold Harmless Black Prong Adventures LLC, Black Prong Equestrian Village LLC, 6851 LLC, 0951 LLC, and their respective members, managers, representatives, volunteers, agents and employees (“Releasees”), from any cause of action, claims or demands of any nature whatsoever (including, but not limited to actions for costs and/or attorney’s fees) which I, or any person or entity on my behalf, may now have, or have in the future, against the Releasees on account of personal injury, loss, property damage, or accident of any kind, including death, arising out of my or my minor child’s participation in Equine Activities.                      

I understand that by signing this Release, I covenant and agree that I, as well as my heirs, next of kin, dependents, representatives, executors, administrators, successors or assigns, will never institute any suit or action at law or otherwise against the Releasees or in any way aid in the institution or prosecution of any claim, demand, action or cause of action for damages, costs, loss of services, expenses or compensation for or on account of any damage, loss or injury either to my or my minor child’s person or property or both, or death, which may result from my or my minor child’s participation in Equine Activities. I am hereby given notice of risk intrinsic and inherent in equine activities, including Equine Activities, including (i) the propensity of an equine to behave in dangerous ways which may result in injury to me or my minor child; (ii) the inability to predict an equine's reaction to sound, movements, objects, persons, or animals; and (iii) hazards of surface and subsurface conditions. I specifically assume this risk and the risk of acts or omissions that constitute negligence for the safety of me or my minor child by the Releasees, whether or not related to the preceding enumerated intrinsic dangers and inherent risks.        

I understand and acknowledge that the Releasees do not provide medical services or emergency transportation during Equine Activities, and that participation in Equine Activities may occur in environments where access to emergency medical services may be delayed. I understand that, in the event of an emergency, Releasees’ staff, guides, or representatives may, but are not required to, provide limited emergency assistance, including basic first aid and, where appropriate, administration of epinephrine in any available form or delivery method, if available. I acknowledge that any such assistance is voluntary, discretionary, and not a substitute for professional medical care. I hereby expressly authorize the Releasees to administer emergency first aid and/or epinephrine to me, my minor child, or any member of my party, in the event of a suspected or perceived medical emergency, and to contact emergency medical responders as deemed appropriate. I agree to assume all risks associated with such emergency assistance and to release and hold harmless the Releasees from any claims arising out of or related to the provision or non-provision of emergency first aid or epinephrine administration, except to the extent prohibited by law. I further agree to assume all costs associated with emergency medical treatment, transportation, or related care.

I am cognizant of all of the intrinsic dangers and inherent risks of participation in Equine Activities including the dangers of participating in and observing Equine Activities; I am of lawful age and legally competent to sign this Participant Release, Waiver and Assumption of Risk which I have fully read and completely understand; I understand the terms herein are contractual and legally binding and not a mere recital; and I confirm that this Participant Release, Waiver and Assumption of Risk has been signed under free will by me for myself or on behalf of my minor child.

I HAVE CAREFULLY READ AND FULLY UNDERSTAND ALL PROVISIONS OF THIS RELEASE, AND FREELY AND KNOWINGLY ASSUME THE RISK AND WAIVE MY RIGHTS CONCERNING LIABILITY AS DESCRIBED ABOVE:

First Rider Name
First Name*
Last Name*
First Rider Age Acknowledgment*
First Rider Date of Birth*
Date of Birth
I certify that I am 18 years of age or older
First Rider Signature*
Second Rider Name
First Name*
Last Name*
Rider Date of Birth*
Date of Birth
Third Rider Name
First Name*
Last Name*
Rider Date of Birth*
Date of Birth
Fourth Rider Name
First Name*
Last Name*
Rider Date of Birth*
Date of Birth
Fifth Rider Name
First Name*
Last Name*
Rider Date of Birth*
Date of Birth
Sixth Rider Name
First Name*
Last Name*
Rider Date of Birth*
Date of Birth
Seventh Rider Name
First Name*
Last Name*
Rider Date of Birth*
Date of Birth
Eighth Rider Name
First Name*
Last Name*
Rider Date of Birth*
Date of Birth
Ninth Rider Name
First Name*
Last Name*
Rider Date of Birth*
Date of Birth
Tenth Rider Name
First Name*
Last Name*
Rider Date of Birth*
Date of Birth
Parent or Guardian's Email Address
Email
Check to receive information, news, and discounts by e-mail.
Your signed waiver will be sent to the email address provided here and is available for download for three days via URL attachment.
Photo Release
I hereby grant to Black Prong Adventures LLC and Black Prong Equestrian Village LLC and its affiliates, the irrevocable, perpetual right, and permission to use my name, portrait, photograph, image, appearance, voice, and likeness (the “Publicity Rights”), for business, commercial, advertising, and/or trade purposes. I hereby waive any right of attribution and any right to payment or an accounting relating to use of the Publicity Rights, and I waive any right I may have to inspect or approve any use of the Publicity Rights
Yes
NO
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*
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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