Loading...

Tennessee Equine Activity Liability Act 

WARNING: Under Tennessee 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, pursuant to Tennessee Code Annotated, Title 44, Chapter 20.

Assumption of Risk

I, the undersigned, acknowledge and understand that participation in activities involving horses, including but not limited to riding, grooming, feeding, handling, leading, observing, and participating in Faith-Based Equine-Assisted Programs (FBEAP) sessions, carries inherent risks. These risks include, but are not limited to:

- Falling, being kicked, bitten, stepped on, or thrown by a horse.

- Equipment failure, such as saddle or tack malfunction.

- Unpredictable horse behavior, regardless of training or experience.

- Environmental hazards, including uneven terrain, weather conditions, and interaction with other animals.

- Emotional responses that may arise during FBEAP sessions, which can be intense and transformative.

I understand that FBEAP sessions involve interactive activities with horses designed to encourage emotional and spiritual healing, personal growth, and connection. While every effort is made to ensure a safe and supportive environment, I acknowledge that personal insights or emotional responses may be unpredictable.

I voluntarily assume all risks, known or unknown, associated with participating in these activities and accept full responsibility for any personal injury, emotional distress, property damage, or loss.

Release of Liability

In consideration of being allowed to participate in any activities at Dark Horse Rescue Ranch, including but not limited to horse riding, ground activities, handling, and FBEAP sessions, I hereby release, waive, and discharge Dark Horse Rescue Ranch, its owners, directors, officers, employees, volunteers, and agents from any and all liability for injuries, damages, or losses that I may incur. This release includes, but is not limited to, any claims for negligence, personal injury, property damage, emotio...

Medical Treatment Consent

In the event of an emergency, I authorize Dark Horse Rescue Ranch to seek medical care for me (or my minor child) if I am unable to do so. I understand that I am responsible for all costs associated with such care.

Acknowledgment of Rules

I agree to abide by all rules and instructions provided by Dark Horse Rescue Ranch staff and understand that failure to follow safety guidelines may result in dismissal from activities without a refund.

I agree to:

- Wear appropriate safety gear, including a helmet, when riding horses.

- Listen to and follow instructions from staff and volunteers.

- Treat all horses and animals with respect and care.

- Notify staff immediately if I feel uncomfortable or unsafe at any time.

Confidentiality for FBEAP Sessions

I understand that personal and sensitive information may be shared during FBEAP sessions. I agree to respect the confidentiality of others participating in these sessions and not disclose personal information shared by other participants.

Severability

If any provision of this waiver is found to be invalid or unenforceable, the remaining provisions shall continue to be valid and enforceable.

Signature

By signing below, I acknowledge that I have read and understood this waiver, and I voluntarily agree to its terms.

(If participant is under 18, a parent/guardian must sign below)

Date: May 11, 2025

First Participant's Name

First Name*

Middle Name

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
First Participant's Signature*
Second Participant's Name

First Name*

Middle Name

Last Name*
Second Participant's Date of Birth*
Second Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
Third Participant's Name

First Name*

Middle Name

Last Name*
Third Participant's Date of Birth*
Third Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
Fourth Participant's Name

First Name*

Middle Name

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
Fifth Participant's Name

First Name*

Middle Name

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
Sixth Participant's Name

First Name*

Middle Name

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
Seventh Participant's Name

First Name*

Middle Name

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
Eighth Participant's Name

First Name*

Middle Name

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
Ninth Participant's Name

First Name*

Middle Name

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
Tenth Participant's Name

First Name*

Middle Name

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Participant'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:*
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*

Emergency Contact's Relation to Participant
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*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Information
Photography & Media Release - I grant Dark Horse Rescue Ranch permission to use any photographs, videos, or other media of me (or my child) for promotional, educational, or fundraising purposes.*
Yes - I consent to the use of my image.
No - I do not consent to the use of my image.
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!