Haile Equestrian 2023 Camper Registration Form
Parent and Camper Statement of Understanding of Haile Equestrian Policy
The following is Haile Equestrian LLC policy information for the safety and protection of each child.
I am the parent or legal guardian of a camper at Haile Equestrian LLC. Understanding that certain activities have a degree of risk and uncertainty involved, and understanding that all reasonable efforts will be made by the staff of Haile Equestrian LLC to see that these activities are carried out and supervised in a competent and responsible manner, permission is hereby given, as indicated below, for the camper above named to participate in horseback riding and other activities. To ensure safety while horseback riding, all campers are required to wear ASTM approved riding helmets (provided by camp if needed) and closed-toe, heeled shoes (preferably boots) that come up to at least the camper’s ankle. If you have any questions regarding the suitability of footwear, please do not hesitate to contact Haile Equestrian LLC.
Nature of Horses
(a) Haile Equestrian follows a rigid safety program. Horses are selected and tested to ensure their safety and suitability for our program. However, no horse is a completely safe horse. Horses are 5 to 10 times larger and 20 to 40 times more powerful than a human. If a rider falls from a horse to the ground, it will typically be at a distance of 3.5 to 5.5 feet and can result in injury to the rider. Horseback riding is one of the only sports where a smaller, weaker predator (human) imposes its will on a much larger, stronger prey animal (horse).
(b) If a horse is frightened or provoked, it may divert from its training and act according to its natural survival instincts, which may include but are not limited to: stopping short, changing directions or speeds at will, shifting its weight, rearing, bucking, bolting, kicking, biting, or running from danger.
Client understands the nature of horses and their unpredictability as described above
We (camper and parent) understand that it is the responsibility of each camper to participate in the whole program, including activities of work, play, and values sharing. We understand and support camp policies prohibiting campers from bringing weapons to camp, and from possessing or using tobacco products, alcoholic beverages or non-prescription drugs while at camp. We recognize that campers must follow safety instructions, remain in areas designated by staff and refrain from behavior that is harmful to themselves or others. Failure to adhere to camp policies may cause the Camp Director to dismiss a camper, without refund of camp fees.
I (parent) understand that I am not to leave my child at Haile Equestrian LLC unless a camp staff member is there to receive and supervise my child. I understand that my child will not be allowed to leave the camp or camp activities with an unauthorized person. Any person other than a parent will not be allowed to pick up the camper unless prior arrangements have been made by calling the Haile Equestrian LLC office to inform them. Campers may bring electronic devices such as MP3 players or cell phones. These are to be used only during limited times designated by the camp staff. Failure to adhere to this policy may result in the Camp Director taking and holding the device in safekeeping until the camper departs. Haile Equestrian LLC is not responsible for lost or stolen items.
I am aware that my child will have the opportunity to participate in camp activities which may involve a degree of risk, and I approve his/her participation in such activities. I understand that accidents can occur.
Recognizing that the camp will do its best to ensure a safe and enjoyable camping experience, I hereby release Haile Equestrian LLC, its officers, directors, shareholders, employees and anyone else directly or indirectly connected with Haile Equestrian LLC from any liability whatsoever in the event of injury or damage of any nature (or perhaps even death) to me or anyone else caused by or incidental to my electing to mount and ride a horse owned or operated by Regina Esterman, Plantation Community Club LLC, or Haile Equestrian LLC. I have read and understand FLORIDA STATUTES for EQUINE ACTIVITIES, Fla. Stat. § 773.01 (1993).
I understand that my child will be photographed, and consent to the photographs being used for camp promotional purposes. Haile Equestrian LLC uses only campers’ first names in photo captions and articles.
Ride & Excursion/Outdoor Adventure/Animal Adventure/Vet Excursion Camps Only:
I consent to our child’s/children’s participation in the offsite excursions facilitated by Haile Equestrian. I further consent to allow Haile Equestrian, its teacher or other volunteers, or whomever any of these so delegate to transport my child/children to and from any such offsite excursions. I further release and hold harmless Haile Equestrian LLC, Plantation Community Club LLC, Regina Esterman, Mauricio Cazanova, and any and every of its subsidiaries or affiliates, and any and every of the teachers, delegates, drivers, volunteers, agents, employees, officers or directors of these entities from any liability or claim of liability, including negligence, and for any personal injury, including death, (and especially including, but not limited to, bodily injury or death from any motor vehicle accident) and for any other damages (including actual, compensatory, consequential, or incidental), arising from or relating to activities which take place during the offsite excursion or in the travel to and from said excursion.
Registration fee of $195 per session must accompany application (this portion of the fee is non-refundable). Balance of all fees is due one month in advance of the camp start date. If spaces remain, registration will continue after this date.
Please make checks payable to “Haile Equestrian”. Credit cards accepted with 4% fee.
Client or Parent/Guardian Signature Date: December 6, 2023
2019 NOVEL CORONAVIRUS (COVID-19) ACKNOWLEDGEMENT AND ASSUMPTION OF RISK
1. I am currently not experiencing COVID 19 symptoms nor have I had COVID-19 symptoms in the last 14 days.
2. I have not travelled outside of the United States or in an area under a travel health advisory in the last 14 days.
3. I have not provided care or had close contact with any person with COVID-19 or with any person reasonably suspected of having COVID-19 or with any person who travelled outside of the United States in the last 14 days or with any person who travelled in an area under a travel health advisory in the last 14 days.
4. I represent and warrant to the Releasees that I have not been advised by the Government of the United States or my doctor to self-isolate due to possible exposure to COVID-19.
5. I am fully aware of the risks and hazards with respect to COVID-19 inherent in mine and my child's attendance at Haile Equestrian LLC and participation in the activities of the facility.
6. I freely and voluntarily agree to assume the risk with respect to COVID-19, including the risk of death, bodily injury or property damage, regardless of severity, that I (or my child) may sustain as a result of my participation in the activities of the facility or attendance at Haile Equestrian LLC, howsoever arising, including, but not limited to, the active or passive negligence of the Releasees.
Date: December 6, 2023
Haile Equestrian LLC
Liability Release & Hold Harmless Agreement
Under Florida law, an equine activity sponsor or 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. FLORIDA STATUTES 1993, Title XLV TORTS, CHAPTER 773 EQUINE ACTIVITIES, Fla. Stat. § 773.01 (1993).
1. I, the undersigned, signing as the legal parent or guardian of the minor listed, have read and understand, and freely and voluntarily enter into this Release and Hold Harmless Agreement with Regina Esterman and Plantation Community Club LLC, their agents and employees, collectively known as Haile Equestrian LLC (“Farm”), understanding that this Release and Hold Harmless Agreement is a waiver of any and all liability(ies).
2. I have read and fully understand the “WARNING” posted above.
3. I understand the potential dangers that I could incur in mounting, riding, walking, boarding, feeding said horse; including, but not limited to, any interactions with other horses. Understanding those risks I hereby release that Farm, its officers, directors, shareholders, employees and anyone else directly or indirectly connected with that Farm from any liability whatsoever in the event of injury or damage of any nature (or perhaps even death) to me or anyone else caused by or incidental to my electing to mount and ride a horse owned or operated by Regina Esterman, Mauricio Cazanova, Plantation Community Club LLC, or Haile Equestrian LLC. I have read and understand FLORIDA STATUTES for EQUINE ACTIVITIES, Fla. Stat. § 773.01 (1993).
4. I understand and recognize and warrant that this Release and Hold Harmless Agreement, is being voluntarily and intentionally signed and agreed to, and that in signing this Release and Hold Harmless Agreement I know and understand that this Release and Hold Harmless Agreement may further limit the liability of equine professionals beyond that statutorily provided by the above referenced Florida Statutes; to include any activity, whatsoever, involving an equine, including death, personal injury and/or damage to property.
5. I recognize and agree that I know which equine professional(s) I will be working with, and acknowledge that I agree said equine professional(s) has/have made reasonable and prudent efforts to determine my ability to engage in the equine activity, and has/have sufficient knowledge of my equine and horseback riding skills as to relieve, release and hold harmless said equine professional(s) from any continuing duty to monitor my equine activities.
6. I further voluntarily agree and warrant to Release and Hold Harmless this (these) equine professional(s) from any liability whatsoever, including, but not limited to, any incident caused by or related to said equine professional’s (s’) negligence, relating to injuries known, unknown, or otherwise not herein disclosed; including, but not limited to, injuries, death or property damage from: mounting; riding; dismounting; walking; grooming; feeding; use of horse barn, paddock, trails or horse ring, in any capacity; falling off horse whether horse is bucking, flipping, spooked; or my failure to understand any equine professional’s directions relating to my riding or otherwise use and control, or lack thereof, of my horse or the horse I have been assigned to.
NOTICE: Wearing an ASTM/SEI approved hard hat is REQUIRED for ALL independent riders. Wearing an ASTM/SEI approved hard hat is HIGHLY RECOMMENDED, but not required for leadline horse or pony rides.
By signing this agreement, you certify that you are at least 18 years of age.
Person voluntarily entering into this Release and Hold Harmless Agreement:
Signature: Date: December 6, 2023