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586 Ranch, Inc

586 ANDERSON HOZAK RD 

Clinton, PA 15026

480-221-0101

www.586ranch.com

IMPORTANT NOTICE:

586 Ranch, Inc (“OWNER”) strictly follows and adheres to the Pennsylvania Equine Activity Act. Chapter 13 – POSTED. OWNER has the sole right and discretion to determine if a rider can ride, and/or a horse or facility can be used.

***READ THIS AGREEMENT CAREFULLY BEFORE SIGNING IT. YOUR SIGNATURE INDICATES YOUR UNDERSTANDING OF AND AGREEMENT TO ITS TERMS.***

  1. I hereby enter into this agreement in consideration of my ability and permission to ride OR use any Horse owned or leased by OWNER. By signing this form and by initialing all the paragraph(s) throughout this document, I hereby acknowledge on behalf of myself that I have familiarized myself with the activities I will be allowed to participate in. I do hereby acknowledge and agree that I will participate in these activities without restriction or limitation. I havI he the sole responsibility for knowing my ability to manage, care for and control any horse or perform any equestrian activity and act within the limits of my ability to maintain reasonable control of any horse I come in contact.

     

2. I agree to refrain from acting in any manner which may cause or contribute to the injury of another person, horse or property. I will also abide by all posted warnings and perform equestrian activities only in designated areas. I recognize the inherent risks involved in riding and working with horses, including but not limited to: 

3. I understand that no person is permitted to mount a horse or participate in any equestrian activities at OWNER’s facilities without wearing an ASTM or SEI certified helmet.



4 .I hereby specifically forever waive and release OWNER and its principals and agents (including its affiliated entities, its successors, subsidiaries, franchisees, officers, directors and employees) from any liability for injury arising out of the inherent risks from riding, working or participating in any and all stable environment(s) and/or with horses, as well as from the active negligence of OWNER its principals and agents.


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5. By signing this agreement I hereby acknowledge that although there may be supervision during my time spent at OWNER’s facility there will not be a nurse on the premises and OWNER and its principals and agents (including its affiliated entities, its successors, subsidiaries, franchisees, officers, directors and employees) bear no responsibility for my health or medical care. If I am involved in any accident or collision while on the premises of OWNER, I will complete an accurate written report on forms provided by OWNER and advise them if I am in need of immediate medical attention.



6. I agree to indemnify, save and hold harmless OWNER and its principals and agents (including its affiliated entities, its successors, subsidiaries, franchisees, officers, directors and employees) from and against any loss, liability, damage, attorneys’ fees, or costs that they may incur arising out of or in any way connected with either my presence or participation at OWNER’s facilities or any acts or omissions of OWNER principals or agents (including its affiliated entities, its successors, subsidiaries, franchisees, officers, directors and employees).


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7. By signing this Agreement, and by initialing all the paragraph(s) here and throughout this document, I hereby acknowledge my complete understanding, agreement and consent to my presence and/or participation in the activities at OWNER’s facilities without restriction, without liability to OWNER, its principals or agents (including its affiliated entities, its successors, subsidiaries, franchisees, officers, directors and employees), and with full knowledge and understanding of the disclosures, waivers, and releases herein.


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8. If I am present at and participate in the activities of OWNER, I do so at my own risk, and I hereby acknowledge and agree that OWNER and/or any of its principals and agents (including its affiliated entities, its successors, subsidiaries, franchisees, officers, directors and employees) shall bear no responsibility or risk associated with injuries that could arise from my presence or participation at OWNER’s facilities.


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**This form must be signed by a legal guardian if the participant is under 18 years of age**


First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Barn Rules and Expected Behavior
  1. Enjoy the fresh country air! No Smoking! ( if you need to do so please do so in your vehicle)
  2. Enjoy the view. Drive SLOWLY! ( Speed Limit 5 MPH) 
  3. Please park with courtesy and don’t block anyone in.
  4. No Yelling or Screaming in or around the barn or horses unless it’s an emergency.
  5. No Dogs allowed on premises ( unless you are given permission)
  6. Please pick up after yourself and “your” horse.
  7. No one may ride or interact with a horse unless a liability waiver is signed. Anyone who comes with or brings student(s) to lessons MUST sign a liability waiver. 
  8. Appropriate footwear must be worn when in horse areas (closed toe). Long pants and boots with a ½-1 inch heel should be worn while riding.
  9. Always use a lead rope when leading a horse in halter. Never grab a halter with just your hand.
  10. Please, for your safety, do not reach over or through fences to pet horses ( We have electric fence). It will be a shocking experience if you do! Also, please do not feed horses anything without permission.
  11. Any Accident or injury to a person or horse must be reported immediately and an accident report must be filled out.
  12. Be safe and take care of those around you. If you see a dangerous situation, please let someone know.
  13. Children must be under adult supervision at ALL times.
  14. Guests and children are not allowed in pastures or paddocks unless given permission. 
  15. Do not climb on fences or gates. If you notice any loose fencing or broken areas please let us know.
  16. No excessive perfumes or jewelry are to be worn while around or riding horses. Please make sure your attire is comfortable for riding and is not distracting. Make sure you come prepared. (i.e. be sure you can pull your hair back if applicable, bring water, if sunny please put on sunscreen before your scheduled time)
  17. No gum or candy while at the barn unless otherwise given permission 
  18. Please refrain from bringing and feeding treats ( i.e. apples, carrots, mints, etc) to horses unless given permission.




I have read the above barn rules and expected behavior and agree and understand them.
Quick Questionnaire
Do you have any horse or riding experience?*
No, I have never been around horses, but love them!
Yes, I have ridden a once or twice. I would consider myself a beginner
Yes, I would consider myself an intermediate rider. I can do most things independently and without direction
2. Do you have any allergies? To food, animals, medications, etc? Please list ALL!
3. Do you have any medical conditions? If so please list




4. Do you take any medication? If so please list
5. If you have any other concerns please list
Photo Release Form

I give permission for photographs of the persons listed below to be published on the website or Facebook Page of 586 Ranch, Inc. I understand that these photos can be viewed by anyone in the world, but no identifying information will be displayed.

 

 

Yes, I give permission
No, I do not give permission
Lesson Cancellation Policy

Cancellation Policy:

● Cancellations will require a 12 hour notice to be eligible for a make up lesson. Lessons cancelled without a 12 hour notice will not be eligible for a make up. One (1) lesson cancellation will be permitted - Any additional cancellations during a session will be billed at $25 for the missed lesson. All cancellations must call or text Sarah @ 480-221-0101.

● Lessons are planned ahead of time and your time slot is held for you. Late ( less than 12 hrs) cancellation prevents someone else from being able to attend at that time . I understand we all have busy lives and things come up, but please be mindful and let us know as soon as possible. 

● If you do need to do a make up lesson please be aware that there are limited times available and finding a time may require some flexibility in your schedule. 

● All lessons (including make ups) must be completed within the session they are purchased. There are breaks in between sessions for the purpose of make-ups if need be. There will be no rollover for unused lessons. If you know you will be gone at the end of a session please plan ahead and do your makeup prior to leaving.

Any lesson cancelled by 586 Ranch is eligible for a make up.


I have read the above cancellation policy and understand and agree to it
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*

Last Name*

Relationship*

Phone*
Parent or Guardian's Date of Birth*
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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