Hold Harmless Agreement / Liability Waiver

Your electronic signature indicates that you have read, understood, and agree to all of the information contained in this Release, and understand that participating in any equine services at Whispering White Horse Stables is at your own risk.

** Warning ** – Please Read Carefully Before Signing 

IL Equine Liability Act – “Under the Equine Activity Liability Act, each participant who engages in an equine activity expressly assumes the risks of engaging in and legal responsibility for injury, loss, or damage to person or property resulting from the risk of equine activities." 

Whereas, the undersigned acknowledges the inherent risks of witnessing, observing, participating, being in close proximity to or working around horses, and/or engaging in any and all equine activities including, but not limited to such activities as equine assisted psychotherapy, equine assisted learning, training, assisting in medical treatment of, delivering to, or assisting a participant, trailering, driving, loading and unloading of horses, and any activity engaged in, whether in or around the Stables, in the indoor and outdoor arenas, or in the paddocks or pasture, and anywhere within the property of “Whispering White Horse Stables”, and understands the possibility of injury to both person and horse in normal use, and;

The undersigned is aware of the risks of engaging in equine activities (as specified above and in the Illinois Equine Liability Act,) including, but not limited to:

1. The propensity of an equine to behave in dangerous ways that may result in the injury, harm, or death to the participant.

2. The inability to predict an equine’s reaction to sound, movement, objects, persons, or animals.

3. The hazards of surface or subsurface conditions.

4. Collisions with other equines or objects, and

5. The potential of a participant to act in a negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the animal or not acting within his or her ability.

In consideration, therefore, for the privilege of engaging in any and all equine activities at Whispering White Horse Stables, LLC, Pagone Psychological Services, PLLC and/or any within the property owned by the Stables or Pagone/Soga family, or any property adjoining, the undersigned does hereby agree to hold harmless and indemnify Jenn Pagone and spouse, Whispering White Horse Stables, LLC, Equid-Nexus, LLC, Pagone Psychological Services, PLLC, their agents, staff, independent contractors, volunteers, and interns, and further releases them from any liability or responsibility for accident, damage, injury, including death, or illness to the undersigned or to any property or to any horse owned by the undersigned or to any family member or spectator accompanying the undersigned on the premises of Whispering White Horse Stables, LLC. The participant further agrees to be personally responsible for own medical expenses and agrees this release shall continue in perpetuity and remain in full force without the necessity of any additional releases.

In addition, the undersigned is aware, that due to the COVID-19 pandemic, they must inform Jenn Pagone about any symptoms or any health or physical condition that may need to be considered at least 24 hours prior to participation.Participants understand and assume all risks for COVID exposure, and release Pagone Psychological Services, PLLC, Whispering White Horse Stables, LLC, and Equid-Nexus, LLC from any liability. For safety reasons, a participant may not actively participate in sessions if they are under the influence of illegal drugs or alcohol. Smoking and/or vaping are strictly prohibited in the facility and around horses.

Please select who will be participating...
First Participant's Name

First Name*

Last Name*

First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Signature*
Parent or Guardian's Email Address


Confirm Email*
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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*

Parent or Guardian's Age Acknowledgment*
Parent or Guardian's 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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