Horseback Adventure Waiver

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Name(Required)
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Address
How many participant adult riders reside at this address?
How many participant minor riders reside at this address
Do any participating riders have physical, mental, and/or special needs which may affect his/her ability to ride a horse?
HEADGEAR: I, for myself and on behalf of my child and/or legal ward, have been offered protective headgear (riding helmet) by this stable, and do understand that the wearing of such headgear while mounting, riding, dismounting and otherwise being around horses, may prevent or reduce severity of some head injuries, and even prevent death happening as the result of a fall or other occurrence. It is understood that stable-provided protective headgear may not be of perfect fit for each rider’s head, and that once provided I/we will be responsible for securing this helmet on this rider’s head at all times.
WASHINGTON STATE EQUINE ACT: This section provides that an equine activity sponsor or an equine professional shall not be liable for an injury to or the death of a participant engaged in an equine activity, nor may he or she maintain an action against or recover form an equine activity sponsor or an equine professional for an injury to or the death while engaged in an equine activity. Liability is not limited by this statute where the equine professional knowingly provided faulty tack or equipment, failed to reasonable and prudent efforts to determine the ability of the participant to engage safely in the equine activity, owns or otherwise is in lawful possession of the land or facilities upon which the participant sustained injuries because of a known, dangerous latent condition, or if he or she commits an act or omission that constitutes willful or wanton disregard for the safety of the participant or intentionally injures the participant.
DECLARATION OF FITNESS TO RIDE: I/We declare that I/We are physically fit. I/we do not, and have not suffered from any of the following conditions, which I/we understand my lead to a dangerous situation with regard to other persons or myself/ourselves during riding activities: Epilepsy fits, severe head injury, recurrent blackouts or giddiness, disease of the brain or nervous system, high blood pressure, lung or heart disease, recurrent weakness or dislocation of any limb, diabetes, mental illness, drug or alcohol addiction, recent back injury, arthritis and severe joint sprains, chronic bronchitis, asthma, rheumatic fever, thyroid, adrenal or other glandular disorder, recent blood donation, or any condition that requires the regular use of drugs. I/we hereby declare that I/we have no physical or mental conditions that should preclude me/us from participating in my/our chosen activity, that I/we am not participating against medical advice or treatment and that I/we have not been diagnosed by a registered doctor as having a terminal illness. I further declare that in the event that I/we feel ill or unwell, have any physical complaints whatsoever or is an injury is sustained of any kind during the course of riding activities, I/we will notify the instructor/guide/employee, of the insured immediately and before moving away from the immediate vicinity.

Trail rides release of liability, waiver of claims, and express assumption of risk and indemnity agreement

I/We do herby affirm and acknowledge that we have been fully informed of the inherent hazards and risks associated with horse riding, instructions, lessons, transportation of equipment related to the activities, and traveling to and from activity sites of which I/We are about to engage in. Inherent hazards and risks include by are not limited to:1. Risk of injury from the activity and equipment utilized in Horse Riding is significant including the potential for permanent disability and death.2. Possible equipment failure and/or malfunction of my own or other’s equipment.3. My own negligence and/or negligence of all others, including employees, agents, independent contractors or representatives of JD Outfitters LLC including but not limited to operator error.4. The propensity of an equine (horse) to behave in dangerous ways that may result in injury to the participant regardless of the equine’s previous training and past performance.5. The inability to predict an equine’s (horse) reaction to sound, movements, unfamiliar environment, objects, persons, or animals.6. Natural hazards including but not limited to surface or subsurface conditions.7. Propensity for an equine (horse) to run, buck , bite, kick, shy, stumble, rear, trample, scratch, peck, fall, make unpredictable movements, spook, down, jump, butt, step on a person’s feet, push or shove without warning or apparent cause.8. Saddles or bridles may loosen or break which may cause the participant to be jolted or fall.9. The domesticated animal may also react in a dangerous manner when a condition or treatment is considered hazardous to the welfare of the animal.10. The potential for a participant to fail to exercise reasonable care, take adequate precautious, or use adequate control when engaging in a domesticated animal activity, including failing to maintain reasonable control of the animal or failing to act in a manner consistent with the person’s abilities.11. Collisions with trees, brush, or other animals or objects.12. Broken bones, severe injuries to the head, neck, and back which may result in severe impairment or even death.13. Cold weather and heat related injuries and illness including but not limited to frostnip, frost bite, heat exhaustion,heat stroke, sunburn, hypothermia, and dehydration.14. Exposure to outdoor elements, including but not limited to avalanche, rock fall, inclement weather, thunder and lightning, severe and/or varied wind, temperature and all other weather conditions.15. Attack by or encounter with insects, reptiles, and/or animals16. Accidents or illness occurring in remote places where there are no available medical facilities.17. Fatigue, chill and/or dizziness, which may diminish my/our reaction time and increases the rist of accident.18. My sense of balance, physical coordination, and ability to follow instructions.I/We understand the description of these risks is not complete and that unknown or unanticipated risks may result in injury, illness, or death. In consideration for being permitted to participate in any way in Trail Rides and Related activities, I hereby agree, sign and acknowledge, and appreciate that:1. I/We hereby release and hold harmless with respect to any and all injury, disability, death, or loss or damage to person or property, whether caused by negligence or otherwise, JD Outfitters LLC.2. To release the Releasees, their officers, directors, employees, representatives, agents and volunteers, an vessels from liability and responsibility whatsoever and for any claims or causes of action that I/We, my/our estate, heirs, survivors, executors, or assigns may have for personal injury, property damage or wrongful death arising from the above activities whether caused by active or passive negligence of the releases or otherwise by executing this document, I agree to hold the releases harmless and indemnity them in conjunction with any injury, disability, death, or loss or damage to person or property that may occur as a result of engaging in the above activities.3. By entering into this agreement, I am not relying on any oral or written representation or statements made by the releases, other than what is set forth in this agreement.I/WE the undersigned have read and do fully understand its terms, and understand that I/WE have given up legal rights by signing it, and I/WE sign it freely and voluntarily without any inducement.
Signature of adult participant or parent/guardian if participant(s) is a minor *
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