HORSE RIDING AGREEMENT AND LIABILITY RELEASE FORM
This form must be completed by and for each participant.
OWNERS NAME IS , Cornerstone Farm Bed & Breakfast, Inc. hereinafter referred to as Cornerstone Farm ADDRESS: 305 Crooked Creek Road Gettysburg, PA 17325 .
PLEASE READ CAREFULLY BEFORE SIGNING
SERIOUS INJURY MAY RESULT FROM YOUR PARTICIPATION IN THIS ACTIVITY. Cornerstone Farm DOES NOT GUARANTEE YOUR SAFETY OR THAT OF YOUR HORSE. IT IS HEREBY AGREED TO AS FOLLOWS THAT:
A. REGISTRATION OF RIDERS AND AGREEMENT PURPOSE I, the following individual hereinafter known as the “RIDER”, and the parents or legal guardians thereof if a minor, do hereby voluntarily request and agree to
participate in horse riding on the Gettysburg National Military Park, and that this RIDER will ride his/her own horse or one borrowed or leased by RIDER own arrangement today , ____/___/_____.
RIDER NAME :____________________________________
RIDER date of birth ______/_______/__________.
B. AGREEMENT SCOPE AND TERRITORY AND DEFINITIONS – This agreement shall be legally binding upon me the registered RIDER, and the parents or legal guardians thereof if a minor, my heirs, estate, assigns, including all minor children, and personal representatives; and it shall be interpreted according to the laws of Adams County in the State of Pennsylvania. Any disputes by the RIDER shall be litigated in and venue shall be Adams County in the State of Pennsylvania.
The term “HORSE” herein shall refer to all equine species. The term “HORSEBACK RIDING” or “RIDING” herein
shall refer to riding or otherwise handling of horses, ponies, mules, or donkeys, whether from the ground or mounted. The term “RIDER” shall herein refer to a person who rides a horse mounted or otherwise handles or
comes near a horse from the ground.
The terms “I”, “me”, “my” shall herein refer to the above registered rider and the parents or legal guardians thereof if a minor.
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C. ACTIVITY RISK CLASSIFICATION – Horseback riding is classified as a RUGGED ADVENTURE RECREATIONAL SPORT ACTIVITY, and that there are numerous obvious and non-obvious inherent risks always present in such activity despite all safety precautions. According to NEISS (National Electronic Injury Surveillance Systems of United States Consumer Products) horse activities rank 64th among the activities of people relative to injuries that result in a stay at U.S. hospitals. Related injuries can be severe, requiring more hospital days and resulting in more lasting residual effects than injuries in other activities.
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D. NATURE OF RIDING HORSES – No horse is a completely safe horse. Horses are 5 to 15 times larger, 20 to 40 times more powerful, and 3 to 4 times faster than a human. If a rider falls from a horse to ground it will generally be at a distance of from 31/2 to 51/2 feet, and the impact may result in injury to the rider. Horseback riding is the only sport where a much smaller, weaker predator animal (human) tries to impose its will on, and become a unit of movement with, another much larger, stronger prey animal with a mind of its own (horse) and each has a limited understanding of the other. 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 speed at will; shifting its weight; bucking; rearing; kicking; biting; or running from danger
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E. RIDER RESPONSIBILITY – Upon mounting a horse and taking up the reins, the RIDER is in primary control of the horse. The RIDER’S safety largely depends upon his/her ability to carry out simple instructions, and his/her
ability to remain balanced aboard the moving animal. The RIDER shall be responsible for his/her own safety.
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F. CONDITIONS OF NATURE – Cornerstone Farm is NOT responsible for total or partial acts, occurrences, or elements of nature that can scare a horse, cause it to fall, or react in some other unsafe way. SOME EXAMPLES ARE: thunder, lightening, rain, wind, wild and domestic animals, insects, reptiles, which may walk, run, fly near, bite and/or sting a horse or person; and irregular footing on out-of-door groomed or wild land which is subject to constant change in condition according to weather, temperature, and natural and man-made changes in landscape.
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G. INPSECTION OF PREMISES – RIDER is satisfied that all conditions are reasonably safe for RIDER’S intended purpose, usage and presence upon the Gettysburg National Military Park Bridal Trails.
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H. ACCIDENT/MEDICAL AND PERSONAL LIABILITY INSURANCE – Should medical treatment be required, I and/or my own accident/medical insurance company shall pay for all such incurred expenses. My accident/medical insurance company is____________________________ and my policy number is ____________________. Should my actions or that
of my horse cause injury or damage of any kind, I and/or my own personal liability shall pay for such damages. My personal liability insurance company is____________________________ and my policy number is ____________________.
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I. PROTECTIVE HEADGEAR WARNING – I have been fully warned and advised by Cornerstone Farm that the RIDER should wear protective headgear (riding helmet), and 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 from happening as the result of a fall or other occurrence. Minors 16 and under are required to wear protective headgear.
____________________(initials).
J. LIABILITY RELEASE – In consideration of Cornerstone Farm allowing my participation in this activity, under the terms set forth herein, I, the RIDER, and the parent or guardian thereof if a minor, do agree to hold harmless and release Cornerstone Farm, its owners, agents, employees, officers, members, premises owners, insurers, and affiliated organizations from legal liability due to Cornerstone Farm ordinary negligence; and I do further agree that except in the event of Cornerstone Farm gross negligence and willful and wanton misconduct, I shall not bring any claims, demand, legal actions and causes of action, against Cornerstone Farm and/or its associates, for any economic and non-economic losses due to bodily injury, death, property damage, sustained by me and/or my minor child or legal ward in relation to the premises and operations of Cornerstone Farm, to include while riding, handling, or otherwise being near horses owned by or in the care,
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custody and control of Cornerstone Farm.
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All Riders and Parents or Legal Guardians must sign below after reading this entire document:
SIGNER STATEMENT OF AWARENESS
I/WE, THE UNDERSIGNED, HAVE READ AND DO UNDERSTAND THE FOREGOING AGREEMENT, WARNINGS, RELEASE AND ASSUMPTION OF RISK. I/WE FURTHER ATTEST THAT ALL FACTS RELATING TO THE APPLICANT ARE TRUE AND ACCURATE.
_________________________________________________________ DATE ______________________
SIGNATURE OF RIDER (Parent must sign for rider 17 & under.)
__________________________________________ for ________________________________________
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SIGNATURE OF PARENT, or GUARDIAN
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(Please print)
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DATE ___________________________
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Address in full: _________________________________________________________________________
Home Phone #: ________________________ Bus. Phone #: ______________________
