Release Form - Kurtz Corral printable pdf download

HORSE RENTAL AGREEMENT AND LIABILITY RELEASE FORM FOR INDIVI DUALS

KURTZ CORRAL, INC., hereafter known as "THIS STABLE"

LOCATION: 5712 Howard Lane, Sturgeon Bay, WI

PLEASE READ CAREFULLY BEFORE SIGNING

SERIOUS INJURY MAY RESULT FROM YOUR PARTICIPATION IN THIS ACTIVITY. THIS STABLE DOES NOT

GUARANTEE YOUR SAFETY.

A. REGISTRATION OF RIDERS AND AGREEMENT PURPOSE - in consideration of the payment of a fee and the signing of this agreement, I, the following

listed individual, and the parent or legal guardians thereof if a minor, do hereby agree to him from THIS STABLE a horse, tack and equipment, personnel

and trail for the purpose of horseback riding today and on all future dates:

RIDERS NAME

AGE

WEIGHT (Over

HORSE RIDING EXPERIENCE (Check on

(If under 21)

240#)

which applies)

_______ YES

_____ BEGINNER (UNDER 10 HRS)

_______ NO

____ OVER 10 HRS ____ OVER 40 HRS

Does this rider have physical and/or mental health conditions, problems, and/or disabilities which may affect his/her safety and ability to ride a horse?

YES

NO (Circle One) If "yes" describe here:

WRITE INITIALS BELOW AFTER READING EACH SECTION. PARENTS OR GUARDIANS MUST ALSO INITIAL

____/____

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 the state and county of THIS STABLE'S physical location. Any dispute by the rider shall be litigated in and

venue shall be the county in which THIS STABLE is physically located. If any clause, phrase or word is in conflict with state law, then that single

part is null and void. The term 'HORSE' herein shall refer to all equine species. The term 'HORSEBACK 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.

____/____

ACTIVITY RISK CLASSIFICATION- I UNDERSTAND THAT: Horseback riding is classified as 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. I/WE further understand that applicant may be participating in a

"WILDERNESS EXPERIENCE" and that the meaning of this term is defined as follows: THE PURSUIT OF ADVENTURE TYPE ACTIVITY IN A

WILD. RUGGED, AND UNCULTIVATED AREA OR REGION, AS OF FOREST and/or HILLS and/or MOUNTAINS and/or PLAINS and/or

WETLANDS, WHICH WOULD LIKELY BE UNINHABITED BY PEOPLE AND INHABITED BY WILD ANIMALS OF MANY TYPES AND SPECIES

TO INCLUDE, BUT NOT LIMITED TO, MAMMALS, REPTILES, AND INSECTS, WHICH ARE NOT TAME, MAY BE SAVAGE AND

UNPREDICTABLE IN NATURE AND ALSO WANDERING AT THEIR WILL.

____/____

NATURE OF STABLE HORSES-I UNDERSTAND THAT: THIS STABLE chooses its rental horses for their calm dispositions and sound basic

training as is required for use as riding horses for novice and beginning riders, and THIS STABLE follows a rigid safety program. Yet, 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

horse to ground it will generally be at a distance of from 3 1/2 to 5 1/2 feet, and the impact may result in injury to the rider. Horseback riding is the

only sport where one much smaller, weaker predator animal (human) tries to impose its will on another much larger, stronger prey animal with a

mind of his 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.

____/____

RIDER RESPONSIBILITY- I UNDERSTAND THAT: 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.

I agree that the rider shall be responsible for his/her own safety, and that of an unborn child if the rider is pregnant. THIS STABLE advises

pregnant women not to ride horses, unless permission is given under advice of her physician.

____/____

CONDITIONS OF NATURE-I UNDERSTAND THAT: THIS STABLE 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, lightning, rain, wind, water, wild and

domestic animals, insects, reptiles, which may walk, run, or fly near, or bite or sting a horse or person; and irregular looting 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.

G. ____/____CARRY-ON OBJECTS AND SHARP NOISES- I UNDERSTAND THAT: Riders must not carry loose items on rides which may fall, blow away,

flap in the wind, bounce, or make sharp noises, possibly scaring a horse. SOME EXAMPLES ARE: Cameras, hats not securely fastened under

chin, toys, purses. Riders must not make sharp, loud noises, such as screaming or yelling, which may scare a horse.

____/____

SADDLE GIRTHS-NATURAL LOOSENING- I UNDERSTAND THAT: Saddle girths (saddle fasteners around horse's belly may loosen during a

ride. If a rider notices this he/she must alert the nearest guide or wrangler as quickly as possible so action can be taken to avoid slippage of saddle

and a potential fall from the animal.

____/____

ACCIDENT/MEDICAL INSURANCE- I AGREE THAT: Should emergency 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

________________________________.