HORSE RIDING AGREEMENT AND LIABILITY RELEASE FORM
This form must be completed by and for each participant
Kicking Back Stables
Joelle & Danny Pinto
3415 Double Springs Road
Monroe, Ga. 30656
PLEASE READ CAREFULLY BEFORE SIGNING
SERIOUS INJURY MAY RESULT FROM YOUR PARTICIAPTION IN THIS ACTIVITY.
THIS STABLE DOES NOT GUARANTEE YOUR SAFETY OR THAT OF YOUR HORSE.
IT IS HEREBY AGREED TO AS FOLLOWS: THAT
A.
REGISTRATION OF RIDERS AND AGREEMENT PRUPOSE. I, the following
listed individual hereinafter known as the “RIDER” and the parents or legal
guardians there of if a minor, do hereby voluntarily request and agree to
participate in horse riding on KICKING BACK STABLE’S premises, and the
neighborhood and parks and ranches and that this RIDER will ride a horse
owned by or boarded at KICKING BACK STABLE’S.
RIDER NAME
AGE (If under 21)
______________________________________
______________________
B.
AGREEMENT SCOPE, TERRITORY AND DEFINITIONS. This agreement shall be
legally binding upon me the registered RIDER, and the parents or legal guardians there
of 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 KICKING BACK STABLE’S physical location. Any disputes by the RIDER shall be
litigated in and venue shall be the county in which KICKING BACK STABLE’S is
physically located. 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, weather from 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. Int.____
C.
ACTIVITY RISK CLASSIFICATION. Horseback riding is classified as a RUGGED
ADVENTURE RECREATIONAL SPORT ACTIVITY, and 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
th
United States Consumer Products) horse activities rank 64
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. Int.____
D.
NATURE OF RIDING A HORSE. 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 from 3-5 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, and become on
unit of movement with, another much larger, stronger pray 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 instances
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. Int.____