RIDING INSTRUCTION AGREEMENT AND LIABILITY RELEASE FORM
THIS FORM MUST BE COMPLETED BY OR FOR EACH PARTICIPANT IN HORSEBACK
RIDING AND RELATED ACTIVITIES AT THE
MORNING GLORY HILL STABLE LLC
3224 118TH ST. SE., BLOOMING PRAIRIE, MN 55917 HEREINAFTER KNOWN AS
CAREFULLY BEFORE SIGNING :
SERIOUS INJURY MAY RESULT FROM PARTICIPATION IN
THIS ACTIVITY. MGHS 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 if a minor, do hereby voluntarily request and agree to participate in riding or riding instruction as a
student at MGHS and that this student will either ride his/her own horse, or school horses provided by MGHS for recreational
or instructional purpose, today and on all future dates:
B. AGREEMENT SCOPE AND TERRITORY
AND DEFINITIONS-- This agreement
shall be legally binding upon me and the registered student, and the parents and 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 of MGHS's physical location. If in any clause, phrase or word is in conflict with state law, then that single
part is null and void. The term "HORSEBACK RIDING" herein shall refer to riding or otherwise handling of horses,
whether from the ground or mounted. The terms "STUDENT" and /or "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 student 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. In the course of learning
to ride, ground work activities such as tumbling and "riding" suspended barrels, and emergency dismounting from
the horse are intended to make riding safer, but these are strenuous activities which themselves carry serious risks.
NATURE OF MGHS'S SCHOOL HORSES-- I UNDERSTAND THAT: MGHS chooses and trains it's school horses for their calm dispositions and sound basic training as
is required for use by STUDENT RIDERS , and MGHS follows a rigid safety program. Yet, no riding horse is a completely safe
horse. Horses are 5 to 15 times larger, 20-40 times more powerful, and 3-4 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- 5 1/2 feet, and the impact may result in injury to the rider.
If a horse is frightened or provoked it may divert from it's training and act according to it's natural survival instincts
which may include but are not limited to : Stopping short; Changing directions or speed at will; Shifting it's weight Bucking,
Rearing, Kicking, Biting or Running from danger.
E. 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 on his/her ability to carry out simple instructions,
and his/her ability to remain balanced and calm aboard a moving animal. I agree that the rider shall be responsible for his/
her own safety
F. CONDITIONS OF NATURE-- I UNDERSTAND THAT: MGHS 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, wild and domestic animals, insects, reptiles, which may walk, run, or fly near , or bite or sting a horse
or person; irregular footing on out-of -door groomed or wild land which is subject to constant change in condition according
to the weather, temperature, and natural man-made changes in landscape.
G. SADDLE GIRTHS/NATURAL
LOOSENING-- I UNDERSTAND THAT:
Saddle girths (fasteners around a horse's belly) may loosen during a ride. If a rider notices this he/she must alert the riding
instructor so action can be taken to avoid slippage of a saddle and a potential fall from the animal.
ACCIDENT/MEDICAL INSURANCE-- I AGREE THAT: Should emergency or other medical treatment be required I and/or my own accident/medical insurance company shall pay
for all such incurred expenses. I shall also pay any medical insurance deductibles
HEAD GEAR WARNING -- I AGREE THAT: I have been fully warned and advised by MGHS that I should purchase and wear protective head gear (equestrian helmet)
, and do understand that the wearing of such head gear while mounting, riding, dismounting, and otherwise being around horses,
may prevent or reduce the severity of some head injuries, and even prevent death from happening as result of a fall or other
occurrence It is understood that MGHS -PROVIDED protective head gear may not be perfect fit for each rider's head, and that
once provided I/WE will be responsible for securing these helmets on this rider's head at all times.
LIABILITY RELEASE -- In consideration
of MGHS 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 MGHS, it's owners, agents, employees, officers, members, premises
owners, and affiliated organizations from legal liability due to THIS MGHS's ordinary negligence; and I do further agree that
except in the event of THIS MGHS's gross and willful negligence, I shall bring know claims, demands, actions, and causes of
action, and/or litigation, against MGHS and ITS ASSOCIATES as stated above in relation to the premises and operations of MGHS,
to include while learning about riding, or while riding, handling, or otherwise being near horses owned by or in the care
, custody and control of MGHS. 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 THE FACTS RELATING TO THE APPLICANTS PHYSICAL CONDITION, EXPERIENCE,
AND AGE ARE TRUE AND ACCURATE
INSURANCE INFORMATION IS REQUIRED.
My ACCIDENT/MEDICAL INSURANCE COMPANY is:_________________________________
and the POLICY NUMBER is: ____________________________________
Riding is a rigorous activity.
Does this rider have physical/mental health problems that will affect his/her ability to ride a horse ?_______YES______NO IF '"yes" describe here:
RIDER OR PARENT/GUARDIAN (IF UNDER 18)______________________________________________
PRINT students name here
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