Student's Name *

First Name

Last Name

Your Name *

First Name

Last Name

Address *

Address 1

Address 2

City

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In case of an emergency contact: *

First Name

Last Name

Phone Number *

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INDEMNIFICATION, WAIVER, AND RELEASE OF LIABILITY *

I understand and acknowledge that any involvement with horses or ponies can be hazardous and that riding is an athletic activity that involves numerous risks of injury, even death, to people riding and working around horses and ponies. I assume responsibility and attest that the Student is in good physical health and capable of participating in the activities at Rising Stars Equestrian LLC, including, but not limited to, grooming, handling horses and participating in lessons (“Activities”). The Student is voluntarily participating in these Activities and assumes all of the risks and hazards incidental to this participation, whether known or unknown to the Student and/or their Guardian. I specifically waive, release, absolve, indemnify, covenant not to sue, and agree to hold harmless Rising Stars Equestrian LLC, its officers, agents, employees, volunteers and contractors (“RSE”) for all actions, claims, demands, costs (including attorney’s fees), losses, liabilities, damages, or injuries to the Student (including death) resulting from conduct that constitutes ordinary negligence or for risks that are inherent in these Activities. I also agree to indemnify and hold harmless RSE for all actions, claims, demands, costs (including attorney’s fees), losses, liabilities, damages or injuries to the Student (including death) arising out of any act or omission of mine or my agents, servants, or employees. This includes a minor or another who is authorized to sign or accept the agreement on behalf of the minor. I understand that Rising Stars Equestrian LLC and Fortuna Properties staff are not qualified to deliver first aid and will not do so in the event of any accident. In the event of an accident, I consent to the calling of an ambulance or an EMT and any emergency, hospital, medical care or surgical diagnosis or treatment to be rendered to me as found advisable, for any injury that may arise from participation in activities. I also understand and agree that I am solely responsible for all applicable charges for such ambulance, medical treatment, evacuation and rescue costs. This indemnification, waiver and release of liability covers any incident occurring or alleged to have occurred from the date it is signed to the date that Rising Stars Equestrian LLC receives written notice of its termination. By typing your name below, you are signing this Agreement electronically. You agree your electronic signature is the legal equivalent of your manual signature on this Agreement. By typing your name you consent to be legally bound by this Agreement's terms and conditions.

I have read and agree to the waiver agreement.

Today's Date *

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