05.05.2013 Views

release of liability and assumption of risk agreement read before ...

release of liability and assumption of risk agreement read before ...

release of liability and assumption of risk agreement read before ...

SHOW MORE
SHOW LESS

Create successful ePaper yourself

Turn your PDF publications into a flip-book with our unique Google optimized e-Paper software.

RELEASE OF LIABILITY AND ASSUMPTION OF RISK AGREEMENT<br />

READ BEFORE SIGNING<br />

PARTICIPANT’S NAME_____________________________________________ AGE______<br />

(Please Print)<br />

Name <strong>of</strong> Parent or Guardian (if applicable)_________________________ _<br />

Christene Cary<br />

The Double C Ranch 9639 WCR 23, Ft. Lupton CO 80621<br />

303-249-4325<br />

RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT<br />

*BY SIGNING THIS AGREEMENT, YOU ARE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE<br />

RIGHT TO RECOVER DAMAGES IN CASE OF INJURY, DEATH OR PROPERTY DAMAGE.<br />

*PLEASE READ ENTIRE DOCUMENT CAREFULLY BEFORE SIGNING IT. Your signature indicates your<br />

underst<strong>and</strong>ing <strong>of</strong> <strong>and</strong> <strong>agreement</strong> to its terms.<br />

UNDER COLORADO LAW, AN EQUINE PROFESSIONAL IS NOT LIABLE FOR ANY INJURY TO, OR THE<br />

DEATH OF, A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF<br />

EQUINE ACTIVITIES PURSUANT TO COLORADO REVISED STATUTES § 13-21-119.<br />

On behalf <strong>of</strong> myself, my personal representatives, heirs, next-<strong>of</strong>-kin, spouse <strong>and</strong> assigns, I hereby:<br />

1. Acknowledge that a horse or mule may, without warning or any apparent cause, buck, stumble, fall, rear, bite,<br />

kick, run, make unpredictable movements, spook, jump obstacles, step on a person’s feet, push or shove a person,<br />

<strong>and</strong> saddles or bridles may loosen or break – all <strong>of</strong> which may cause the rider to fall or be jolted, resulting in serious<br />

injury or death.<br />

2. Acknowledge that horseback riding is a dangerous activity <strong>and</strong> involves <strong>risk</strong> that may cause serious injury <strong>and</strong>, in<br />

some cases, death, because <strong>of</strong> the unpredictable nature <strong>and</strong> behavior <strong>of</strong> horses, regardless <strong>of</strong> their training <strong>and</strong> past<br />

performance.<br />

3. Voluntarily assume the <strong>risk</strong> <strong>and</strong> danger <strong>of</strong> injury or death inherent in the use <strong>of</strong> any horse I ride or h<strong>and</strong>le at The<br />

Double C Ranch <strong>and</strong> any accompanying equipment <strong>and</strong> gear.<br />

4. Release, discharge, <strong>and</strong> promise not to sue Christene Cary <strong>and</strong>/or The Double C Ranch, <strong>and</strong>/or any partners,<br />

employees <strong>and</strong> agents for any loss, <strong>liability</strong>, damage, or cost whatsoever arising out <strong>of</strong> or related to any loss,<br />

damage, or injury (including death) to my person or property.<br />

5. Acknowledge that I have been <strong>and</strong> will continue to be c<strong>and</strong>id <strong>and</strong> honest with Christene Cary <strong>and</strong>/or The Double<br />

C Ranch, <strong>and</strong>/or any partners, employees <strong>and</strong> agents concerning my riding experience <strong>and</strong> ability around horses.<br />

6. Indemnify, <strong>and</strong> save <strong>and</strong> hold harmless Christene Cary <strong>and</strong>/or The Double C Ranch, <strong>and</strong>/or any partners,<br />

employees <strong>and</strong> agents from <strong>and</strong> against any loss, <strong>liability</strong>, damage or cost they may incur arising out <strong>of</strong> or in any<br />

way connected with my use <strong>of</strong> any horse I ride or h<strong>and</strong>le at The Double C Ranch <strong>and</strong> any accompanying equipment<br />

or gear.<br />

7. Agree I will abide by <strong>and</strong> follow any instruction given or rules established by Christene Cary <strong>and</strong>/or The Double<br />

C Ranch, <strong>and</strong>/or any partners, employees <strong>and</strong> agents with regard to the use <strong>of</strong> horses or equipment or gear in<br />

connection with the horse I ride or h<strong>and</strong>le.<br />

8. Acknowledge that this document is a contract <strong>and</strong> agree that if a lawsuit is filed against Christene Cary <strong>and</strong>/or The<br />

Double C Ranch, <strong>and</strong>/or any partners, employees <strong>and</strong> agents for any injury or damage in breach <strong>of</strong> this contract, the


Undersigned will pay all attorney’s fees <strong>and</strong> costs incurred by Christene Cary <strong>and</strong>/or The Double C Ranch, or any <strong>of</strong><br />

their agents, partners, or employees in defending such an action.<br />

The undersigned expressly agrees that the foregoing <strong>release</strong> <strong>and</strong> waiver <strong>of</strong> <strong>liability</strong>, <strong>assumption</strong> <strong>of</strong> <strong>risk</strong> <strong>and</strong><br />

indemnity <strong>agreement</strong> is governed by the Sate <strong>of</strong> Colorado <strong>and</strong> is intended to be as broad <strong>and</strong> inclusive as is<br />

permitted by Colorado law, <strong>and</strong> that in the event any portion <strong>of</strong> this Agreement is determined to be invalid, illegal,<br />

or unenforceable, the validity, legality <strong>and</strong> enforceability <strong>of</strong> the balance <strong>of</strong> the Agreement shall not be affected or<br />

impaired in any way <strong>and</strong> shall continue in full legal force <strong>and</strong> effect.<br />

I HAVE READ THIS DOCUMENT. I UNDERSTAND IT IS A PROMISE NOT TO SUE AND A RELEASE<br />

AND INDEMNITY FOR ALL CLAIMS.<br />

Signed_____________________________________ Date______________________<br />

(Signature <strong>of</strong> parent or guardian or minor rider)<br />

Your Contact Information:<br />

Name: Age:<br />

Name <strong>of</strong> Parent or Guardian (if applicable):<br />

Address:<br />

Phone: __________________________________________________________<br />

Email: __________________________________________________________<br />

Date <strong>of</strong> Birth: ____________________________________________________<br />

Please provide emergency contact information for another individual below:<br />

Emergency Contact Information:<br />

Name: _________________________________________________________________<br />

Phone: _________________________________________________________________<br />

Relation: ________________________________________________________________<br />

Please list all allergies, injuries <strong>and</strong> other pertinent medical information, behavioral issues, or<br />

other things that may affect you when riding or being around horses:

Hooray! Your file is uploaded and ready to be published.

Saved successfully!

Ooh no, something went wrong!