Acknowledgement of Warning and Assumption of Risk and Complete Release

Participant Name: __________________________________________________

(Please print. If participant is under 18, include name of parent or guardian at bottom of form.)

Street Address:  ____________________________________City, State & Zip: ___________________________

Home Phone: (_____)_________________ Email Address: ___________________________________ 

Warning: Under Florida Law (FLORIDA STATUTES, TITLE XLV TORTS, CHAPTER 773, EQUINE ACTIVITIES), an Equine Activity Sponsor or Professional is not liable for any injury to, or the death of a participant to Equine activities, resulting in the inherent Risk of Equine Activities.

In consideration of permission to use today and on all future days, the property, Equines (horses, ponies, mules or donkeys), facilities and service of HIRE A PONY RIDING ACADEMY, INC. 

I, the undersigned participant, hereby expressly agree

1. That I am fully aware of the inherent risk of Equine activities, including but not limited to the propensity of Equines to behave in ways that may result in injury, harm or death to persons on or around them; the unpredictability of an Equine reaction to such things as sounds, sudden movement, and unfamiliar objects, persons or other animals. Certain hazards such as surface and sub-surface conditions, collisions with other Equines or objects and the potential of a participant to act in negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the animal or not acting within his or her ability.  I HEREBY ASSUME ANY AND ALL RISKS INVOLVED IN OR ARISING FROM MY PARTICIPATION IN EQUINE ACTIVITIES OR MY USE OF OR PRESENCE UPON THE PROPERTY OR FACILITIES OF HIRE A PONY RIDING ACADEMY,INC._______(Initial)

1. To release HIRE A PONY RIDING ACADEMY, INC. and all of its successors, assigns, affiliates, officers, directors, employees, and agents from and agree not to sue any or all of them on account of or in connection with any claims, causes of action, injuries, damages cost or expenses arising  out of my participation in Equine activities or my presence upon or the use of the property, facilities, or service of HIRE A PONY RIDING ACADEMY, INC., whether or not caused by the negligence or other fault of HIRE A PONY RIDING ACADEMY, INC. or any property or equipment supplied by HIRE A PONY RIDING ACADEMY, INC. ________ (Initial)

1. That this release shall be binding upon my heirs, assigns, legal representatives, or personal representatives. _______ (Initial)

1. To waive the protection afforded by any statute or law in any jurisdiction whose purpose, substance, and/or affects is to provide that a general release shall not extend to claims, material or otherwise, which the person giving the Release does not know or suspect to exist at the time of the execution of the Release. _______ (Initial)

1. That, if I ignore this agreement and initiate claim or suit against HIRE A PONY RIDING ACADEMY, INC., I will be responsible for all attorneys’ fees and costs incurred by HIRE A PONY RIDING ACADEMY, INC. ________ (Initial)

1. That if the participant under this release is a minor child, I as parent or guardian of that minor child undertake the obligation of this Release on behalf of the minor child in giving my permission and consent for the minor child to participate in Equine activities and therefore, do agree to the fullest extent allowable by law on behalf of a minor child confer upon HIRE A PONY RIDING ACADEMY, INC. all the benefits of this Assumption of Risk and Complete Release and do further agree to indemnify and hold harmless against any claim, demand, or suit including all attorneys’ fees and costs incurred by HIRE A PONY RIDING ACADEMY, INC. whether or not the basis for any claim, demand, or suit is caused in whole or in part by the actual or alleged negligence or other fault of HIRE A PONY RIDING ACADEMY, INC., its Equines, facilities or service.     _______ (Initial)

1. I have read and fully understand this Agreement.  I understand that by making and signing this Agreement I surrender valuable rights, including, but not limited to, my right to sue. _________ (Initial)

Riding ability of participant:   Beginner _______ Intermediate _________   Experienced _________ (Initial)

Is participant a minor?     Yes     No    (Circle one)

If participant is a minor child, name of parent or guardian:  (Please print) ______________________________

Parent/Guardian: Relationship:  _____________________

Health Insurance policy number and/or company name:  _______________________

IF YOU ARE UNDER THE AGE OF 16, YOU MUST WEAR A HELMET.

A riding helmet is recommended safety gear for all participants.  I will wear a helmet _____. I will not wear a helmet ____(Initial)

_______________________________________________________________________

Participant’s Signature or Parent/Guardian signature if participant is a minor.  

Hire a Pony Riding Academy, Inc. provides this document in good faith absent any intention to misstate any declaration of danger associated with participation in Equine activities.

8005 South Racetrack Rd., Tampa, Florida  33635 –  www.hireapony.com – hireapony1@aol.com

EQUINE ACTIVITY SPONSOR RELEASE

Please fill out front & back. Thank You.

KNOW ALL MEN BY THESE PRESENTS, that _________________________, who resides at _________________________________________________________________, (hereinafter referred to as “Participant”), desires to engage in and does hereby engage in the following equine activity, to wit: A guided tour of the ecosystems; riverine, cypress swamp, pastureland, flatwoods and sand pine communities, as well as, but not limited to, holes or uneven ground, cattle, white tailed deer, Osceola turkey, armadillos, feral hogs, snakes, and birds located at the Anclote River Ranch, Anclote Management Company and Flatwoods Adventures at 12959 S.R. 54, Odessa, Florida  33556.

FOR AND IN CONSIDERATION OF THE ABOVE ACTIVITIES, SERVICES AND ENTRY FEES PAID, receipt and sufficiency of which is hereby acknowledged, Participant hereby does forever and finally release, remise, acquit, satisfy and forever discharge the Equine Activity Sponsor of and from all manner of action and actions, cause and causes of action, suit debts, dues, sums of money, bonds, billings, contracts, controversies, agreements, promises, damages, variances, judgments, executions, claims and demands whatsoever, in law or in equity, which may arise or might in the future arise or herein after may arise for or against the Equine Activity Sponsor for the activities as stated above.  ________ (Initial)

This document is meant to be a full and complete release from any and all liability that may arise from participating in the above-described equine activity.  The release is given freely and voluntarily by the Participant and is meant to remain in existence throughout the duration of the equine activity.  ________ (Initial)

WARNING

Under Florida law, an equine activity sponsor or equine professional is not liable for an injury to, or the death of a participant in equine activities resulting from the inherent risks of equine activities.

Dated this the _____day of ________________, 20______.

Participant: ______________________________________

Legal Guardian (If participant is a minor child)  __________________________________