Easy Street Horse & Barnyard Rescue, Inc. 109 Langley Road,. Email:
. Amsterdam, NY 12010. Farm Phone: 518-421-0125.
Release ...
Easy Street Horse & Barnyard Rescue, Inc. 109 Langley Road, Amsterdam, NY 12010
Email:
[email protected] Farm Phone: 518-421-0125
Release and Hold Harmless Agreement This form must be completed in full. Name:
____________________________________________________________
Street Address:
___________________________________________________
City, State, Zip ________________________________________________________ Telephone:___________ Emergency name/phone number:_____________________ Email:______________________________________________ Age:_____________ Horses are a prey animal, which means their reactions to unknown threats are flight or fight. They are determined under the law to carry an inherent risk due to the very nature of the horse. Even a very well trained horse is considered unpredictable and an inherent risk. The person signing this release acknowledges the inherent risks involved in riding horses and just being around horses, which risks may include bodily injury and even death from using, riding, or being in close proximity to horses, among other risks. In CONSIDERATION, therefore, for the privilege of riding/working/volunteering around horses at 109 Langley Rd, Amsterdam NY 12010 and/or at any location of a horse owned by Easy Street Horse Rescue, the undersigned does hereby agree to hold harmless and indemnify Nina and Paul Bellinger, owners of aforementioned property, and EASY STREET HORSE & BARNYARD RESCUE, INC. and all employees and/or volunteers thereof, and further release them from any and all liability or responsibility for accident, damage, injury, or illness to the undersigned or any horse owned by the undersigned or to any family member or spectator accompanying the undersigned on the premises. I, ____________________________________,[NAME PRINTED] AGREE TO THIS “RELEASE AND HOLD HARMLESS AGREEMENT” IN ITS ENTIRETY. WE WILL ABIDE BY ANY AND ALL RULES AS SET FORTH BY THE FARM, WHICH INCLUDES WEARING A HELMET WHEN RIDING, AND WILL NOT PHYSICALLY HANDLE ANY HORSE WITHOUT PERMISSION OF MANAGEMENT, NOR TAKE ANY ACTION THAT MIGHT BE DEEMED HARMFUL TO ANY HORSE ON THE PREMISES.
Date___________Signature______________________________________________
If under 18, Signature of Parent or Guardian: ___________________________________________________________
