release » Sunnyside Farms

RELEASE AND HOLD HARMLESS AGREEMENT

Whereas, the undersigned acknowledges and understands the benefits and inherent risks involved in riding and working with and around horses, and in spending time in a farm environment. This includes, but is not limited to: Visiting, haltering, leading, grooming, saddling, bridling, basic barn maintenance, stall cleaning, feeding, arena riding, trail rid- ing, carriage riding, indoor activities, time spent with other animals and people, and other normal and special activities that take place at Sunnyside farm. In consideration of the privilege of visiting, riding and/or working around horses and oth- ers at Sunnyside farm, 104 West First Street, Clyde Park, Montana, the undersigned therefore agrees to release from any and all liability, hold harmless and indemnify Wendy Bauwens (farm and property owner, instructor, trainer, business owner, barn manager) and Sunnyside Farms, Inc. (nonprofit organization) in relation to any accident, damage, injury, or illness or any other claims by or on behalf of the undersigned or any horse owned by the undersigned or to any family member or spectator accompanying the un- dersigned on the premises of Sunnyside Farm. As specially noted, our society is in the midst of the COVID-19 pandemic. While Wendy Bauwens and Sunnyside Farms, Inc. and all staff, volunteers and helpers will do our best to appropriately manage group size, quantity of visits, social distancing, sanitary practice, cleanliness and safety protocols, it is ultimately the parent’s and participant’s choice to attend activities at Sunnyside Farms, and maintain their own oversight of health practices. The undersigned is solely responsible to provide and/or approve of proper PPE and make all health-related judgments and decisions regarding known or perceived risk relating to COVID-19, whether great or small. The undersigned further agrees to notify Wendy Bauwens and stay home in any event of not feeling well, showing any signs of COVID-19, or if they or anyone in their home (or in their exposure cluster) is at high risk. Wendy Bauwens and Sunnyside Farms, Inc. shall not be held liable for any role or responsibility in any known or suspected transmission of COVID-19 or any other illness.

Initial

Helmets*

Farm safety rules and practices are presented by Wendy Bauwens of Sunnyside Farm with good faith efforts to avoid any and all accidents. No Guarantees provid- ed. Participants agree to provide their own SEI approved helmets or will not be able to ride or drive. The Montana equine activity liability act provides that it is the policy of the state of Mon- tana that a person is not liable for damages sustained by another solely as a result of risks inherent in equine activities if those risks are or should be reasonably obvious, expected, or necessary to persons engaged in equine activities. Liability is not limited by this statute where the equine professional knowingly provided faulty tack or equipment, failed to make reasonable and prudent efforts to determine the ability of the participant to en- gage safely in the equine activity, owns or otherwise is in lawful possession of the land or facilities upon which the participant sustained injuries because of a known, dangerous latent condition, or if he or she commits an act or omission that constitutes willful or wanton disregard for the safety of the participant or intentionally injures the participant.

Initial

Participant and Guardian Information

Please fill out the information below.

Participant's Name:

First Last

Participant's Age*

Guardian's Name (if participant is under 18):

First Last

Participant or Guardian's Email:

Participant or Guardian's Phone Number:

Participant or Guardian's Address:*

Participant or Guardian (over 18) Signature:*

Date of Liability Release:*

In Case of an Emergency, Contact:*

Emergency Contact Phone Number:

Health Insurance Plan:*

Is this used for primary coverage?

Yes
No

Medical Doctor:*

Doctor's Phone Number:

Dentist:*

Dentist's Phone Number:

Please List Allergies:*

Please List any Special Needs, Concerns or Indications:*

In what program and capacity will you or your child be participating at Sunnyside Farms?*

How much and what kind of equine experience do you (or does the participant) have?

Do you understand the risks inherently associated with being on and around horses and farm activities?

Yes
No

Do you own and can you provide a helmet for yourself and/or the participant?

Yes
No

Do you understand the risks of group activities and the spread of disease/infection?

Yes
No

Do you own and can you provide PPE for yourself and/or the participant?

Yes
No

Additional Information

Please provide any additional information

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Release and Hold Harmless Agreement

Participant and Guardian Information

Additional Information

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