DIAMOND LK COUNSELING, P.L.L.C.
EQUINE LIABILITY RELEASE AND ASSUMPTION OF RISK
AGREEMENT
AGREEMENT SCOPE, GOVERNING LAW AND DEFINITIONS: This Equine Liability
Release and Assumption of Risk Agreement (this “Release”) shall be legally binding upon me,
the participant, and the parent and/or legal guardian(s) thereof (if I am a minor), my heirs, estate,
and assigns, including all minor children and personal representatives. This Release shall be
interpreted according to the laws of the State of Texas. If any clause, phrase or word is in conflict
with state law, then that single part is null and void. The term “Horse” used herein shall refer to
any equine animal as defined in Chapter 87 of the Texas Civil Practice and Remedies Code (the
“TCPRC”) and any successor provisions. “Equine Activity” shall refer to riding, driving or
otherwise handling Horses, whether from the ground or mounted, and any other equine activity
as defined in the TCPRC. The term “Participant” shall herein refer to any person who rides a
Horse, or otherwise drives, handles, or comes near a Horse and any participant as defined in the
TCPRC. The terms “I”, “me”, “my” shall herein refer to the participant and the parents or legal
guardians thereof, if a minor. The term “Diamond LK Counseling, P.L.L.C.” shall herein refer to
its owners, premises, employees, contract workers and other agents.
EQUINE ACTIVITIES WARNING: UNDER TEXAS LAW (CHAPTER 87, CIVIL
PRACTICE AND REMEDIES CODE), AN EQUINE PROFESSIONAL IS NOT LIABLE
FOR ANY INJURY TO OR DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES
RESULTING FROM THE INHERENT RISK OF EQUINE ACTIVITIES.
1. LIABILITY RELEASE & INDEMNIFICATION: In consideration of allowing my
participation in any Equine Activity with Diamond LK Counseling, P.L.L.C.:
a.
I, the Participant, and the legal parent or guardian thereof if a minor,
expressly acknowledge and agree that equine activities are very dangerous and
involve risk of serious injury and/or death and/or property damage.
b. I, for myself, my heirs, successors, executors and agents, hereby
KNOWINGLY AND INTENTIONALLY WAIVE AND RELEASE,
INDEMNIFY AND HOLD HARMLESS: (i) DIAMOND LK
COUNSELING, P.L.L.C., its owners, agents, contract workers, employees
and any owner of any horse used by Diamond LK Counseling, P.L.L.C., (ii)
LISA J. KRUSE-LONG and (iii) DIAMOND LK CUTTING HORSES,
L.L.C., its owners, agents, contract workers, employees and any owner of any
Horse used by Diamond LK Cutting Horses, L.L.C. from and against any and
all claims, actions, causes of action, liabilities, suits, expenses (including
reasonable attorney’s fees) and NEGLIGENCE of any kind or nature, whether
foreseen or unforeseen, arising directly from or indirectly out of any damage,
loss, injury, paralysis or death to me or my property as a result of my presence
at or participation in any activities at or during transport to or from Diamond
LK Counseling, P.L.L.C., whether such damage, loss, injury, paralysis or
death results from negligence of Diamond LK Counseling, P.L.L.C., or its
DIAMOND LK COUNSELING, P.L.L.C. EQUINE LIABILITY RELEASE FORM- PAGE 1 OF 4
owners, agents, and employees, or from some other cause. I AGREE that
neither I, nor anyone acting on my behalf, will make a claim against, sue or
otherwise maintain action of any kind against Diamond LK Counseling,
P.L.L.C. as a result of any injury, paralysis or death to me, or damage to my
property.
2. INHERENT RISKS / ASSUMPTION OF RISKS: I HEREBY ACKNOWLEDGE THAT:
Horseback riding is classified as RUGGED ADVENTURE RECREATIONAL SPORT
ACTIVITY and that risks, conditions, and dangers are inherent in (meaning an integral part
of) horse / equine / animal activities, regardless of all feasible safety measures which can be
taken, and I agree to assume them. The inherent risks include, but are not limited to any of
the following: The propensity of an animal to behave in ways that may result in injury, harm,
death, or loss to persons on or around the animal; The unpredictability of an equine’s reaction
to sounds, sudden movement, unfamiliar objects, persons, or other animals; Hazards,
including, but not limited to, surface or subsurface conditions; A collision, encounter and / or
confrontation with another equine, another animal, a person, or an object; The potential of an
equine activity participant to act in a negligent manner that may contribute to injury, harm,
death, or loss to the participant or to other persons, including but not limited to, failing to
maintain control over an equine and / or failing to act within the ability of the participant.
Horses are 5 to 15 times larger, 20 to 40 times more powerful, and 3 to 4 times faster than a
human. If a rider falls from horse to ground it will generally be at a distance of from 3 1/2 to
5 1/2 feet, and the impact may result in harm to the rider. Horseback riding is an activity in
which one much smaller, weaker predator animal (the human) tries to impose its will on, and
become one unit of movement with, another much larger, stronger prey animal that has a
mind of its own (the horse) and each has a limited understanding of the other. If a horse is
frightened or provoked it may divert from its training and act according to its natural survival
instincts which may include, but are not limited to: stopping short; spinning around; changing
directions and / or speed at will; shifting its weight; bucking; rearing; kicking; biting; and / or
running from danger. I also acknowledge that these are just some of the risks and I agree
to assume others not mentioned above. I am not relying on DIAMOND LK
COUNSELING, P.L.L.C., to list all possible risks for me.
3.
DIAMOND LK COUNSELING, P.L.L.C.’s PROTECTIVE HEADGEAR / HELMET
POLICY I understand and agree that Diamond LK Counseling, P.L.L.C. requires riders to
wear ASTM Standard F 1163 Protective Headgear / Helmet according to the following
requirements:
Rider Age
6 Yrs and
Younger
7 Yrs through
15 Yrs
16 and 17 Yrs
18 Yrs and
Older
Protective Headgear/ Helmet Requirement
For their Safety, children 6 yrs old and younger may not participate as a rider
in horse rental and trail riding equestrian services.
Must wear the protective headgear / helmet.
Must wear the protective headgear / helmet unless their parents or legal
guardians sign the refusal statement in the box that follows.
Must choose to wear or not to wear the protective headgear / helmet by
checking the acceptance or refusal box that follows.
DIAMOND LK COUNSELING, P.L.L.C. EQUINE LIABILITY RELEASE FORM- PAGE 2 OF 4
4. PROTECTIVE HEADGEAR / HELMET ACCEPTANCE OR REFUSAL
SELECTION FOR RIDERS 16 YEARS AND OLDER
✔Check your choice:
PROTECTIVE HEADGEAR / HELMET ACCEPTANCE: I / WE request for this
participant to wear protective headgear / helmet which THIS STABLE provides and will
be solely responsible for securing the headgear / helmet on the participant’s head.
PROTECTIVE HEADGEAR / HELMET REFUSAL: I / WE refuse for this
participant to wear any type of protective headgear / helmet and / or will
provide MY / OUR own. I / WE assume full responsibility for MY / OUR safety in this
decision.
SIGNER STATEMENT OF AWARENESS
I, THE PARTICIPANT, AND THE PARENT OR LEGAL GUARDIAN THEROEF, IF
MINOR, HAVE READ AND UNDERSTAND THE FOREGOING WARNINGS, THE
LIABILITY RELEASE AND THE ASSUMPTION OF RISK AND VOLUNTARILY
SIGN THIS AGREEMENT.
[Signature Page to Follow]
DIAMOND LK COUNSELING, P.L.L.C. EQUINE LIABILITY RELEASE FORM- PAGE 3 OF 4
______________________________________________________________________________
Signature of Participant
Date
______________________________________________________________________________
Signature of Parent or Guardian
Date
Please Print Clearly:
PARTICIPANT’S NAME:____________________________ DATE OF BIRTH:___________
Address:_______________________________
Telephone:__________________________
_______________________________
Alt. Phone:__________________________
_______________________________
Email address: _______________________
If under Age 18:
NAME OF PARENT OR GUARDIAN:_____________________________________________
Address:_______________________________
Telephone:__________________________
_______________________________
Alt. Phone:__________________________
_______________________________
Email address: _______________________
EMERGENCY CONTACTS
Name:_________________________________
Telephone:__________________________
Relationship to Participant:___________
Name:_________________________________
Telephone:__________________________
Relationship to Participant:___________
DIAMOND LK COUNSELING, P.L.L.C. EQUINE LIABILITY RELEASE FORM- PAGE 4 OF 4
Download

File - Diamond LK Counseling