Release Form
(this information is confidential)
Student
Staff
Volunteer
Name:______________________ DOB:___________ Phone:_____________________
Address:_______________________________________________________________
City:
State:
Zip:
Email:_________________________________________________________________
Allergies to Medications:__________________________________________________
In the event of an emergency contact:
name: ________________________ relation:______________phone:_______________
name: ________________________ relation:______________phone:_______________
name:_________________________relation:______________phone:_______________
Title 4. Liability in Tort. Chapter 87. Liability Arising from Equine
Activities or Livestock Shows. This Texas section provides that any person, including an
equine activity sponsor, equine professional, livestock show participant, or livestock show sponsor, is not
liable for property damage or damages arising from the personal injury or death of a participant in an equine
activity or livestock show if the property damage, injury, or death results from the dangers or conditions that
are an inherent risk of an equine activity or the showing of an animal on a competitive basis in a livestock
show. 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
engage 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. The statute also requires the visible displaying of "clearly readable"
warning signs that alert participants to the limitation of liability by law.
--I
understand that horseback riding and any activity that involves horses can be
dangerous. I understand that all instructors, volunteers and other workers will not be held
responsible for any injury that may occur. I will comply with all safety precautions
designated by the facility.--
X ______________________________________Date:______________