Stubbe Horse Farm Ltd. Student Registration Form
Rider's name: ___________________________________________________
Guardian's name(s): ___________________________________________________
Phone number(s): ___________________________________________________
Health Card number: _____________________________________
OEF #:__________________ D.O.B.:_________________
E-mail: ___________________________________________________________
Emergency contact: _________________________________________________
Emergency phone number: ___________________________________________
Address:__________________________________________________________
_________________________________________________________________
Any medical concerns, allergies:_______________________________________
_________________________________________________________________
I HAVE RECEIVED, READ, AND UNDERSTAND THE MAKEUP POLICIES AND RULES OF Stubbe
Horse Farm Ltd, AND AGREE TO ABIDE BY THESE POLICIES.
SIGNATURE: __________________________ DATE: ___________________
(SIGNATURE OF PARENT OR GUARDIAN IF UNDER 18)
Please fill out one Registration per rider. For parents of riders under 18 we ask you to also fill out a waiver
form.
Thank you!
Stubbe Horse Farm Ltd.
Effective Mar 2013
Lesson Registration & Payment
Lessons are billed monthly due the beginning of the month please bring
cheque or cash to the first lesson of the month, or no later then the 10 of
that month. Payments submitted after the 10th of the month are subject to a
$10 late fee. Invoices will be on the Bulletin board or send via e-mail if
available one week before the billing month. *Boarders and leasers are
required to pay by the 1st of the month. *
There is a $20 NSF cheque fee.
Makeups for Lesson Cancellations
 If you wish to cancel a lesson you must inform Stubbe Horse Farm
Ltd. at least 24 hours before your lesson time. Makeups will not be
given for no-shows or late cancelations.
 There are limited amounts of spots available for makeup lessons, so
please book as soon as you can. It is the rider’s responsibility to book
the makeup lessons.
 All make up lessons need to be taken WITHIN THE MONTH that you
cancelled your lesson.
 If Stubbe Horse Farm Ltd. cancels lessons for any reason and no
makeup lesson can be found credit will be given.
 Stubbe Horse Farm Ltd. will try its best to give convenient make up
times, but note that Stubbe Horse Farm Ltd. cannot guarantee
convenient days/times for makeup lessons.
Stubbe Horse Farm Ltd.
Effective Mar 2013
Rules and Regulations of Stubbe Horse Farm Ltd.
1. All Riders MUST wear an ASTM approved helmet with attached harness and
heeled boots when riding any horse. Hair should be tied back neatly, avoid long
scarves and dangling jewellery.
2. Riders are welcome to bring friends and family but they are responsible for their
guests. Guests are not allowed in stalls or paddocks or to help with your horse.
Children under the age of 10 must be supervised at all times by an adult.
3. Riders are allowed to give treats to their horses at appropriate times but may not
feed tied horses while other horses are around/close to them. You can give your
horse a snack on the way in or out to the paddock. If your horse gets grain
please ensure there is plenty of room beside the horse so no horse fights start.
Never leave your horse while it is eating its grain.
4. All students are shown how to properly tack up their horse, sweep up their area
and clean the tack/ put it away. As a rider it is expected that you groom your
horse properly, sweep before and after you ride, tell us about any cuts that you
may find on your horse and clean tack thoroughly. Please treat our horses and
tack as if they are your own. If you arrive late to a lesson you are still expected to
groom the horse properly and clean up your area!
5. All riders MUST sign a waiver form! There are absolutely NO EXCETIONS TO
THIS! If you have not signed a waiver form please stay off the horse.
6. When entering the arena or tack up area please yell “door”, and wait for an ok.
7. When riding in the arena with other people, please be courteous with your
actions. Try and stay on the same rein as the other horses, call out what you are
doing before you do it and talk to the other riders in the arena.
8. No horse should be loose in the arena or sand ring at any time, always hold onto
your horse while fixing stirrups/ tightening girths etc.
9. Free lunging is only allowed with permission from Silke Stubbe or Justin Norell.
10. There should be no jumping in free rides on Stubbe Horse Farm Ltd. school
horses. If you are over 18 years old and own your own horse you may jump but
please have a second person with you while you jump in case something
happens. Stubbe Horse Farm Ltd. reserves the right to ask anyone jumping to
stop if they are putting themselves or the horse at risk.
Thank you,
Stubbe Horse Farm Ltd.
Stubbe Horse Farm Ltd.
Effective Mar 2013
ACKNOWLEDGMENT of RISK and RELEASE of LIABILITY – “For Participants Not 18 Years Old”
Please Print Clearly
Infant Participant’s Name: ____________________________Date of Birth: _________________
Infant’s Address: ___________________________City: ____________Prov:___Postal:_______
Guardian’s Name: ____________________________________Date of Birth: _______________
Guardian’s Address: _________________________City:____________Prov:___Postal:_______
The Guardian must Read and Understand the following prior to the Infant Participating in Equine Activities
Initial each item below after reading and understanding the item
TO: Stubbe Horse Farm Ltd, their directors, employees, officers, volunteers, business operators, and
site property owners (all of them collectively called the HOST).
____ 1. I am the Parent and/or Legal Guardian of the infant Participant named above and am
executing this form on behalf of the infant Participant in my capacity as parent and/or guardian and with
the intent that this form be binding to myself and infant Participant for all legal purposes.
____ 2. I Understand there are Inherent DANGERS, HAZARDS and RISKS, (collectively called RISKS)
associated with Equine Activities and injuries resulting from these “RISKS” are a common occurrence.
____ 3. I Acknowledge that the Inherent “RISKS” of Equine Activities mean those DANGEROUS
conditions which are an integral part of Equine Activities, including but not limited to:
• The propensity of any equine to behave in ways that might result in injury, harm or death to persons
on or around them and to potentially collide with, bite or kick other animals, people, or objects.
• The unpredictability of an equine’s reaction to such things as sounds, sudden movement, tremors,
vibrations, unfamiliar objects, persons or other animals and hazards such as subsurface objects.
• The potential for other participant (s) to act in a negligent manner that might contribute to injury to
themselves or others, such as failing to act within their ability or to maintain control over an
equine.
____ 4. I Freely Accept and Fully Assume All Responsibility for the Inherent “RISKS” and the
possibility of personal injury, death, property damage or loss which might result from the infant being a
Participant.
____ 5. I Acknowledge that it remains my Sole Responsibility for the safety of the infant Participant and
for the infant to Participate within his/her own limits.
____ 6. In addition to consideration given for the infant to participate in Equine Activity, I and my
heirs, executors, administrators and assigns (collectively called my “Legal Representatives”)
agree:
• To Waive All Claims that I or the infant Participant might have against the “HOST”; and
• To Accept Responsibility for the actions and safety of all Guests whom accompany me onto
the property and whom have not signed a waiver form; and
• To Release the “HOST” from Any and All Liability for any loss, damages, injury, or expense that
I, the infant Participant or our “Legal Representatives” might suffer as a result of the infant’s
Participation due to any cause including any NEGLIGENCE ON THE PART OF THE “HOST”;
and
• To HOLD HARMLESS AND INDEMNIFY THE “HOST” from any and all liability for property
damage or personal injury to the infant Participant or to any third party which might result from the
infant’s Participation.
Before signing this form I read it (as indicated by my initials above) and I stated that I understand it. I
further state I am aware that signing this form, waives certain legal rights I and/or the infant Participant
and/or our “Legal Representatives” might have against the “HOST”.
SIGNED this __________day of ______________________________20 ________
________________________________________ X_____________________________________
(Print Name of HOST Witness to signing & initialing)
(Signature of Participant)
________________________________________ X______________________________________
(Signature Host Witness)
(Signature of Parent/Guardian)
Do Not Sign until you Understand All Items Above
IT IS MANDATORY THAT ALL RIDERS WEAR A HIGH IMPACT HELMET, AND FOOTWEAR
APPROPRIATE FOR RIDING
Stubbe Horse Farm Ltd.
Effective Mar 2013
ACKNOWLEDGMENT of RISK and RELEASE of LIABILITY – “For Participants 18 or Older”
Please Print Clearly
Participant’s Name: _________________________________Date of Birth: _________________
Address: _________________________________City: ______________Prov: _______Postal:________
Every Person must Read and Understand this form before Participating in Equine Activities
Initial each item below After Reading and Understanding the item
TO: Stubbe Horse Farm Ltd, their directors, employees, officers, volunteers, business operators, and
site property owners. (all of them collectively called the HOST)
____1. I Understand there are Inherent DANGERS, HAZARDS and RISKS, (collectively called RISKS)
associated with Equine Activities and injuries resulting from these “RISKS” are a common
occurrence.
____2. I Acknowledge that the Inherent “RISKS” of Equine Activities mean those DANGEROUS
conditions which are an integral part of Equine Activities, including but not limited to:
• The propensity of any equine to behave in ways that might result in injury, harm or death to persons
on or around them and to potentially collide with, bite or kick other animals, people, or objects.
• The unpredictability of an equine’s reaction to such things as sounds, sudden movement, tremors,
vibrations, unfamiliar objects, persons or other animals and hazards such as subsurface objects.
• The potential for other participant (s) to act in a negligent manner that might contribute to injury to
themselves or others, such as failing to act within their ability or to maintain control over an
equine.
____3. I Freely Accept and Fully Assume All Responsibility, for the Inherent “RISKS” and the
possibility of personal injury, death, property damage or loss resulting from my Participation in
Equine Activities.
____4. I Acknowledge that it remains my Sole Responsibility to act in such a manner as to be
responsible for my own safety and to Participate Within My Own Limits.
____5. In addition to consideration given for my Participate in Equine Activity, I and my heirs,
executors, administrators and assigns (collectively called my “Legal Representatives”)
agree
• To Waive All Claims that I or the infant Participant might have against the “HOST”; and
• To Accept Responsibility for the actions and safety of all Guests whom accompany me onto
the property and whom have not signed a waiver form; and
• To Release the “HOST” from Any and All Liability for any loss, damages, injury, or expense that
I or my “Legal Representatives” might suffer as a result of my Participation due to any cause
whatsoever including any NEGLIGENCE ON THE PART OF THE “HOST”; and
• To HOLD HARMLESS AND INDEMNIFY THE “HOST” from any and all liability for property
damage or personal injury to any third party which might result from my Participation in Equine
Activities.
Before signing this form I read it (as indicated by my initials above) and I stated that I understand it. I
know that signing this form, waives certain legal rights I or my “Legal Representatives” might have against
the “HOST”.
SIGNED this __________day of ______________________________20 ________
_____________________________________________ _____________________________________
(Print Name of HOST Witness to signing & initialing)
(Signature of Participant)
_______________________________________________________
(Signature Host Witness)
Do Not Sign until you Understand All Items Above
IT IS MANDATORY THAT ALL RIDERS WEAR A HIGH IMPACT HELMET, AND FOOTWEAR
APPROPRIATE FOR RIDING
Stubbe Horse Farm Ltd.
Effective Mar 2013