Horse Riding Agreement and Liability Release Form - Please read carefully
Crestone Welsh Ponies Imports and Sales – 15493 North 107th Ave, Colorado 80504
(hereinafter known as "THIS STABLE")
SERIOUS INJURY MAY RESULT FROM YOUR PARTICIPATION IN THIS ACTIVITY. THIS
STABLE DOES NOT GUARANTEE YOUR SAFETY.
AGREEMENT SCOPE AND TERRITORY AND DEFINITIONS - This agreement shall be legally
binding on me the registered rider, and the parent and legal guardian thereof if a minor, my heirs, estate,
assigns, including all minor children, and personal representatives; and it shall be interpreted according to the
laws of the state and county of THIS STABLE. (The term "HORSE" herein shall refer to all equine species.)
The term "HORSEBACK RIDING" herein shall refer to riding a horse mounted or otherwise handling of
hoses, ponies, mules, or donkeys, whether from the ground or mounted. The term "RIDER" shall herein refer
to a person who rides a horse mounted or otherwise handles or comes near a horse from the ground. The
terms "I", "ME", "MY" shall herein refer to the registered rider names below and the parents or legal
guardians thereof if a minor.
NATURE OF STABLES HORSES - THIS STABLE follows a rigid safety program. Horseback riding is
the only sport where one much smaller, weaker, predator animal (human) tries to impose its will on another
much larger, stronger prey animal with a mind of its own (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, Changing directions or speed at
will, Shifting its weight, Bucking, Rearing, Kicking, Biting or Running from danger.
Horseback riding is an inherently risky and dangerous activity. A horse, regardless of its training and usual
past behavior, may act unpredictably at times based upon instinct or fright which may cause you to be thrown
from or injured by the horse. Horses may bite, kick, buck, fall, or stumble. You or Your horse may collide
with obstacles, cows, other horses, barbed wire, trees, branches, natural and man made objects whether
obvious or not. Each of these obstacles and variations in terrain, could cause you to lose control of your horse
and be injured. Saddles may slip and tack or saddle problems may develop as a result of normal use and
wear. Riders may lose their balance which can result in falling from the horse. I acknowledge that if I ride or
travel with horses, I am subject to injury and no form of planning can remove the danger.
RIDER RESPONSIBILITY - I understand that the rider is in primary control of the horse. The rider's
safety largely depends upon his/her ability to carry out simple instructions, and his/her ability to remain
balanced aboard the moving animal. I agree that the rider shall be responsible for his/her own safety, and that
of an unborn child if the rider is pregnant. THIS STABLE ADVISES A PREGNANT WOMAN NOT TO
RIDE A HORSE unless permission is given under advice of her physician. (It is also the rider's responsibility
to notify the staff of any physical/mental health condition and/or disability which the rider may have that will
affect his/her ability to ride a horse.)
SADDLE GIRTHS - NATURAL LOOSENING - I UNDERSTAND THAT: Saddle girths (saddle
fasteners around horse's belly) may loosen during a ride. If rider notices this he/she must alert the nearest
employee as quickly as possible so action can be taken.
LIABILITY RELEASE - In consideration of THIS STABLE allowing my participation in this activity,
under the terms set forth herein, I, the rider and the parent or legal guardian thereof if a minor, do agree to
hold harmless and release THIS STABLE, its owners, agents, employees, officers, members, premises
owners, insurers, and affiliated organizations from legal liability due to THIS STABLE'S ordinary
negligence; and I do further agree that I shall bring no claims, demands, actions and causes of action and/or
litigation against THIS STABLE AND ITS ASSOCIATES as state above in this clause, for any economic
and non-economic losses, due to bodily injury, death, property damage, sustained by me and/or my minor
child or legal ward in relation to the premises and operation of THIS STABLE, to include while riding,
handling, or otherwise being hear horses owned by or in the care, custody and control of THIS STABLE.
I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless CWP from any and
all claims, demands, or causes of action, which are in any way connected with my participation in this
activity or my use of CWP's equipment or facilities, including any such claims which allege negligent acts or
omissions of CWP.
Should CWP or anyone acting on their behalf, be required to incur attorney's fees and costs to enforce this
agreement, I agree to indemnify and hold them harmless for all such fees and costs.
I certify that I have adequate insurance to cover any injury or damage I may cause or suffer while
participating, or else I agree to bear the costs of such injury or damage myself. I further certify that I have no
medical or physical conditions which could interfere with my safety in this activity, or else I am willing to
assume - and bear the costs of - all risks that may be created, directly or indirectly, by any such condition.
In the event that I file a lawsuit against CWP, I agree to do so solely in the state of Colorado, and I further
agree that the substantive law of that state shall apply in that action without regard to the conflict of law rules
of that state. If I, or anyone acting on their or my behalf, should bring such suit, that I/they shall pay all
reasonable attorney fees, court and costs of defense should I/they not prevail.
I agree that if any portion of this agreement is found to be void or unenforceable, the remaining portions shall
remain in full force and effect.
By signing this document, I acknowledge that if anyone is hurt or property is damaged during my
participation in this activity, I may be found by a court of law to have waived my right to maintain a Lawsuit
against CWP on the basis of any claim from which I have released them herein.
I have had sufficient opportunity to read this entire document. I have read and understood it, and I
agree to be bound by its terms.
Signature of Participant:_Lydia Dissly / Caroline Dissly______________________Print
name__________________________
Address:___________________________________________________________________
Phone:__________________________Date:_10/03/04_________________
PARENT'S OR GUARDIAN'S ADDITIONAL INDEMNIFICATION
(Must be completed for participants under the age of 18)
In consideration of____________________(print minor's name) ("Minor) being permitted by AS. to
participate in its activities and to use its equipment and facilities, I further agree to indemnify and hold
harmless AS from any and all claims which are brought by, or on behalf of Minor, and which are in any way
connected with such use or participation by Minor.
Parent or GuardianLydia Dissly___________________print name________________________Date_______
Page three of three
PROTECTIVE EQUESTRIAN HEADGEAR REFUSAL AGREEMENT
I, for myself and/or on behalf of my child or legal ward, have been fully warned and advised by Crestone
Welsh Ponies (hereinafter collectively referred to as "CWP"), that we should purchase and/or wear a properly
fitted and secured ASTM/SEI (Equestrian standard) certified helmet while riding or being around horses
(whether on the premises of CWP. or off the premises) in order to reduce the severity of some of our head
injuries and to possibly prevent my/our death from happening as the result of a fall(s) or any other occurrence
associated with this activity. We realize that we are subject to injury from this activity and that no form of
preplanning can remove all of the danger to which we are exposing ourselves. Against the advice of CWP,
the guide/instructor, numerous court cases and CWP's insurance company, we are refusing this critical safety
precaution.
SIGNER STATEMENT OF AWARENESS
I/we the undersigned, have read the foregoing statement carefully before signing and do understand its
warnings and assumption of risks.
________________________________Date_________________
Signature of Rider (spouse must sign for themselves)
____________________________________Date_____________
Signature of parent, guardian and or spouse
____________________________________________________
Name of additional minor (s) rider (s)
PROTECTIVE HEADGEAR OFFERING: I, for myself and on behalf of my child and/or legal ward,
have been offered protective headgear (riding helmet) by THIS STABLE and do understand that the
wearing of such headgear around horses may prevent or reduce severity of some head injuries, and may
even prevent death happening as the result of a fall or other occurrence. It is understood that STABLEPROVIDED protective headgear may not be of perfect fit for each rider's head, and that once provided
I/WE will be responsible for securing the helmet on this rider's head at all times.
ALL RIDERS AND PARENTS OR LEGAL GUARDIAN MUST SIGN BELOW AFTER READING
THIS DOCUMENT.
YES, I/we request to wear protective headgear which THIS STABLE provides.
NO, I/we refuse to wear any type of protective headgear or will provide my/our own.
Rider's riding ability:
Beginner
Good
Advanced
I agree that should medical treatment be required, I and/or my own accident/medical insurance company
shall pay for ALL such incurred expenses.
I HAVE GIVEN EXTRA ATTENTION TO THE ABOVE STATEMENT. Please initial ___________
SIGNER STATEMENT OF AWARENESS: I/we the undersigned have read and do understand the forgoing
agreement, warnings, release and assumption of risks. I/we further attest that all facts relating to the applicant's physical
condition, experience and age are true and accurate.