HORSE COUNTRY FARM
RIDING LESSON &
VISIT RELEASE FORM
I give permission for my child, _______________________ (name)
who is _________(age)______/_____/______(birthdate), to use or ride a
(mo)
(day)
(year)
horse or pony provided by HORSE COUNTRY FARM OR TO VISIT
the grounds of Horse Country. I understand that it is the nature of
large animals such as horses/ponies to occasionally be unpredictable
especially when startled by other animals or circumstances not
easily anticipated.
There is an INHERENT RISK IN RIDING, ATTENDING, OR
VISITING horses/ponies and/or stables and I assume this risk on
behalf of my child. Because of this inherent risk, I agree to hold
HORSE COUNTRY FARM OWNERS/EMPLOYEES HARMLESS in
case of accident or injury.
PARENT’S NAME (printed):____________________________________
PARENT’S SIGNATURE:_______________________________________
ADDRESS:____________________________________________________
CITY:________________________STATE:_________ZIPCODE:_______
HOME PHONE:_________________WORK PHONE:________________
CELL PHONE:__________________DATE:_________________________
Remember!
Bring your EQUESTRIAN Helmet for riding &
carrots for your horse. Wear jeans & sturdy shoes. .
(No shorts, sandals or crop tops.)
HORSE COUNTRY FARM
8507 Highway 92 – P.O. Box 2
Granite Falls, WA 98252
(360) 691-7509/(425) 335-4773
www.horsecountryfarm.com