Redbird Farm

Release of Liability

Student's Name (first and last)

Additional students and family members that may accompany students

Phone

Emergency contact

Phone

WARNING

Under Kansas law, there is no liability for an injury to or the death of a participant in domestic animal activities resulting from the inherent risks of domestic animal activities, pursuant to K.S.A 60-4004. You are assuming the risk of participating in this domestic animal activity.

Inherent risks of domestic animal activities include but shall not be limited to:

1. The propensity of a domestic animal to behave in ways i.e. running, bucking, biting, kicking, shying, stumbling, rearing, falling or stepping on, that may result in an injury, harm or death to persons on or around them;

2. the unpredictability of a domestic animal’s reaction to such things as sounds, sudden movement and unfamiliar objects, persons or other animals;

3. certain hazards such as surface and subsurface conditions;

4. collisions with other domestic animals or objects; and

5. the potential of a participant to act in a negligent manner that may contribute to injury to the participant or others, such as failing to maintain control over the domestic animal or not acting within such participant’s ability.

Helmet Policy:

It is statistically clear that there are certain inherent dangers associated with horseback riding. One of those dangers is the risk of suffering serious head injury should the rider fall or be thrown from his/her horse. It is the policy of Redbird Farm that protective headgear which meets or exceeds the quality standards of the SEI certified and ASTM standard F1163 equestrian helmet be worn at all times when riders are mounted on a horse. The wearing of such a helmet may reduce the severity of some head injuries and may prevent serious injury or death as a result of a fall or other occurrence. Students need to purchase their own helmet for fitting and sanitary reasons, but we do have a limited number of helmets available to use until you are sure of your commitment.

I am aware of the helmet policy of Redbird Farm and acknowledge that wearing a helmet when mounted may prevent serious injury or death. I understand that students are required to purchase a helmet, and that a limited number of helmets are available to use until I am ready to purchase one.

I acknowledge that there is a possibility of injury when riding or working with horses. I hereby release Redbird Farm, its owners, executives, employees, property owners, and all heirs from any and all liability for any injuries that I may receive while preparing to ride, mounting, riding, dismounting, handling horses, and any other activities not listed but which may pertain to my participation with or visiting Redbird Farm.

I understand that by signing this document that I am releasing my rights to seek recovery from Redbird Farm, its owners, the property owners, executives, employees and their heirs. I also acknowledge that this total waiver shall operate to prevent my spouse or my heirs from pursuing any such action arising out of this activity.

By signing this form, I acknowledge that I have read and understand it, and that I am the student or the parent/guardian.

Check here if you do not want your child's photograph or video to be taken during any Redbird Farm lesson, camp, or other event, or to be displayed on the Redbird Farm website, brochures and other publicity, or in the news media.

Date

Signature