Fill and Sign the An Examination of Liability Duty and Disclaimers for the Form

Helmet Waiver in Favor of a Business Offering Pony Rides This document will affect your legal rights and liabilities. Please read carefully.Under _________________ (Name of State), an equine activity sponsor or equine professional is not liable for any injury to, or death of, a participant in equine activities resulting from the inherent risk of equine activities.Whereas, _____________________ (Name of Participate in Pony Ride), hereinafter called Rider, of ________________________________________________ _______________________ (street address, city, state, zip code), desires to ride a pony owned by ________________________________ (Name of Business) , a sole proprietorship doing business as _________________________________ (Name of Business), whose address is ______________________________________________ ___________________________ (street address, city, state, zip code), hereinafter called Business ; and Whereas, part of the consideration for riding a pony of Business, is the execution of this Waiver, Release and Assumption of Risk Agreement; and Whereas, Rider has read this Agreement and agrees to the terms if said Agreement; Now, therefore, for and in consideration of riding a pony of Business, and payment of the sum of $___________, and in further consideration of the mutual covenants contained in this Agreement, and other good and valuable consideration, the receipt and sufficiency of which is hereby acknowledged, the parties agree as follows: 1. The undersigned has requested to ride one of the ponies of Business at any time and at any location.2. The undersigned understands that anyone riding, handling, or even near a horse,or pony (hereafter be referred to as equines in this document) can suffer bodily and other injuries at any time and without warning. Among other things, equines areunpredictable by nature. For example, when frightened, angry, or under stress, the natural instincts of an equine are to jump forward or sideways, back up quickly, or run away from danger by trotting or galloping. Equines are also known to kick, buck, rear up, spin around, strike, or bite. The undersigned knows that equines can do any of these things without warning. The undersigned also understands that all equines, even if they have no history of inflicting injury, are powerful and have the potential to be dangerous to people and animals that are on, near, or around them. 3.Further, the understand understands and agrees that riding, handling, or being near an equine and/or receiving instruction or guidance on or around equines can expose the undersigned to numerous hazards, which could include, for example: The propensity of an equine to behave in ways that may result in injury, harm, or death to persons on or around them; andThe unpredictability of an equine’s reaction to sounds, sudden movements, and unfamiliar objects, persons, or other animals; certain hazards such as surface or subsurface conditions on, near, or off of the property on which the ride is taking place; and/or collisions with other equines, animals, or objects. 4. The undersigned understand these risks and dangers inherent in equine activities and agrees to assume each and every one of them. The undersigned also understands that these are just some of the risks, and the undersigned agrees to assume others that are not mentioned above. The undersigned is not relying on Business, the Owner of the Business, or any employees or volunteers of Business to list all possible equine-related risks for the undersigned in this document or at any time, now or in the future.5. Waiver and Assumption of RiskAs part of the consideration for the Business allowing the undersigned to engage in any or all of the pony riding activities, now or in the future, and with full knowledge and appreciation of the risks of equine activities, the undersigned freely and voluntarily agrees to assume the risks involved in any aspect of the Activities. The undersigned agrees to assume full responsibility for any and all bodily injuries, losses, or damages which the undersigned may sustain at any time when engaging in the riding. The term damages, means, for example, medical expenses, losses incurred because of bodily injuries or property damages, and/or personal property damages. The undersigned for his heirs, administrators, personal representatives or assigns, releases and discharges the Business, its managers, employees, agents, assistants, representatives, assigns, and others acting on the Business’ behalf of and from any and all claims, demands, damages, actions, omissions, suits, or causes of action (present and future), whether the same be known or unknown, anticipated or unanticipated, resulting from or arising out of the bodily injury of the undersigned or damage that may be sustained, or property damage which may occur at any time – now or in the future – as a result of engaging in any or all of the Activities at any time and at any location. Notwithstanding the foregoing the waiver and assumption of risk does not apply if such injury or damage is directly caused by the intentional misconduct, reckless misconduct, wanton misconduct, and/orgross negligence.6. IndemnificationThe undersigned also agree to indemnify and hold harmless Business, itsmanagers, employees, agents, assistants, representatives, assigns, and others acting on his behalf from liability for any and all injuries, damages, or losses that the equine(s) may sustain at any time arising out of its involvement (directly or indirectly) in the Activities that may accrue from any cause whatsoever, including accidents, illness, or injuries (except if directly caused by the Business’ gross negligence or wanton and willful misconduct). Third persons are any and all people who are not parties to this Agreement and includes, but is not limited to, relatives or guests of the undersigned, other clinician participants, spectators, or visitors. The indemnification shall include reimbursement of the Business’ reasonable attorney fees.7. ASTM/SEI HeadgearThe undersigned agrees to be fully responsible for his own safety at all times while engaging in any or all of the Activities at any time and at any location. Business has advised the undersigned that, for the protection or the undersigned, the undersigned should purchase and wear properly fitted and secured ASTM Standard SEI Certified protective headgear (helmet and strap) that is designed for use when riding or when near equines. The undersigned is NOT relying on Business to provide a certified helmet for the undersigned, to check any helmet or helmet strap that the undersigned may wear, or to monitor compliance by the undersigned with this suggestion at any time – now or in the future. If the undersigned chooses to wear an ASTM Standard SEI Certified, or if the undersigned choose not to, this is the decision of the undersigned alone.8. Emergencies -- Person(s) to Contact in Case of EmergencyName(s): ___________________________________________________Phone Number(s): _____________________________________________Relationship(s): __________________________________________________9. Health and Physical ConditionsSome people have physical conditions that pose special physical risks to them while they engage in exercise. Riding and handling equines as well as equine-related activities are exercise. The undersigned understands that the Business recommends that the undersigned seek the advice of a physician before participating in activities that involve riding or being near equines. Also, the undersigned wants the undersigned to be aware of the following physical, learning, or personal needs that might affect the undersigned’s ability to ride, handle, be near an equine, or otherwise engage in any of the Activities: __________________________________________________________________________________________________________10.Governing Law This Agreement shall be governed by, construed, and enforced in accordance with the laws of the State of _____________. 11. Attorney’s Fees In the event that any lawsuit is filed in relation to this Agreement, the unsuccessful party in the action shall pay to the successful party, in addition to all the sums that either party may be called on to pay, a reasonable sum for the successful party's attorney fees. 12. The undersigned also represents that he: IS AT OR OVER ____ YEARS OF AGE;IS OF SOUND MIND, AND THE UNDERSIGED IS NOT SUFFERING FROM SHOCK OR UNDER THE INFLUENCE OF ALCOHOL, DRUGS, OR INTOXICANTS;THE UNDERSIGNED HAS READ THIS ENTIRE WAIVER, AGREEMENT AND LIABILITY, AND FULLY UNDERSTANDS IT; THE UNDERSIGEDS INTENDS FOR THIS WAIVER, AGREEMENT AND LIABILITY RELEASE TO BE VALID AND BINDING TODAY AND AT ALL TIMES IN THE FUTURE; ANDTHE INFORMATION THE UNDERSIGED HAS PROVIDED IN THIS WAIVER, AGREEMENT AND LIABILITY RELEASE IS TRUE AND ACCURATE.13.The undersigned does further covenant and represent that he/she has voluntarily signed this Release, Waiver of Liability and Assumption of Risk.14.SeverabilityThe invalidity of any portion of this Agreement will not and shall not be deemed to affect the validity of any other provision. If any provision of this Agreement is held to be invalid, the parties agree that the remaining provisions shall be deemed to be in full force and effect as if they had been executed by both parties subsequent to the expungement of the invalid provision. 15.No Waiver The failure of either party to this Agreement to insist upon the performance of any of the terms and conditions of this Agreement, or the waiver of any breach of any of the terms and conditions of this Agreement, shall not be construed as subsequently waiving any such terms and conditions, but the same shall continue and remain in full force and effect as if no such forbearance or waiver had occurred. 16. Notices Any notice provided for or concerning this Agreement shall be in writing and shall be deemed sufficiently given when sent by certified or registered mail if sent to the respective address of each party as set forth at the beginning of this Agreement. 17.Entire Agreement This Agreement shall constitute the entire agreement between the parties and any prior understanding or representation of any kind preceding the date of this Agreement shall not be binding upon either party except to the extent incorporated in this Agreement. 18. Modification of Agreement Any modification of this Agreement or additional obligation assumed by either party in connection with this Agreement shall be binding only if placed in writing and signed by each party or an authorized representative of each party. 19.Assignment of Rights The rights of each party under this Agreement are personal to that party and may not be assigned or transferred to any other person, firm, corporation, or other entity without the prior, express, and written consent of the other party. 20.Counterparts This Agreement may be executed in any number of counterparts, each of which shall be deemed to be an original, but all of which together shall constitute but one and the same instrument. 21. In this Agreement, any reference to a party includes that party's heirs, executors, administrators, successors and assigns, singular includes plural and masculine includes feminine. Agreement and Consent of Parent or Guardian of Minor I, as parent or guardian of _______________________________ (Name of Participate in Pony Ride), represent to the parties that the facts in this document concerning _____________________ (name of child or ward) are true. I give my permission for my child or ward to rent a bicycle from Lessor and further, in consideration of renting said bicycle to my child or ward, I agree individually and on behalf of my child or ward, to the terms of the above Waiver and Release just as if I had signed it as and individual. WITNESS my signature on this the _____ day of ______________, 20____. ________________________________ (Printed Name of Rider) _______________________________(Signature of Rider)________________________________(Printed Name of Parent or Guardian)________________________________ (Signature Parent or Guardian)Acknowledgment before Notary Public (form may vary by state)