Fill and Sign the Release Personal Form

Release and Waiver of Liability Given by Customer in Favor of Owner/Operator of Pony Rides including Assumption of all Risks of Bodily Injury Whereas, _____________ Amusements (_________) owns and operates a business that offers pony rides to children at _____________________________ (street address, city, state, zip code) and at parties at various locations; Whereas, the undersigned __________________________ (name of customer) (Customer) desires to ride one or more of Acme’s ponies; and Whereas, Customer acknowledges that __________ does not, will not, and has no duty to, insure or guarantee that Customer will not have an accident resulting in serious injury or death while riding said pony or ponies; Now, therefore, for and in consideration of riding one or more of ______________ ponies, the undersigned Customer hereby releases __________________ Amusements , its employees, officers, directors, successors, and assigns (collectively Releasees) from all liability to Customer for any loss or damage to property, physical injury or death whether caused by Releasees or otherwise that result, directly or indirectly from Customer’s riding said pony or ponies. Customer further agrees to indemnify, save and hold Releasees harmless from any loss, liability, attorneys ’ fees, damage, or costs that they (or any of them) may incur arising out of or related Customer’s riding said pony or ponies whether caused by the negligence of the Releasees or otherwise, and Customer does hereby assume the risk of any such loss or damage. The undersigned do further covenant and represent that I/we have read this document; and that I/we voluntarily signed this Release, Waiver of Liability and Assumption of Risk. This Agreement shall be governed by the laws of the State of ____________and the Parties agree that any legal action relating to or arising out of this agreement shall be brought exclusively in binding arbitration in ______________________ (city, state) and subject to the Rules of the American Arbitration Association. WITNESS our signatures this the _____ day of ___________ 20___. __________________________________ _____________________________________ Customer _______ Amusements AGREEMENT AND CONSENT OF PARENT OR GUARDIAN OF MINOR I, as parent or guardian of the above Customer, represent to the Releasees that the facts in this document concerning my child or ward are true. I give my permission for my child or ward to ride said pony or ponies, and further, in consideration of allowing my child or ward to ride said pony or ponies, I agree individually and on behalf of my child or ward, to the terms of the above Release, Waiver of Liability and Assumption of Risk. WITNESS my signature on this the ____ day of ___________, 20____. ________________________ Parent or Guardian