Beulah Land Farms Release Form- Beulah Land Farm Drive (3065 Highway 81 North) Calhoun Falls, SC 29628. Phone: 864-348-3232
Name:________________________________________Age:
(if under 21):__________Date:_________________
Address:____________________________________________________________Phone:____________________
City:____________________________________________State:______________________
Zip:_______________
Warning:
UNDER SOUTH
CAROLINA LAW, AN EQUINE ACTIVITY SPONSOR OR EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF
A PARTICIPANT IN AN EQUINE ACTIVITY RESULTING FROM AN INHERENT RISK OF EQUINE ACTIVITY, PURSUANT TO ARTICLE 7, CHAPTER 9 OF
TITLE 47, CODE OF LAWS OF SOUTH CAROLINA, 1976.
Assumption of Risk
I acknowledge that the enjoyment and excitement of Horseback riding is derived in part from the inherent risk incurred
by this activity. These inherent risks contribute to such enjoyment and excitement and are a reason for my participation.
I am solely responsible for my decision to participate in this activity. I understand and accept that Horseback riding involves
dangers and risks which may include, but are not limited to the following:
·
Horse behavior or temperament which includes,
biting, kicking or stepping on a person;
·
Falling off or being thrown from a horse,
such risk increases at higher speeds;
·
Unforeseen maladjustment or malfunction
of saddles and tack;
·
Horseback riding on rugged terrain, including
slippery trails;
·
Injuries inflicted by animals, insects,
plants or other participants;
·
Accidents or illness in remote places
without medical facilities;
·
The forces of nature including lighting,
unsuspected changes in terrain, weather changes, and others not named;
·
The physical exertion associated with
Horseback riding.
Release Agreement
In consideration of Beulah Land Farm furnishing horses to enable me to participate in this activity in which
I may not be skilled, I hereby assume all risk of injury or loss of life to myself, and loss of or damage to property arising
out of my participation in such an activity, including hazards associated with any defect in a manufacturer’s product.
I specifically release and hold Beulah Land Farm, its owners, operators, agents, volunteers, guides, employees, participants
and Beulah Land Farm harmless from any and all liability, including negligence (active or passive), as to any right of action
or claim to relief that may accrue either to me or to my heirs or personal representatives for any such injury, loss of life,
medical costs, attorney’s fees, court costs, or loss of or damage to property which I may suffer while participating
in equine activities, including activities preliminary and subsequent thereto. I declare that I carry medical insurance fully
covering any and all injuries incurred. I further understand Beulah Land Farm carries no medical insurance for the protection
of participants in Horseback riding, and any insurance coverage existing with respect to Beulah Land Farm, shall not alter
the terms of this waiver nor impose any liability on Beulah Land Farm. I have carefully read this release and fully understand
its contents, I am aware that this is a complete release of liability and I sign it of my own free will. This release will remain in full force and effect for all visits by me to Beulah Land Farm unless I explicitly
revoke it in writing and deliver such revocation in person to Beulah Land Farm.
I also agree to obey all Stable Rules and all other posted signs or directions while participating in the equine activities.
Signature:__________________________________________Date___/___/___Confirmation
Number _________
If under
18 years of age:
SIGNATURE
OF PARENT OR GUARDIAN: ________________________________________________________________________
PRINT
NAME OF PARENT OR GUARDIAN: ________________________________________________________________________
I understand and acknowledge that wearing a protective helmet
may reduce the risk of head and spinal cord injuries to me while participating in equine activities; nevertheless, I hereby
voluntarily choose not to wear a protective helmet.
Signature: ____________________________________
Parent/Guardian Signature:______________________
______________________________________________________________________________