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RIDING INSTRUCTION AGREEMENT AND LIABILITY RELEASE

Today's Date: April 25, 2024

By this agreement made and entered into this day of April 25, 2024 by and between participant, hereinafter referred to as "I" and Millbrook Equestrian LLC and Alexia Honegger, who resides at 38643 CR 13, Elizabeth, CO 80107 hereinafter referred to as "Instructor."

IT IS HEREBY AGREED TO AS FOLLOWS:

** Please note there is a stringent 24 hour cancellation policy on all lessons **

1. That, I, the undersigned, do for myself and on behalf of my child or legal ward, hereby voluntarily request to participate in riding instruction as a student(s) with INSTRUCTOR, and that student will either ride his or her own horse or school horses provided by Millbrook Equestrian LLC for instructional purposes.

2. That parent or guardian and student understand that horses are unpredictable by nature; that when frightened or angry or under stress, a horse's natural instincts are to jump forward or sideways, to run away from danger at a trot or gallop, to kick, to buck, to rear up in front, or to bite; that horses are extremely powerful; and that if a rider falls to the ground, the fall distance will be generally from 3 1/2 to 5 1/2 feet. I understand these risks, and I voluntarily assume these risks and dangers.

3. That parent or guardian and student understands that upon mounting the horse and taking up the reins the rider is in primary control of the horse, and that INSTRUCTOR is not responsible for the results of the student's actions or inactions. The rider further agrees to not abuse, misuse or deliberately agitate the horse as these actions may result in increased risk to myself and others.

4. That I have been advised that student's should purchase and wear a helmet or hard hat and wear it to prevent horse related injuries.

5. LIABILITY RELEASE: That I understand that, except in the event of INSTRUCTOR'S wanton and willful negligence, I am responsible for bodily injury or property damage which I or my child or legal ward should sustain on Millbrook Equestrian's premises and/or trails and/or while riding a horse, and/or while in transit to or at horse shows, trail rides, or similar expeditions, and for any time I or my child or legal ward shall lose from employment or school or other activity, and for medical expenses or any other expenses incurred because of such bodily injury or property damage; and that I hereby, for myself, my heirs, administrators and assigns release and discharge the property owners (Paul and Rebecca Herskovitz and Flintwood22 LLC), owners, operators, and sponsors of INSTRUCTOR and their respective servants, agents, officers and all other participants of and from all claims, demands, actions and causes of action for such injuries sustained to my person or that of my child or legal charge and/or property.

WARNING:

Under Colorado Law, an equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to section 13-21-119, Colorado Revised Statutes.

6. That the student is currently covered by accident-medical insurance and will remain insured for the duration of all riding instruction at INSTRUCTOR.

7. That this agreement is entered into in the state of CO and will be interpreted and enforced under the laws of that state.

8. That all fees are payable at the beginning of the month and $25 late fee will be applied to bills paid after the 10th of the month.

I, THE UNDERSIGNED, BEING OF LEGAL AGE AND OF SOUND MIND AND NOT BEING UNDER THE INFLUENCE OF ALCOHOL, DRUGS OR INTOXICANTS, HAVE READ AND UNDERSTAND THE FOREGOING AGREEMENT AND RELEASE. I ALSO ACKNOWLEDGE RECEIPT OF A COPY OF THIS AGREEMENT THIS DATE.

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Age Acknowledgment*
First Participant's Date of Birth*
I certify that I am 18 years of age or older
First Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
First Participant's Signature*
Second Participant's Name

First Name*

Last Name*
Second Participant's Date of Birth*
Second Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Third Participant's Name

First Name*

Last Name*
Third Participant's Date of Birth*
Third Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Fourth Participant's Name

First Name*

Last Name*
Fourth Participant's Date of Birth*
Fourth Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Fifth Participant's Name

First Name*

Last Name*
Fifth Participant's Date of Birth*
Fifth Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Sixth Participant's Name

First Name*

Last Name*
Sixth Participant's Date of Birth*
Sixth Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Seventh Participant's Name

First Name*

Last Name*
Seventh Participant's Date of Birth*
Seventh Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Eighth Participant's Name

First Name*

Last Name*
Eighth Participant's Date of Birth*
Eighth Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Ninth Participant's Name

First Name*

Last Name*
Ninth Participant's Date of Birth*
Ninth Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Tenth Participant's Name

First Name*

Last Name*
Tenth Participant's Date of Birth*
Tenth Participant's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Participant's Address
Address Line 1:*
Street address, P.O. box, company name, c/o
Address Line 2:
Apartment, suite, unit, building, floor, etc.
Country:*
City:*
State/Province:*
Zip/Postal:*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information about Millbrook events and happenings
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.


By signing below the Parent or Court-Appointed Legal Guardian agrees that they are also subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Age Acknowledgment*
Parent or Guardian's Date of Birth*
I certify that I am 18 years of age or older
Parent or Guardian's Information

Listed the details of any allergies, ailments or handicap a student may have, and of which INSTRUCTOR should be aware.
Parent or Guardian's Signature*
Electronic Signature Consent*
 By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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