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Equine Unlimited, Inc.

3984 Green Valley Road, Rescue, CA 95672

SPECIAL YOUTH CAMP SESSION 8/3 - 8/7 2015

2015 Summer Horse Camp Registration & Waiver

 

1. INHERENT RISKS: I the Undersigned adult participant, or if a minor, the parent or guardian of minor participant, acknowledge and assume the inherent risks involved in riding and working around horses, that are both known and unknown, such as bodily injury or death from using, riding or being in close proximity to horses, amoung other risks such as acts of God, loose or running horses or other animals; mechanical, agricultural or construction failures or difficulties; climatic conditions or arena or facility conditons; or any other abnormal conditions or developments that affect a horse, rider, or equipment and property. I further acknowledge that a horse and/or rider can be permanently injured or killed in normal use or in competiton and schooling.

2. IN CONSIDERATION, therefore for the privilege of riding and/or working around horses at EQUINE UNLIMITED, INC. located at 3984 Green Valley Road, Rescue, California, 95672, I the Undersigned residing at the address I provided on this form, do hereby agree to assume the risk of injury, hold harmless and indemnify EQUINE UNLIMITED, INC. and its owners, managers, employees, associates, teachers, sponsors and contractors, and further release them from any liability or responsibility for accident, damage, injury, illness to the Undersigned or any horse owned by the Undersigned or to any family member or spectator accompanying the Undersigned while on the premises of EQUINE UNLIMITED, INC.: and that except in the event of EQUINE UNLIMITED, INC.'S gross and willful negligence, I shall bring no claims, demands, actions and causes of action, and /or litigation against EQUINE UNLIMITED, INC. for any economic and non-economic losses due to bodily injury, death, and/or property damage sustained by me and/or my minor child or legal ward in relation to the premises and operations of EQUINE UNLIMITED, INC., Including riding, handling, or other wise being near horses on the premises. I the Undersigned herby release EQUINE UNLIMITED, INC. from any duty of controlling any other participants, spectators, or animals.

3. I the Undersigned do hereby, and for my heirs, legal representatives, agents, succossors-in-interest and assigns, expressly waive and relinquish all rights and benefits afforded by Section 1542 of the Civil Code of California or any other state laws, which provides as follows:

"A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which if known by him might have materially affected his settlement with the debtor."

By waiving said statute I declare that I understand and acknowledge the significance and consequences of such specific waiver of Section 1542 of the Civil Code of California, that I intend to waive and assume the risk of existing but yet unknown claims as of the date of signing this AGREEMENT and have been encouraged by EQUINE UNLIMITED, INC. to consult independent legal counsel in relation to my waiver of rights under said Section.

4. COSTS AND FEES: I the Undersigned agree to hold EQUINE UNLIMITED, INC. harmless from any claim resulting from personal or property damage or injury caused by my participation with horses or presence at EQUINE UNLIMITED, INC. and agree to pay any legal fees and/or expenses incurred by EQUINE UNLIMITED, INC. in defense of such claims. In the event of legal dispute, the parties agree to participate in mediations. Any legal dispute between the parties shall be heard only by courts in El Dorado County, California.

5. SEVERABILITY: The terms of this AGREEMENT are independent of each other; if a court finds any provisions of this Agreement contract invalid or unenforceable, such a finding shall not affect the validity of any other provision of the Agreement contract, which shall remain in full force and effect.

6. USEF. EQUINE UNLIMITED, INC. encourages all riders to be familiar and act in compliance with industry standards and United States Equestrian Foundation (USEF) rules. EQUINE UNLIMITED, INC. recommends all participants wear an approved helmet in accordance with USEF guidelines, which can be found in a USEF handbook or at www.USEF.org.

7. By signing this document, I the Undersigned declare that I understand and warrant that this AGREEMENT is being voluntarily and intentionally signed, and that in signing this AGREEMENT I declare I am free of influence of drugs, alcohol, and other modifying substance that would prevent my free and knowing consent to this agreement to release, hold harmless, and indemnification of EQUINE UNLIMITED, INC. and its owners and managers. I am of sound mind and have had sufficient time and conditions to read the AGREEMENT, and have had the opportunity to ask questions regarding this agreement.

Please select who will be attending camp...
Minor
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First Campers Name

First Name*

Last Name*

Phone*
First Campers Date of Birth*
First Campers Signature*
Campers 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, news, and discounts by e-mail.
Emergency Contact

First Name*

Last Name*

Emergency Contact's Phone Number*
Registration Information

We offer a Kiddie Camp (for kids 4 - 6) and a Youth Camp (for kids 7 and older). Please note that Kiddie Camps and Youth Camps are offered on different weeks - there are no combined camps.

Please select the camp(s) your child will be attending:

Camp Sessions: *
August 3 - 7, 2015 - YOUTH CAMP (Ages 7+)

Do you need child care before or after camp?

Youth Camp (Ages 7+) - Camp starts at 9:00AM and ends at 3:00PM - Child care is $10.00/hour and is available until 6:00 PM

Youth Camp Care:
Before Care (Youth Camp)
After Care (Youth Camp)

What time will you be dropping off or picking up?
Parent or Guardian's Alternate Phone Numbers

You have supplied your phone number and an emergency contact number. If there are any other numbers we can reach you at, please include them here.


Additional Contact Number

Additional Contact Number

Additional Contact Number
Medical Contact:

Doctor *

Doctor's Phone Number *

Hospital Preference

Allergies

Special Instructions/Notes
Riding Ability/Experience:
Riding Experience*
None
Beginner
Intermediate
Advanced

Please describe riding experience.
Photography Release:

Photographs are often taken of clients on our property. They are used to market our riding programs and Equine Unlimited, Inc. in general. If you do not want photographs of your child used, please mark the box below. 

Photography
Do not use photographs
How did you hear about us?
Advertising*
From a friend
Website
Print Ad
Banner
School Flyer
Craigslist
Special Instructions or notes:

Please let us know if there are any special instructions or notes regarding your camper.
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 Date of Birth*
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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