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Harris Riding Academy, LLC
Brittany Harris
4024 Barfield Crescent Road, Murfreesboro, TN 37128

EQUINE RELEASE AND WAIVER OF LIABILITY 

This EQUINE RELEASE AND WAIVER OF LIABILITY is voluntarily and knowingly entered into by participant listed below, hereinafter referred to as PARTICIPANT , and Harris Riding Academy LLC, Brittany Harris, Thorsport Farm, its owners, their families, members, guides, employees, agents, volunteers and all other persons and organizations in any way connected with the events, property, boarding, lessons, and other activities described herein, hereinafter collectively referred to as PROVIDERS .

PARTICIPANT, for and on behalf of myself, my heirs, personal representatives, successors and assigns and any minor child for which I am the parent/legal guardian, hereby releases and forever discharges PROVIDERS, of and from any and all claims or demands of any kind or nature whatsoever which I may have or hereafter acquire or have accrued to them arising as a result of, or incident to; my presence on or utilization of PROVIDERS or any of its facilities.

Such release of liability includes, but is not limited to liability for any sickness, disease, theft, death or injury to or incurred by me, any horses or any property associated with PROVIDERS or any of its facilities or while in the custody of or under the direction of PROVIDERS at other locations. Any and all claims and demands are hereby waived and released. Furthermore, with this waiver, the PARTICIPANT expressly assumes the risk of injury or death due to negligence by PROVIDER for my own safety or for the safety of my minor child.

PARTICIPANT acknowledges that they are familiar with the hazards associated with horses, horse barns and all related equestrian facilities; that horses and riding and proximity to horses are dangerous activities; and assumes all risk associated with the foregoing.

Under Tennessee law, an equine professional is not liable for an injury to or the death of a participant in equine activities pursuant to the Tennessee code annotated, Title 44, Chapter 20, Part 1. 

Date Signed: March 19, 2024

First Participant's Name

First Name*

Last Name*

Phone*
First Participant's Date of Birth*
First Participant's Information

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
First Participant's Signature*
Second Participant's Name

First Name*

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

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
Third Participant's Name

First Name*

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

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
Fourth Participant's Name

First Name*

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

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
Fifth Participant's Name

First Name*

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

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
Sixth Participant's Name

First Name*

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

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
Seventh Participant's Name

First Name*

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

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
Eighth Participant's Name

First Name*

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

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
Ninth Participant's Name

First Name*

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

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
Tenth Participant's Name

First Name*

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

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
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, news, and discounts by e-mail.
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 Information

MEDICAL INFO 

Does your child have any physical, emotional or mental handicaps or been diagnosed with any specific related illnesses?*
No
Yes

If yes, please explain:

HELMET OPT OUT AND WAIVER

It is the policy of Harris Riding Academy, LLC that ASTM/SEI Certified helmets are MANDATORY UNLESS EXPRESSLY WAIVED. PARTICIPANT expressly acknowledges that they understand the risks associated with not wearing an ASTM/SEI approved riding helmet.
PARTICIPANT is voluntarily choosing not to wear a helmet and expressly assuming any additional associated risk.
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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