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Louisiana Liability Release Form 1

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Louisiana Liability Release Form 1
LIABILITY RELEASE FORM
SOAR of SWLA (Steeds of Acceptance & Renewal of Southwest Louisiana) 401 17th Street Lake Charles, LA 70601 (337) 474-2560
NOTICE: THIS IS A LEGALLY BINDING AGREEMENT. By signing this agreement, you waive your right to bring to court action to recover
compensation or obtain any other remedy for injury whatsoever resulting from your use of the premises, facilities, horses, or equipment owned,
leased or otherwise in control of SOAR of SWLA, Friends of Therapeutic Riding,Vinson Arabians, Lake Charles Riding Academy (Mills Properties)
its owners, officers, agents, contract staff, employees or volunteers.
ACKNOWLEDGMENT AND ASSUMPTION OF RISK
By signing this agreement, I (print name of rider, or parent or legal guardian if rider is under 18 years of age),
________________________________________hereby acknowledge and agree that horseback riding and horse handling of any kind is a
dangerous activity. I understand that horses are creatures of independent action and may act unpredictably at any time. I recognize that by engaging
in equestrian activities, I am putting myself in substantial risk of injury and I hereby agree to assume all such risk associated with this activity. I
acknowledge that I HAVE READ, UNDERSTAND AND AGREE TO BE BOUND BY THE FOLLOWING WARNING relating to the provision of equine
services, instruction, equipment, tack, or horses or relating in participation in equine activities whether on premises owned by SOAR of SWLA, Friends
of Therapeutic Riding, Kirby Vinson or Vinson Arabians, Scott and/or Holly Mills or Lake Charles Riding Academy (Mills Properties) or elsewhere.
Further, I recognize that the owners, officers’ agents, employees, contract staff, and volunteers of SOAR of SWLA, Friends of Therapeutic Riding,Vinson
Arabians, Lake Charles Riding Academy (Mills Properties) are protected by Louisiana Law as follows:
WARNING:
Under Louisiana Law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities
resulting from the inherent risk of equine activities pursuant to R.S. 9:2795.l.
WAIVER/RELEASE/INDEMNIFICATION AND COVENANT NOT TO SUE
As partial consideration for my use of the services, equipment, horses, and/or premises of SOAR of SWLA, Friends of Therapeutic Riding, Vinson
Arabians and/or Kirby Vinson, Lake Charles Riding Academy (Mills Properties) and/or Scott and/or Holly Mills, I hereby agree to release from liability
SOAR of SWLA, Friends of Therapeutic Riding, Vinson Arabians, Lake Charles Riding Academy (Mills Properties) its officers, owners, agents, contract
staff, employees, and/or volunteers and do hereby waive any rights, I, my heirs, representatives, or assigns may have against SOAR of SWLA, Friends
of Therapeutic Riding,Vinson Arabians, Lake Charles Riding Academy (Mills Properties) its officers, owners, agents, contract staff, employees and/or
volunteers to assert any cause of action, possible cause of action, claim or demand of any nature whatsoever, including, but not limited to, a claim
for negligence or gross negligence which, I, my heirs or assigns, may have now, or in the future, on account or personal injury or damage is caused,
including, but not limited to the negligence, gross negligence, reckless or wanton conduct of any owner, officer, agent, contract staff, employee, or
volunteer of SOAR of SWLA, Friends of Therapeutic Riding,Vinson Arabians, Lake Charles Riding Academy (Mills Properties) or the conduct of any
party connected in any way with Vinson Arabians, Lake Charles Riding Academy (Mills Properties).
As further consideration for my use of services, equipment, horses, and/or premises of SOAR of SWLA, Friends of Therapeutic Riding, Vinson
Arabians, Lake Charles Riding Academy (Mills Properties) I agree to use and follow the established safety policies, procedures, rules, and guidelines
of SOAR of SWLA,Vinson Arabians, Lake Charles Riding Academy (Mills Properties) and I agree to indemnify and hold harmless SOAR of SWLA,
Friends of Therapeutic Riding, Vinson Arabians, Lake Charles Riding Academy (Mills Properties) its owners, officers, agents, contract staff, employees,
and volunteers from any and all causes of action, claims or demands arising out of or in any way relating to my use of services, equipment, horses,
and/or premises of SOAR of SWLA, Friends of Therapeutic Riding, Vinson Arabians, Lake Charles Riding Academy (Mills Properties) whether asserted
by Vinson Arabians, Lake Charles Riding Academy (Mills Properties) its owners, officers, agents, contract staff, employees, or volunteers, or by any
third parties who may be injured on account of or relating to my use of SOAR of SWLA, Friends of Therapeutic Riding,Vinson Arabians’ Lake Charles
Riding Academy’s’ (Mills Properties) services, equipment, horses, and/or premises.
HEALTH CARE AUTHORIZATION
Authority is hereby given to SOAR of SWLA and/or Vinson Arabians, its owners, officers, agents, contract staff, employees, and volunteers to make
health care arrangements for me in the event of an accident, injury, or illness.
I hereby certify that I am of the lawful age (18 years or older) and that either I personally am the “rider” referred to herein, or that I am parent
or legal guardian of the “rider”, and that I have read and fully understand the provisions of the Release Form.
IN WITNESS WHEREOF, the instrument is duly executed at_____________________________, Louisiana
on______________day of____________, 20________.
X________________________________________
Signature of rider, owner or agent or rider’s parent or legal guardian
Rider’s name: ____________________________Birthdate:_______/________/________
Address: ____________________________Home Phone_________________________
City/St/Zip ____________________________Work Phone_________________________
IN EMERGENCY, NOTIFY: __________________________Phone__________________
__________________________________________________________________________________________
__________________________________________________________________________________________
____________________________________
Signatory must write in the above lines:
I HAVE READ AND UNDERSTAND THE ABOVE RELEASE FORM.
Louisiana Liability Release Form 1