Riding Application and Waiver Name(Required) First Last Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone(Required)Email(Required) AgeHeight and Weight Birth Date(Required) MM slash DD slash YYYY Emergency contact name(Required) First Last Emergency contact phone(Required)Rider Ability Beginner Intermediate Advanced Beginner: Little or no riding experience Novice: Some riding experience, can walk, trot, and canter and comfortable riding outside an enclosed area Intermediate Advanced: Very confident riding different types of horses in all gaits and various degrees of training, is capable of producing some lateral work, in all situationsDescribe riding experience in more detail:Describe physical ailments/disabilities that may affect your ability to participate in horseback riding activities:Please list any current medications that may affect your riding ability or safety to ride: I hereby acknowledge and understand that horseback riding and the handling of horses and ponies are dangerous activities which can result in injury or death. I, the undersigned, from this date on, hereby release, indemnify, and hold harmless Dawn Bonin Horsemanship LLC, Babcock Hill Horses Naturally LLC, and all owners, and affiliations of property where horse is stabled, from any and all claims, actions, suits, and/or damages that may occur as a result of any injuries sustained while taking horseback riding instruction, handling, or being near horses or ponies. This shall include all losses, damages, costs, and counsel fees that may occur as a result of injury, and related claims by any parties. I understand that inherent risks are involved in riding, handling, or being near horses and ponies. The inherent risks include but are not limited to the propensity of equines to behave in a way such as, running, bucking, biting, kicking, shying, stumbling, rearing, falling, or stepping on. Also the unpredictability of equines' reaction to such things as sounds, sudden movement and unfamiliar objects, persons, or other animals. By signing this agreement take full responsibility in the event of any injury. I have filled out this application in full disclosure and truthfulness. I have read this release, waiver and indemnity agreement, and understand the risks involved and agree to assume them. I sign this agreement voluntarily and with full knowledge of its significance. I acknowledge that all horse handlers and riders should wear protective headgear which meets or exceeds the quality standards of the SEI certified ASTM standard while riding and being near horses and ponies. I understand that the wearing of such helmet may reduce the severity of any head injury incurred. If I choose not to wear such helmet, I assume all such risk of injury resulting therefrom. I further agree that all minors (under 18 years of age) must wear protective headgear while riding.Permission to photograph Permission to Photograph. I grant to Dawn Bonin/Babcock Hill, the right to take photographs of me and my family in connection with the above-identified program. I authorize Dawn Bonin/Babcock Hill, its assigns and transferees to copyright, use and publish the same in print and/or electronically. I agree that Dawn Bonin/Babcock Hill may use such photographs of me with or without my name and for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and Web content.Agreement(Required) Yes, I agree No, I don't agree Signature(Required)I am the(Required) Applicant Parent/Guardian (if under 18)
