East Hill Farm VT 2025 Release Form

NAME: ADDRESS: CITY/STATE: HOME PHONE:

• “Directly engages in an equine activity” means a person who rides, trains, drives, or is a passenger upon an equine, whether mounted or unmounted, but does not mean a spectator at an equine activity or a person who participates in the equine activity but does not ride, train, drive, or ride as a passenger upon an equine. “Equine activity” means (i) equine shows, fairs, competitions, performances, or parades that involve any or all breeds of equines and any of the equine disciplines, including, but not limited to, dressage, hunter and jumper horse shows. (ii) equine training or teaching activities; (iii) boarding equines; (iv) riding, inspecting, or evaluating an equine belonging to another whether or not the owner has received some monetary consideration or other thing of value for the use of the equine or is permitting a prospective purchaser of the equine to ride, inspect, or evaluate the equine; and (v) rides, trips, hunts, or other equine activities of any type however informal or impromptu that are sponsored by an equine activity sponsor. “Equine professional” means a person or his agent engaged for compensation in (i) instructing a participant or renting to a participant an equine for the purpose of riding, driving, or being a passenger upon an equine or (ii) renting equipment or tack to a participant. “Spectator” means any person in the vicinity of an equine activity whether watching the activities or simply in the area. “Participant” means any person, whether amateur or professional, who directly engages in an equine activity, whether or not a fee is paid to participate in the equine activity. All the above named must understand that there are risks inherent in dealing with horses and ponies (equine activity Some of the inherent risks include:
• The propensity of an equine to behave in ways that may result in injury, death, or loss to persons on or around the equine.
• The unpredictability of an equine's reaction to sounds, sudden movements, unfamiliar objects, persons, or other animals.
• That there may be hazards including, but not limited to, surface or subsurface conditions.
• The possibility of a collision with another equine, another animal, a person, or an object.
• The potential of an equine activity Participant to act in a negligent manner that may contribute to injury, death, or loss to the person of the Participant or to other persons, including, but not limited to failing to maintain control over an equine or failing to act within the ability of the Participant.

Poulsen Dressage llc Hold Harmless Agreement

• Participants and spectators further understand the examples of the equine activity taking place at Poulsen Dressage LLC include but are not limited to:
• Riding, training, showing, trail riding, and the like.
• Routine care and feeding of the equine, including veterinary and farrier services.
• Traveling, loading and unloading of equine.

, the undersigned have read and understand, and freely and voluntarily enter into this Release and Hold Harmless Agreement with Ruth Hogan Poulsen, Poulsen Dressage LLC, East Hill Farm VT, and their agents and employees, dba, Poulsen Dressage LLC, understanding that this Release and Hold Harmless Agreement is a waiver of any and all liability(ies 2. I understand the potential dangers that I could incur in mounting, riding, walking, boarding, feeding said horse; including, but not limited to, any interactions with other horses and dogs. Understanding those risks I hereby release Poulsen Dressage, its officers, directors, shareholders, employees and anyone else directly or indirectly connected with that Company from any liability whatsoever in the event of injury or damage of any nature (or perhaps even death) to me or anyone else caused by or incidental to my electing to mount and ride a horse, or be a spectator at such event, at Poulsen Dressage LLC. 3. I understand that there are risks inherent in dealing with equines (including horses, ponies, mules, donkeys, and hinnies) as itemized above. 4. I understand and recognize and warrant that this Release and Hold Harmless Agreement, is being voluntarily and intentionally signed and agreed to, and that in signing this Release and Hold Harmless Agreement I know and understand that this Agreement may further limit the liability of equine professionals to include any activity, whatsoever, involving an equine, including death, personal injury and/or damage to property. 5. I recognize and agree that I know which equine professional(s) I will be working with, and acknowledge that I agree said equine professional(s) has/have made reasonable and prudent efforts to determine my ability to engage in the equine activity, and has/have sufficient knowledge of my equine and horseback riding skills. 6. I also freely and voluntarily enter into the following Mediation and Arbitration Agreement concerning any equine activity incidents relating to or allegedly involving Poulsen Dressage LLC or its agents.

NOTICE: Wearing an ASTM/SEI approved hard hat is REQUIRED while riding or driving.

, acknowledge that I have read the above statements and definitions, and hereby indemnify and hold harmless, Poulsen Dressage LLC, East Hill Farm, and its employees or owners from any liability arising from accident, injury, theft, or damages to myself, my representatives, and helpers, all equipment and property, and all animals under my jurisdiction. I have received a copy of Poulsen Dressage LLC barn rules and will adhere to them strictly. This agreement shall continue for each and every visit to Poulsen Dressage LLC property. Participant agrees that Participant has been given sufficient time to read, and understand, and ask questions, if any, concerning the nature and scope of this Voluntary Waiver Agreement.

Poulsen Dressage llc Hold Harmless Agreement

The terms of this release form shall be construed as the entire agreement and may not be altered, amended, or modified except in writing and signed by both parties. The terms of this release shall be governed by the laws of the State of Vermont and Florida.

In addition, I, parents/guardians) hereby grant permission and authority to Poulsen Dressage LLC, its officers and authorized employees to act for us in executing verbal instructions of if unable to contact us, to act for us in dealing with physicians, available ambulance companies and hospitals, to obtain prompt medical attention for the participant named above in the event of any perceived medical emergency. I hereby covenant and agree to release Poulsen Dressage LLC and East Hill Farm, Properties LLC it’s officers, agents and employees, and owners of any property concerned, and hold harmless from liability for any injury or damage which the rider may sustain while at Poulsen Dressage LLC or participating in any activity sponsored by Poulsen Dressage LLC, and from any liability connected with obtaining prompt medical attention for the rider named above.

, (student/rider above named for, if minor,

The undersigned declares that the undersigned is the parent or legal guardian of the minor named below. The undersigned has read the foregoing Release and Indemnity Agreement and in consideration of Poulsen Dressage LLC allowing such minor entry onto its premises and/or allowing such minor to participate in equestrian activities, hereby agrees that all of the terms and conditions contained herein shall apply to such minor and shall be binding upon the undersigned and the minor.

The undersigned declares under penalty of perjury under the laws of the State of Vermont and Florida, that the foregoing is true and correct. Executed this day of , 202

If under 21, the parent or guardian must read and sign the above, indicting his/her acceptance.

Poulsen Dressage llc Hold Harmless Agreement