I hereby grant Newfoundland Pony Conservancy Center hereby known as NPCC, permission to use my likeness in a photograph or other digital reproduction in any and all of its publications, including website entries, without payment or any other consideration.

I understand and agree that these materials will become the property of NPCC and will not be returned. I hereby irrevocably authorize NPCC to edit, alter, copy, exhibit, publish or distribute this photo for purposes of publicizing the its programs or for any other lawful purpose.

In addition, I waive the right to inspect or approve the finished product, including written or electronic copy, wherein my likeness appears. Additionally, I waive any right to royalties or other compensation arising or related to the use of the photograph.

I hereby hold harmless and release and forever discharge NPCC from all claims, demands, and causes of action which I, my heirs, representatives, executors, administrators, or any other persons acting on my behalf or on behalf of my estate have or may have by reason of this authorization.

I am 18 years of age and am competent to contract in my own name. I have read this release before signing below and I fully understand the contents, meaning, and impact of this release.

PHOTO RELEASE

Do you consent and authorize the use and reproduction by True Hope Therapeutic Horsemanship of any and all photographs and any other audio/visual materials taken of participant and/or me for promotional material, educational activities, exhibitions or for any other use for the benefit of the program.

I certify I am physically fit, have sufficiently trained for participation in Riding, and have not been advised otherwise by a qualified medical person. I attest I do not have any condition or limitation that would prevent me from participating in riding and other equine activities.

I certify that the answers given herein are true and complete to the best of my knowledge.

This form must be completed for each participant.

PLEASE READ CAREFULLY BEFORE SIGNING:

Under New Hampshire law, an equine activity sponsor or professional shall not be liable for any injury to, or the death of a participant in equine activities resulting from the inherent risk of equine activities (New Hampshire Stat. 508:19).

I acknowledge that riding a horse is an inherently dangerous activity and carries with it the potential for death, serious injury, and property loss. “Horse” as used herein shall refer to all equine species. “Horseback Riding” or “Riding” shall refer to riding or otherwise handling of horses, ponies, mules, or donkeys, whether from the ground or mounted. The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of animals, equipment, vehicular traffic, actions of other people including, but not limited to, participants, spectators, volunteers, and/or instructors or coaches. These risks are not only inherent to participants but are also present for others present during Riding. I therefore realize that participation in Riding includes but is not limited to participating in any True Hope program or event, volunteering, and observing. I hereby assume all of the risks of participating in the Horseback Riding. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released, from their horses, volunteers, or employees, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

I certify that I am physically fit, have sufficiently trained for participation in Riding, and have not been advised otherwise by a qualified medical person. I attest that I do not have any condition or limitation that would prevent me from participating in Riding. It is the responsibility of the participant to carry full and complete insurance coverage on his/her horse, personal property, and him/herself.

I acknowledge that this Accident Waiver and Release of Liability form will be used by the owners of the horses, owners of the real estate, owners of the facility, or others employed by such parties, and that it will govern my actions and responsibilities at each Riding occasion.

In consideration of my application and permitting me to participate in Horseback Riding, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release, and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me, including my traveling to and from the Riding facility, THE FOLLOWING ENTITIES OR PERSONS:

True Hope Therapeutic Horsemanship

and any and all directors, officers, employees, volunteers, representatives, and agents, and/or sponsors of the above; (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in Riding, whether caused by the negligence of releasees or otherwise.

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness.

The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

I hereby certify that I have read this document and I understand its content.

I acknowledge that riding a horse is an inherently dangerous activity and carries with it the potential for death, serious injury, and property loss. “Horse” as used herein shall refer to all equine species.  “Horseback Riding” or “Riding” shall refer to riding or otherwise handling of horses, ponies, mules, or donkeys, whether from the ground or mounted.  The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of animals, equipment, vehicular traffic, actions of other people including, but not limited to, participants, spectators, and/or coaches. These risks are not only inherent to participants but are also present for others present during Riding.

I hereby assume all of the risks of participating in the Horseback Riding. I realize that liability may arise from negligence or carelessness on the part of the persons or entities being released, from their horses or employees, from dangerous or defective equipment or property owned, maintained, or controlled by them, or because of their possible liability without fault.

New Hampshire Bill 793 508:19

I certify that I am physically fit, have sufficiently trained for participation in Riding, and have not been advised otherwise by a qualified medical person.

I acknowledge that this Accident Waiver and Release of Liability form will be used by the owners of the horses, owners of the real estate, owners of the facility, or others employed by such parties, and that it will govern my actions and responsibilities at each Riding occasion.

In consideration of my application and permitting me to participate in Horseback Riding, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) Waive, Release, and Discharge from any and all liability for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me, including my traveling to and from the Riding facility, THE FOLLOWING ENTITIES OR PERSONS:

Renee Pecor and Mike Southwell

and their directors, officers, employees, volunteers, representatives, and agents, and/or sponsors; (B) Indemnify and Hold Harmless the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in Riding, whether caused by the negligence of releasees or otherwise.  

I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness.

I understand that Horseback Riding or related activities, I may be photographed. I agree to allow my photo, video, or film likeness to be used for any legitimate purpose by any of the releasees.

The Accident Waiver and Release of Liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable law.

In the event that emergency medical aid/treatment is required due to illness or injury during the process of receiving services, or while being on the property of the agency, I authorize True Hope Therapeutic Horsemanship to:

1. Secure and retain medical treatment and transportation, if needed.

2. Release client records upon request to the authorized individual or agency involved in the medical emergency treatment.

CONSENT PLAN

This authorization includes x-ray, surgery, hospitalization, medication and any treatment procedure deemed “life-saving” by the physician. This provision will only be invoked if the person(s) listed cannot be reached.

NON-CONSENT PLAN

I do not give consent for emergency medical aid/treatment in the case of illness or injury and agree to be present with the participant during the process of receiving services or while being at True Hope Therapeutic Horsemanship during the participant’s lessons.