Blazing Hope Release of Liability

Blazing Hope Youth-Family Ranch Release of Liability

READ CAREFULLY AND COMPLETE ALL SECTIONS BEFORE SIGNING

This is Required to be filled out by

Adults whether riding or not.

This is a one person form

For Family Form click here

No, need to print just click submit at the bottom of this page.

Confirmation is sent to your email.
WARNING:

Under Idaho Law, an equine professional is not liable for an injury to or the death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to Title 6 Chapter 18 Idaho Equine Activities Immunity Act
Adult or Child*
(First & Last Name)*
Date of Birth*

MonthDayYear
Date
Phone #*
Parent/Guardian Name: (if a minor)
Mailing Address*

Street Address: (If different)

Street Address Line 2

CityState

Postal / Zip Code
Email*
example@example.com
Address ( If different from above)

Address ( if different)

Street Address Line 2

CityState

Zip
Preferred contact method. phone, email, text*
Please Check all that currently apply to this PARTICIPANT*

AGE 18 or olderUnder AGE 18Over 240 lbsUnder 10 hours riding experienceOr, over 10 hours riding experience
Does this participant have any physical or mental condition(s), which may affect his / her safety and ability to ride, drive and/or train a horse?*

yesno
If you checked "YES," how can we help them with their special needs?
PHOTO AND VIDEO RELEASE
I hereby grant Blazing Hope Youth-Family Ranch and their officers, directors, contractors or staff permission to take or have taken still or moving photographs and videos and authorize the Blazing Hope Youth-Family Ranch to reproduce said photographs and use them at their discretion (i.e. brochures, websites, Social Media etc*
I, the undersigned, warrant and agree that I will make no claim or file suit for any injury to person or property, or for any loss or destruction of any article of any kind or nature in connection with my participation at Blazing Hope Youth-Family Ranch. I understand that the Blazing Hope Youth-Family Ranch nor their officers, directors, contractors or staff accept any responsibility for accidents, damage, injury or illness to the riders, horses, members, sponsors, agents, spectators or any other person or property owner in connection with operation at Blazing Hope Youth-Family Ranch. I understand that there are inherent risks in my participation and those risks are assumed by me. I fully understand that animals (horses) and conditions are unpredictable and that the risk of injury or death is inherent to the activity of horseback riding and/or being around horses. I fully assume the responsibility for the risk of injury or death caused by my contact with horses and horseback riding. I completely release Blazing Hope Youth-Family Ranch and theirofficers, directors, contractors or staff from any and all liability for any and all injuries or death to me caused by mycontact with horses and/or horseback riding.

Signing of this form binds me to this hold harmless agreement.

This document will be constructed under the laws of the State of Idaho.
Today's Date*

MonthDayYear
Date
Signature*
AUTHORIZATION TO ARRANGE MEDICAL CARE
**Please add at least one emergency contact**

In the event that I or my minor child, have an emergency, and a parent/guardian named above cannot be reached,

Please contact the following trusted Emergency Contacts:
(1) Name*
Relationship*
PHONE*
(2) Name
Relationship
PHONE
Preferred medical facility*
Health insurance company
Policy #
Family physician
Phone#
Any medical information,medications, allergies etc
Illness
Medication(s)
Allergies
Other
I authorize Blazing Hope Youth-Family Ranch officers, directors or staff to obtain medical assistance for me/my child. As a parent/guardian of , a minor child or myself, I hereby authorize Blazing Hope Youth-Family Ranch officers, directors or staff to obtain medical aid for the above-named child or myself. I understand that this authorization will be used only in the case of an emergency, and if the speed of treatment is essential to the well-being of my child or myself in the case of an injury, the child or I will be taken to the nearest hospital. I also understand that I release the Ranch, directors, staff and officers, from all liability. Blazing Hope Youth-Family decisions made in regard to my child's or my injury, care or hospitalization. If I do not consent to authorize Blazing Hope Youth-Family Ranch officers, directors or staff to arrange medical care, I will specify on paper that will then be attached to this as to my desired course of action. The fee for treatment will be paid by the undersigned. I am aware Blazing Hope Youth-Family Ranch does not provide medical coverage to participants/volunteers.
Today's Date*

MonthDayYear
Signature*
Blazing Hope Youth-Family Ranch 26512 Farmway Rd Caldwell, ID 83607

Revised August 2023
Should be Empty:

PHOTO AND VIDEO RELEASE

AUTHORIZATION TO ARRANGE MEDICAL CARE