Waiver Logo
  • EQUINE ACTIVITY RELEASE, HOLD HARMLESS AGREEMENT

  • 1. I, (printed and signed below)  , the undersigned, on behalf of myself and/or, as parent and natural, have read, understand and freely and voluntarily enter into this Release and Hold Harmless Agreement with LMNM understanding that this Release and Hold Harmless Agreement is a waiver of any and all liabilities.


    2. I understand the potential dangers that I or my minor child can incur in mounting, riding, walking, boarding, feeding any horse; including but not limited to, interactions with other horses. I understand these risks and I hereby release LMNM, its owners, managers, employees, family, and anyone directly or indirectly connected with LMNM from any liability whatsoever in the event of injury or damage of any nature, including death, to me, or anyone else caused by or incidental to my electing to mount, ride, or interact with horses in any way, on LMNM's premises.

    3. 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 Release and Hold Harmless Agreement may further limit the liability of equine professionals in my undertaking in any equine activity whatsoever, including death, personal injury and/or damage to any property.

    4. I recognize and agree that I have selected the 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 as to relieve, release and hold harmless said equine professional(s) from any continuing duty to monitor my equine activities.

    5. I further voluntarily agree and warrant to Release and Hold Harmless these equine professionals from any liability whatsoever, including, but not limited to, any incident caused by or related to said equine professional's negligence, relating to injuries known, unknown, or otherwise not herein disclosed, including, but not limited to, injuries, death or property damage from equipment failure; mounting, riding, jumping; dismounting; walking; grooming; feeding; use of horse barn, electric fencing, paddock, trails or horse arena/ring, in any capacity; falling off horse whether horse is bucking, flipping, spooked, or my failure to understand any equine professional's direction relating to my riding or otherwise use and control, or lack thereof, of my horse or the horse I have been assigned to.

    6. I understand and acknowledge that I have been provided an opportunity to inspect, survey and traverse the premises to be utilized, by the equine professional (LMNM) and I have accepted the premises in the "AS IS" condition. I also acknowledge these inherent risks of equine activities:

    1) The propensity of an equine to behave in a manner, which may cause injury, harm or death to a person on or near it.

    2) The unpredictability of an equine's reaction to sounds, sudden movements, unfamiliar objects, individuals or other animals.

    3) An equine's reaction to certain natural hazards, such as surface and subsurface ground collisions.

    4) A collision with other equines or objects.

    5) An equine's response to the participant's manner of handling or controlling it or inability to handle or control it. Pennsylvania has adopted an Equine Activity Immunity Act. That Act recognizes the inherent risks involved in equine activities. I have voluntarily chosen to participate in these equine activities despite being aware of the risk involved.

  • Clear
  •  / /
  •  / /
  • If minor, person representing himself/herself to the lawful Guardian under this Release and Hold Harmless Agreement:

  • Clear
  • Emergency Contact: Name: Medical Insurance Information: Insurance Company:

  • I had the opportunity to ask questions about this document before signing it. I read and understood all of it, and by my signature I agree to be bound by each and every one of the terms herein.

  • PHOTO RELEASE

  • PHOTO RELEASE - I hereby grant to LMNM the unrestricted and absolute, perpetual, worldwide right to reproduce, exhibit, display, perform, transmit, broadcast, distribute, modify, create derivatives, and otherwise use the photograph(s) of myself and any minor(s) identified below (the "photograph(s)" for any purpose whatsoever ("Grant" I acknowledge that the purposes for which the photographs may be used include without limitation, LMNM publications, videos, books and newsletters. I agree that this Grant includes, without limitation, the right to use the photograph(s) - or part of it - in combination with, or as a composite of, other matter, including, but not limited to text, data, images, photographs, illustrations, animation and graphics, video or audio segments of any nature, in any media embodiment, now known or hereafter developed, including, without limitation, print, film, video tape, DVD, broadcast, digital transmission and electronic/online media. I acknowledge that this Grant includes the right to use the name of the minor(s) identified below, whether in original or modified form, or fictitious name, in connection with the photograph(s I hereby voluntarily release and forever discharge - for myself and on behalf of the minor(s) identified below -LMNM from any and all claims, demands, or causes of action for libel, defamation, invasion of privacy or right of publicity infringement of copyright, or violation of any other right arising out of or relating to any utilization of the photograph(s) or the name of the minors identified below. Such claims, demands, and causes of actions include, without limitation, inadvertent errors, such as blurring, distortion, or alteration, or based upon any decision not to make use of the photograph(s) I understand that LMNM and its licensees and assigns are relying on my consent to use the photograph(s) with respect to the promotion of various services or products. I acknowledge that neither myself nor any minor(s) identified below shall receive compensation with respect to any matter referred to in this Photo Release. All images, electronic or non-electronic, negative, positives and prints - are owned by LMNM. LMNM is free to assign and license any and all of the rights granted in this Photo Release. I acknowledge that in no event will I have the right to enjoin the distribution or exploitation of the photograph(s) I hereby relinquish any right that I may have to examine or approve the completed product(s) or advertising copy or printed matter that may be used by LMNM or its' licensees or assigns.

  • Clear
  • Session Policies

    Please read each policy and initial.
  • What we offer:

    LMN offers mentorship sessions including equine activities but may also include other activities such as picking berries, searching for caterpillars, visiting and helping with other animals as we attain them, as well as other projects we may initiate. The sessions include biblical scripture and discussion. We do not offer ‘therapy’ or ‘riding lessons’. 

  • Guardian Initials

  • Requirements: 

    The only requirement for attending is that the child wants to come. After three missed sessions, the next child on the wait list will be contacted so please be sure your child will be able to attend sessions at their session time. 

  • Guardian Initials

  • What to bring:

    - Closed toed shoes or boots that may on occasion get muddy and will most likely get horse poop on them.
    - Water 
    - Jacket and appropriate clothing for cooler nights 

  • Guardian Initials

  • Cancellations:

    In the case of inclement weather we may cancel at times. If possible, we will attempt to reschedule for a different night of the week to make up the missed session. 

  • Guardian Initials

  • Parents:

    Please wait until your session time to bring your child to the arena and barn area for the privacy of other session participants. You are welcome to enjoy the gardens present on the property around the house and shed until your child’s session time and during your child’s session. 

  • Guardian Initials

  • Should be Empty: