RIDING LESSON LIABILITY RELEASE
PATCHWORK PARK EQUINE SERVICES
Street Address Line 2
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Do you consent to photos of your horse being used on our Social Media Platforms, ie: Facebook, YouTube, Website?
How did you hear about us?
Do you have Ambulance Cover?
DRAW BRAND (NEARSIDE)
DRAW BRAND (OFFSIDE)
WHICH RIDING INSTRUCTOR WOULD YOU LIKE TO USE?
WHAT ARE YOUR GOALS WITH THIS HORSE? WHAT WOULD YOU LIKE TO ACHIEVE IN SESSIONS?
IS THERE ANYTHING ELSE WE NEED TO KNOW? IE, INJURIES, TRAUMA, BAD EXPERIENCE ETC, OR ANYTHING THAT MAY AFFECT YOUR SESSION?
DO YOU HAVE ANY HEALTH ISSUES?
LIABILITY RELEASE FORM
PLEASE READ CAREFULLY
1. WEARING OF APPROVED HELMET AND BOOTS
I understand the very real risks associated with horses (whether mounted or unmounted) and agree to wear a helmet (within date and Australian Standard Approved) and approved riding boots when partaking in any mounted activities. Unmounted activities will always be conducted wearing protective, enclosed shoes or boots.
2. RISK OF INJURY
a. I acknowledge that there is always a chance of DEATH OR SERIOUS INJURY when working with horses. I understand that horses are living creatures that can act unpredictably, making them at times dangerous or damaging. I accept all responsibility for this risk. b. I agree to act sensibly, refraining from interacting with other horses aside from my own (unless granted permission by the owner, even during an emergency where management must be notified) c. I will not allow inexperienced persons (accompanying me or others) to be hurt or harmed by my own horse. This includes acting irresponsibly, allowing inexperienced persons to ride or handle unsuitable horses, etc. d. I will not act in any way that could place myself, my horse (or any horse), members of Patchwork Park or any other visitors at risk of injury or harm. I will also act in a way to avoid damages to any assets or equipment on site. Should damages occur, I understand that there may be additional costs incurred to replace or repair items affected. e. I relinquish all rights of prosecution towards Patchwork Park Equine Services, should any damages or losses occur to myself, my horse or my possessions while on Patchwork Park Premise.
3. IN AN EMERGENCY
a. If I am involved in an accident while on premise, Patchwork Park maintains the right to call an ambulance on my behalf. b. If an ambulance is called on my behalf and I do not have ambulance cover, I will be billed for any costs incurred. c. If I am injured in a fall and removed from site, Patchwork Park may take temporary control of my horse and feed / husbandry / agistment costs incurred to keep my horse safe will be billed to me. d. Necessary husbandry requirements are at Patchwork Park's discretion and determined by duration of stay.
4. SAFE PROXIMITY BETWEEN HORSES
a. I MUST KEEP MY HORSE AWAY from other horses at all times. This is to prevent the spread of diseases and also prevent risk of injury to myself or any horse through biting, striking or kicking. A safe distance between horses will be created at all times. b. I will not allow my horse to sniff other horses over fences. c. I will not walk my horse within biting or kicking distance of another horse. d. I have been notified that Patchwork Park is home to many stallions and colts that may become aggressive if safe distances are not maintained.
5. HANDLING OF OTHER HORSES / WANDERING
a. I will not handle any horse other than my own b. I will not enter paddocks, stables or yards with horses other than my own, even if the horse is in trouble. If a horse requires assistance I will notify Patchwork Park Staff immediately. c. I WILL NOT WANDER / EXPLORE THIS FACILITY without supervision. This is a private facility and Patchwork Park has a duty of care for agisted horses.
6. SOBRIETY OF ALCOHOL, SMOKING OR ILLICIT DRUGS
a. I will not arrive for a session UNLESS I am completely sober of alcohol and free from any drugs that may hinder my ability to make decisions or remain safe. b. Patchwork Park premise is a SMOKE FREE ZONE. I will not smoke for the duration of my visit. c. I will not arrive for any session while under the influence of any illicit drugs.
7. MY RIGHTS TO REFUSAL
a. I may express discomfort towards activities suggested by my Patchwork Park instructor and may rightfully refuse to perform said activities at any stage. I am encouraged to communicate my emotions of current confidence and competency to best dictate suitable exercises during supervised sessions.
8. MY BEHAVIOUR
a. I will interact civilly and courteously towards other riders, staff members and management. This includes riding in the arenas, using tie bays, etc. b. I will treat any horse on the property with dignity, empathy and respect, and understand that any form of animal cruelty is strictly forbidden. c. I may be asked to leave the property and/or further action taken if I am warned that my behaviour is unacceptable and I ignore the warning.
a. I will not bring dogs onto the property without prior arrangement. b. Dogs with prior arrangement must be well behaved and either safely restrained or on a leash at all times. Many horses have natural urges to chase and kill dogs and our fences are also electrified at head height for a dog. c. I will not allow my dog to chase the horses.
a. I will supervise my child / children at all times. b. I will not allow my child to handle,feed or enter any paddock, yard or stable of a horse on premise other than my own
11. USE OF CAMERAS
a. I am permitted to use video and photography devices for the purpose of recording my session only. I am not permitted to take photos and videos of horses belonging to others, or training sessions of other riders. b. I may publish footage online of photos obtained from sessions for the purpose of encouragement, improvement or positive remarks only. Footage is not to be obtained for the purpose of defamation.
I am permitted to bring a stallion onto the property, provided the following points are adhered to: a. My stallion is well behaved and under control at all times. b. I present clear EA Approved green stallion discs on either side of the animal (headstall, bridle or saddle cloth). c. Persons under 18 are experienced with stallions and are supervised by an adult.
BY SIGNING THIS FORM, YOU ACKNOWLEDGE AND ACCEPT THE TERMS AND CONDITIONS OF THIS CONTRACT
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