AATA Equine Program Waiver

APPALACHIAN ACADEMY OF THERAPEUTIC ARTS ("AATA")

Equine Program Waiver

As a group of parents and parent-teachers, we believe that a sacred connection exists between children and the natural world, including the rhythms of change throughout the seasons of the year. We have chosen to create a cooperative learning environment for our children that includes farm activities, gardening, outdoor exploration, academics, traditional crafts and lore, and overall immersion in the natural world.

AATA operates as a 508c1a unicorporated Religious based eleemosynary society.

In consideration of being allowed to participate in the Equine Program at AATA, for myself and any minor children for whom I am a parent, legal guardian or otherwise responsible for, I hereby acknowledge the risks of injury or damage (to property, personal injury and/or death) involved with live animals, and acknowledge any participation in purely voluntary. I assume full responsibility for myself and any other minor children for whom I am parent, guardian or otherwise responsible for any bodily injury, accident, illness, paralysis, death, loss of personal property and expenses therefore as a result of an accident which may occur while participating in Equine and Farm Animal activities at AATA.

I/we further agree to abide by all safety instructions, and to wear any safety equipment provided during Equine and Farm Animal activities. I/we acquit and forgive AATA, family, heirs, employees, visitors and volunteers of any and all liability, injury, damage, illness, paralysis, or death associated with Equine and Farm Animal activities at AATA. I/we expressly waive any claim, lawsuit, complaint, charge or cause of action again AATA, family, heirs, employees, visitors and volunteers for any any all liability, injury, damage, illness, paralysis, or death associated with Equine & Farm Animal activities at AATA.

Location

I understand that AATA has several field areas that may utilized during the Equine Program, all are located on Shope Creek Rd, Asheville, NC. Participants may be driven in the AATA shuttle van to and from different fields during programming time as needed.

My child has my permission to be transported to and from AATA in the transportation van, and/or by designated and screened parents/teachers/staff/volunteers in private vehicles accompanied by AATA parents/teachers/staff/volunteers. I hereby agree to release AATA, its representatives and/or fellow parents of liability related to injury to said student while traveling to and from AATA or field trip location. All driver's licenses must be valid and current and he/she must have a clean driving record. Any AATA transportation vehicle will be insured and registered in the State of North Carolina.

Field Trip Permission & Waiver

My child has permission to attend all field trips related to the Equine Program planned and accompanied by AATA teachers and volunteers. I hereby release AATA, it's staff and any volunteers or any liability incurred to myself or a member of my family as a result of participation in any planned field trips. *All field trips will be given written notice of and the option to opt out if a family desires.

Photo/Video Permission

SCSMT may photograph or record video of child(ren) for use on AATA websites, bulletin boards, fundraising materials, newsletters or other publicity materials.

First Aid & Medical Emergencies

SCSMT, its employees, and/or parents may administer basic homeopathic and traditional first aid to my child as needed. This first aid includes but is not limited to the following:

Hydrogen Peroxide Antibacterial Ointment/spray
Arnica
Antibacterial Ointment/spray
Anti-ich cream
Benadryl (to be used in the case of severe allergic reaction only)
All items in our Wellness Kits

In case of an emergency, every effort will be made to contact the parent/guardian. In the event that a parent/guardian cannot be reached, SCSMT staff will select a physician/medical institution to secure treatment for the child(ren) experiencing the emergency.

This waiver is made voluntarily, upon signing I agree to all Agreements outlined in this document.

I understand that I must also complete the Private Membership Association Agreements before myself or child(ren) attend an Equine Program.

Child's Name*

First NameLast Name

Which program are you enrolling in?*

Please describe/share any other details pertinent the program you are joining (ie: if you'd like to join multiple programs, please list here):

Date of Birth*

Date

Gender*

Child's Name

First NameLast Name

Date of Birth

Date

Gender

Parent/Guardian #1 *

First NameLast Name

Parent/Guardian #1 Phone *

Please enter a valid phone number.

Parent/Guardian #1 Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian #2

First NameLast Name

Parent/Guardian #2 Phone

Please enter a valid phone number.

Parent/Guardian #2 Email

example@example.com

Please list 2 Emergency Contact People and Phone Numbers*

Please list any special accommodations, requirements, allergies, health challenges and/or diet preferences of the participant(s)*

Please share what/if any Equine experience of participant(s)*

Is there anything else you would like to share with us?

A $50 non-refundable deposit is due after submitting this form to secure your child's spot in the class. You may also pay the full amount of the class after submission to reduce the number of transactions. Please send via paypal to:

The remaining balance must be paid one week before the start of the class, either via the above email at paypal, mailed check, or cash/check dropped off at AATA. If a child decides not to participate after the balance is paid, before the first day of class, 50% of the balance will be refunded minus the $50 deposit via mailed check within 2 weeks of the class start date.

After the first class begins, no refund will be issued.

Signature*

Parent/Guardian #1 Name*

First NameLast Name

Signature

Parent/Guardian #2 Name

First NameLast Name

Date*

Date