SEC Risk Acceptance Form

Risk Acceptance Form

Please complete the following form to acknowledge your acceptance of the risks associated with equestrian activities.
Name

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Activity
Date of Activity

MonthDayYear
Date
Warning: Under South Carolina Law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in an equine activity resulting from an inherent risk of equine activity, pursuant to Article 7, Chapter 9 of Title 47, Code of Laws of South Carolina, 1976
Emergency Contact

First NameLast Name
Emergency Contact Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
I have read and understand, and freely and voluntarily enter into this Release and Hold Harmless Agreement with Shadydale Equine Center, understanding that this Release and Hold Harmless Agreement is a waiver of any and all liabilities. EVERYONE on SEC property, including non-riding guest, must sign an Equine Activity and Hold Harmless Agreement and everyone on horseback must wear an approved ASTM helmet.

YesNo
I understand the potential dangers that I could incur in mounting, riding, walking, boarding, feeding said horse; including, but not limited to, any interactions with other horses. Understanding those risks I hereby release Shadydale Equine Center, its officers, directors, shareholders, employees and anyone else directly or indirectly connected with that Company from any liability whatsoever in the event of injury or damage of any nature (or perhaps even death) to me or anyone else caused by my electing to mount and ride a horse.

YesNo
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 understandthat this Release and Hold Harmless Agreement may further limit the liability of equine professionals to include any activity,whatsoever, involving an equine, including death, personal injury and/or damage to property.

YesNo
I further voluntarily agree and warrant to Release and Hold Harmless this (these) equine professional(s) from any liability whatsoever, including, but not limited to, any incident caused by or related to said equine professional’s (s’) negligence, relating to injuries known, unknown, or otherwise not herein disclosed; including, but not limited to injuries, death or property damage from: mounting; riding; dismounting; walking; grooming; feeding; use of horse barn; paddocks, trails or horse ring, in any capacity; falling off horse whether horse is bucking, flipping, spooked; or my failure to control, or lack thereof, my horse or the horse I have been assigned to.

YesNo
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Activity

Outdoor Arena

2 Hr Limit

$20.00 Quantity

Indoor Arena

2 Hr Limit

$35.00 Quantity

Total

$0.00

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