All adults and minors coming onto the farm premises must have a completed waiver.
NOTICE
Under Wisconsin Law, a person who is engaged for compensation in the rental of equines or equine equipment or tack or in the instruction of a person in the riding or driving of an equine or in being a passenger upon an equine is NOT liable for the injury or death of a person involved in equine activities resulting from the inherent risks of equine activities, as defined in section 895.481(1)(e) of the Wisconsin Statutes.
VISITATION, PARTICIPATION AGREEMENT
(the “Agreement”)
READ THIS DOCUMENT CAREFULLY BEFORE SIGNING. IT CONTAINS LEGAL CONSEQUENCES THAT WILL AFFECT YOUR LEGAL RIGHTS AND ELIMINATE YOUR ABILITY TO BRING FUTURE LEGAL ACTIONS. RELEASED PARTIES INCLUDE:
Memory Lane Farm, Inc., Doug Zarnke, Beth Zarnke, its agents, owners, officers, volunteers, participants, employees, landlords and property owners and all other persons or entities acting in any capacity on their behalf (collectively referred to as “Farm” RELEASING PARTIES INCLUDE: The undersigned participant and minor(s) listed in the Agreement, participant's spouse, children, parents, guardians, heirs, next of kin, and any legal or personal representatives, executors, administrators, successors and assigns, or anyone else who might claim or sue on participant's behalf.
AGREEMENT - READ BEFORE SIGNING IN CONSIDERATION OF SERVICES
I hereby agree to release and discharge Farm on behalf of myself, my heirs, assigns, personal representatives, my estate and any other person listed in this Agreement (cumulatively “participant”, “I”, “myself”), and as follows: RELEASE OF LIABILITY, ASSUMPTION OF RISK, INSTRUCTION, JURISDICTION, VENUE:
I understand that by my presence on Farm premises, I may engage in activities or utilize the premises in a way that may involve inherent risks that are beyond the control of Farm. Farm has taken precautions to provide a safe setting, but I understand that the possibility of injury, death, or loss to persons is present. Activities may include, but are not limited to, physical activity, walking/running, group games, sports, aquatic activities, general recreation, general use of grounds including its improvements, working on projects in a woodshop, cooking, craft making, handling and petting or working with livestock to include but not limited to dogs, cats, cows, sheep, goats, bees, chickens, and riding the Tractor and other ranch equipment. By signing below, I hereby give consent for the below mentioned participants to use the grounds and activities. (2) I further agree that horseback riding and all equine activities are inherently Memory Lane Farm, Inc., 8638/8640 Heritage Dr., Marshfield WI 54449 (“premises”, “property”) dangerous activities and that these activities will expose me to significant risks, both known and unknown, which could result in physical or emotional injury, or possible death, or damage to myself, to property, or to third parties. (3) I expressly agree and promise to accept and assume all the risks existing in Farm activities, both known and unknown, whether caused or alleged to be caused by the negligent acts or omissions of Farm. My participation in all Farm activities is purely voluntary and I elect to participate in spite of the risks. (4) I agree to acknowledge all of Farm’s rules and regulations pertaining to any and all activities (equine or otherwise) occurring on or off of Farm’s property. I agree to and I am responsible for wearing protective gear appropriate for said activities to ensure my safety while engaging in same. (5) I understand that protective gear includes, but is not limited to, protective footwear and headgear. I agree that Farm has fully warned and advised me that protective equine headgear that meets or exceeds the quality standards of the SEI certified ASTM standard F1163 equestrian helmet should be worn while riding or training horses. I understand that wearing such protective headgear at these times may reduce the severity of some of the wearer’s head injuries and possibly prevent the wearer’s death. I am not relying on Farm to provide a certified equestrian helmet for me, to check any headgear or equestrian helmet that I may wear, to check any headgear strap or equestrian helmet strap that I may wear, or to monitor my compliance with this suggestion at any time now or in the future. (6) I understand the risks, conditions, and dangers inherent in all Farm activities, including equine activities. I agree to assume any and all risks involved in my use of or presence upon Farm’s property and facilities while engaging in any activity without limitation. These risks include, but are not limited to, death, bodily injury, property damage, falls, kicks, bites, unavailability of emergency medical care, the ordinary negligence of another person or Farm, and the deliberate acts of another person. I understand that if a horse is frightened or provoked it may divert from its training and act according to its natural survival instincts which may include, but are not limited to, stopping short, spinning around, changing direction or speed, shifting its weight, bucking, rearing, kicking, biting, or running from danger. The same is true for other animals upon the property. I acknowledge that these are just some of the risks and I agree to assume others not mentioned above. (7) I agree that Farm is not responsible for total or partial acts, occurrences, or elements of nature or unfamiliar sights, sounds or sudden movements that may scare an animal, including a horse, cause it to fall, or cause it to react in some other unsafe way. Some examples include: thunder, lightning, rain, wind; wild and domestic animals, insects, reptiles, which may walk, run or fly near, or bite or sting a horse or person; and irregular footing on outdoor groomed or wild land which is subject to constant change in condition according to weather, temperature, and natural and man-made changes in landscape. I also acknowledge that these are just some of the risks and I agree to assume others not mentioned above. I have asked or waived my right to inspect Farm’s facilities and am satisfied that all premise conditions are reasonably safe for my intended purpose, usage and presence upon Farm’s premises. (8) I agree to stay out of all sheds, paddocks, corrals, tack-rooms, feed-rooms, offices, and non-office related buildings, Memory Lane Farm, Inc., 8638/8640 Heritage Drive, Marshfield WI 54449 (“premises”, “property”) (excluding the barn), while waiting for horse related or other activities or while waiting for a participant of such activities. (9) I acknowledge that saddle girths (the fastener straps around a horse’s belly) may loosen during riding. I must alert the instructor or attendant of any girth looseness so action can be taken to avoid slippage of saddle and the potential for me to fall from the horse. (10) I hereby voluntarily release, forever discharge, and agree to indemnify and hold harmless Farm from any and all claims, demands, or causes of action, which are in any way connected with my participation in these activities or my use of Farm’s equipment or facilities, including any such claims which allege negligent acts or omissions by Farm but not grossly negligent or intentional. (11) I agree not to sue or initiate any legal action (whether in court or in arbitration) against Farm or any present or future owners, officers, members, managers, agents, employees and representatives of Farm, in connection with any claim which could have been or could be raised against any of them in any way connected with, arising out of, or relating to, personal injury or damage to the maximum extent permitted by law. (12) I certify that I have adequate insurance to cover any injury I may suffer while participating, or otherwise agree to bear the costs of such injury or damage myself. I further certify that I have no medical or physical conditions, which could interfere with my safety in this activity, or am otherwise willing to assume and bear the costs of all risks that may be created, directly or indirectly, by any such condition. It is recommended that I visit with a physician to ensure that these physical activities do not pose an unacceptable health risk. (13) I understand that in this Agreement the terms “horse” and “equine” mean all equine species, including, but not limited to, horses, ponies, mules, donkeys, and foals.
Initial Acceptance:*
PHOTO RELEASE
I hereby grant to Memory Lane Farm, Inc. 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”). (15) I acknowledge that the purposes for which the photograph(s) may be used include, without limitation, Farm publications, videos, books, newsletters, calendars, websites, blogs, and social media. (16) I agree that this Grant includes, without limitation, the right to use the photograph(s) – or any 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, videotape, DVD, broadcast, digital transmission and electronic/online media. (17) I acknowledge that this Grant includes the right to use the name of the minor(s) Memory Lane Farm, Inc., 8638/8640 Heritage Drive, Marshfield WI 54449 (“premises”, “property”) identified below, whether in original or modified form, or a fictitious name, in connection with the photograph(s). (18) I hereby voluntarily release and forever discharge – on my behalf and on behalf of the minor(s) identified below – Farm 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 minor(s) 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). (19) I understand that Farm and its licenses 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 negatives, positives, and prints – are owned by Farm.
Farm is free to assign and license any and all of the rights granted in this Photo Release. (20) 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 Farm or its licensees or assigns.
WORKSHOP, GARDEN, & ACTIVITIES
(21) I understand that in any Farm activity I may use inherently dangerous tools, equipment, machines, chemicals, or substances. Such activities include, without limitation, participating in woodworking, sewing, crafting, cooking, and outdoor gardens. I agree that I will not use equipment or materials without familiarizing myself with their safe use. I will educate and inform myself on the inherent dangers and risks that are associated with participation in any Farm activity. I will inspect any related facility and equipment to be used in support of an activity at the Farm, and if I believe anything is unsafe, I will immediately advise Farm of such condition. I acknowledge that risks of this nature could lead to illness, serious injury or even death. I am aware that my own behavior can affect my personal safety and the safety of others involved at the Farm. I will act according to all Farm rules, instructions and policies. (22) Knowing the risks described above, I agree, on behalf of myself, my family, heirs, and personal representative(s), to assume all risks and responsibilities surrounding my participation in such activities. To the fullest extent permitted by law, I release and indemnify Farm from and against any present or future claim, loss or liability for injury to person or property which I may suffer, up to and including death, or for which I may be liable to any other person, during or as a result of my participation in any activity at the Farm. Memory Lane Farm, Inc., 8638/8640 Heritage Drive, Marshfield WI 54449 (“premises”, “property”).
MISCELLANEOUS
(24) I agree these releases are binding upon me, the minor(s) below for whom I am contracting, my heirs, executors, administrators, legal representatives, and successors. (25) Should Farm or anyone acting on its behalf be required to incur attorney’s fees and costs to enforce this Agreement, I agree to indemnify and hold them harmless for all such fees and costs. (26) I agree that the validity and enforceability of this Agreement will be governed by the substantive law of Wisconsin without regard to its conflict of law rules. (27) If a provision of this Agreement is determined to be unenforceable in any respect, the enforceability of the provision in any other respect and of the remaining provisions of this Agreement will not be impaired. (28) I agree that any action, suit, or proceeding arising out of the subject matter of this Agreement will be litigated in courts located in Wood County, Wisconsin, I consent and submit to the jurisdiction of any local, state, or federal court located in Wood County, Wisconsin. Not a contract of employment: I understand and agree that any activities or tasks performed by me are strictly voluntary and are not in any way subject to not give rise to an employment relationship. I agree to save and hold harmless and indemnify each and all the parties previously referred to in this document, including without limitation Farm, from all liability, loss, cost, claim or damage whatsoever that may be imposed upon said parties because of any failure, or defect in or the lack of the minor(‘s/s’) capacity, to act in accordance with this Agreement, and I release the Farm and said parties on behalf of the minor(s) and the minor(‘s/ s’) parents or legal guardian of said minor(s). (29) I have carefully read this consent form, have been given the opportunity to ask questions and fully understand its contents. No representations, statements, or inducements, oral or written, apart from this form, have been made, except for those made by me in Farm’s participation agreement (which is incorporated herein by this reference My agreements to the provisions in this form are voluntary. I agree my releases are binding upon me, the minor(s) below for whom I am contracting, my heirs, executors, administrators, legal representatives, and successors.
Initial Acceptance:*
I am aware “The Agreement” will need to be renewed each
calendar year if I make a return visit to the premises.
ADULT/LEGAL GUARDIAN SIGNATURE
I/We , the undersigned, represent that we have read and understand the foregoing agreement, liability release and assumption or risk agreements, I/We understand that by signing this document I am giving up the right to sue today and in the future. I/we attest that all facts are true and accurate. I am signing this while of sound mind and not suffering from shock or under the influence of alcohol, drugs or intoxicants. By my signature below, I represent that I am a parent or legal guardian (“responsible party”) of the above listed minor(s), whom I am able to and do contract for. I will ensure the minor(s) act in accordance with this Agreement, and I am liable for their actions. I had the opportunity to ask questions about this document before signing it. I verify that I am 18 years or older at the date of this signing.