Volunteer/Visitor/Participant Liability Waiver Form

I recognize that participation in the activities in the Riverside Ranch program located at 221 Clark Pond Rd. Clayton, NC 27527 ("the facility") involves significant hazards and risks in riding and handling horses. I certify that neither I nor the participant for which I am responsible has any physical conditions which might interfere with my/his/her capacity to participate in horseback riding and other activities offered by the Riverside Ranch program. Knowing the inherent risks, dangers, and rigors involved in horseback riding and other activities involving horses, I assume full responsibility for myself or the participant for which I am responsible for any and all bodily injury, death, loss of personal property and expenses thereof, which may occur as a result of participation in the handling of horses, horseback riding and other activities sponsored by the Riverside Ranch program or may occur at the facility. I waive any and all claims which may result from any such participation. I expressly release and waive all such liability and claims, even if they should arise out of the negligence of other persons, including other persons released hereby. I further agree that if anyone makes any claim on my behalf or on behalf of the participant for which I am responsible because of any injury, death, or damage to property, I will indemnify and hold harmless all of those persons released by this agreement against any damage, or costs which may result because of those claims, including legal fees. I will observe all rules, regulations, and instructions of the facility and will exercise due care to avoid injury, damage or loss to person and property. The persons and entities which are hereby released and to which the benefit of this liability and release adheres are Riverside Ranch, Inc. and its employees, volunteers, participants, guardians, officers, directors, and any other person connected to or participating in the Riverside Ranch program. I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me and the participant for whom I am responsible during the entire period of my/his/her participation in the handling of horses and/or the participation and therapeutic riding lessons upon the premises of the facility. The undersigned understands that under North Carolina Law an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 99E of the North Carolina General Statutes.

As of 1 JANUARY 2022--REQUIRED FOR ALL STAFF, CONTRACTORS, VOLUNTEERS, AND CLIENTS I am aware of the risks of contracting or spreading Covid-19 while working, volunteering, or participating in activities at Riverside Ranch; attending an event; and/or receiving face-to-face services from during the time of a pandemic outbreak, and/or North Carolina's Governor's or Johnson County's declaration of a "stay-at-home" order(s). I am aware that face-to-face services and experiences increase my risk of contracting and passing on the Covid-19 or Coronavirus and agree to hold harmless Riverside Ranch and its residents, members, officers, managers, agents, employees and all other individuals I may come in contact with during this interaction and receiving of services, providing services, attending an event or volunteering within this organization. I agree to and will follow all guidelines for personal hygiene, personal safety and public safety as recommended by Riverside Ranch; as well as my individual provider/practitioner. This may include, but is not limited to; waiting in my vehicle or specified area until I am asked to enter the farm/arena and maintaining social distance, washing my hands prior to and following each session or activity, use of hand sanitizer upon request, wiping down surfaces with disinfecting wipes and/or wearing a protective medical mask and/or gloves. I agree to stay home and/or cancel my services should I have personally exhibited or have been in contact with someone who has presented with illness within the last 24-48 hours. If I am exhibiting any symptoms such as coughing, sneezing, fever, chest congestion or additional signs of potential spread of any virus or bacteria/disease, I will stay home until all symptoms have subsided or my general practitioner advises that I am able to do so without being contagious. In addition, if I have received a positive result from a Covid test, I will stay home until I get a negative result and my general practitioner has given me their approval. Riverside Ranch will engage in regular cleaning and sanitizing of the facility, horse tack, grooming supplies and frequently touched areas in-between clients and on a daily basis as recommended by the CDC for the safety of clients, employees, volunteers and horses. I am signing under my own free will and agree to follow these and hold harmless all individuals associated with or through my services acquired from Riverside Ranch BY SIGNING BELOW, I CONFIRM THAT I HAVE READ AND UNDERSTAND THIS DOCUMENT. *In the event that the undersigned is under the age of 18, the signature of a parent or guardian is required.

Please sign either Consent or Non-Consent.

I consent to and authorize the use and reproduction by Riverside Ranch of any and all photographs and any other audio-visual materials, including videotape, taken of me for promotional material, educational activities, exhibitions or for any other use for the benefit of the program.

I do not give my consent nor do I authorize the use and reproduction by Riverside Ranch of any photographs or any other audio-visual materials taken of me.

Because of the nature of the program, Riverside Ranch Therapeutic Riding Program may have access to confidential medical and financial records of riders. To protect the confidentiality of our riders, Riverside Ranch has instituted a confidentiality policy. Riverside Ranch Therapeutic Riding Program shall preserve the right of confidentiality for all riders participating in its program. Individuals bound by this policy include part and full time staff members, volunteers who may have access to confidential knowledge, independent contractors involved with the program, instructors, and board members. Individuals subject to this policy shall keep confidential any and all medical, social, referral, personal, and financial information regarding a person and/or his or her family. All riders or rider parent(s), legal representatives, or others as defined by state stature must sign consent or non-consent release forms regarding medical and sensitive information disclosure, and consent or non-consent release forms regarding use of photography and/or videotape prior to participation in the program. Penalties for breach of confidentiality shall include immediate loss of any responsibilities that would allow the individual access to confidential records. Additional penalties may include, at the discretion of the board of directors, reprimand, loss of certain job responsibilities, and/or termination from the program. I understand and will observe the confidentiality policy of Riverside Ranch.

Thank you for joining the Riverside Ranch community by participating in our Grief-Focused Group Day Retreat. The Day Retreat will cost $90 per participant, which covers the cost of a devotional book, lunch, and 4 hours of facilitated group activities to help each person heal and process their grief. We value each individual who sets foot on the property and don't want finances to limit access to our programs and retreats. We're able to provide financial assistance to those who need it through the generous support of our sponsors.