Acknowledgement of Risk& Release of Liability

Acknowledgement of Risk & Release of Liability - Under the Age of Majority

Jade Farrington, Nicole Neddow, Justine Wylie, Megan Desjardins & Hot 2 Trot Stables
For Participants Under the Age of Majority in the Province or Territory in which the Equine Activities are provided by the Host.

WARNING: THIS AGREEMENT WILL AFFECT YOU LEGAL RIGHTS, READ IT CAREFULLY!

The Parent/Guardian Must Read and Understand this Waiver Prior to Infant Participating in Equine Activities.

The following waiver of all claims, release from all liability, assumption of all risks, agreement not to sue and other terms of this agreement are entered into by me on behalf of Infant Participant named below with and for the benefit of Jade Farrington, Nicole Neddow, Justine Wylie, Megan Desjardins, Hot 2 Trot Stables, directors, officers, employees, volunteers, business operators, agents and site property owners or lessees (the "Host"). Without limiting the generality of foregoing, "Equine Activities" includes but is not limited to competitions, tournaments organized and/or operated by the "Host", riding instruction, coaching & training provided by the "Host" to the Infant Participant.

INITIAL EACH ITEM BELOW AFTER READING & UNDERSTANDING EACH ITEM:
1. I am the Parent/Guardian of the Infant Participant and am executing this waiver on behalf of the Infant Participant in my capacity as Parent/Guardian and with the intent that this waiver be binding on myself and the Infant Participant for all legal purposes.*

I HAVE READ & UNDERSTAND THE ABOVE STATEMENT(S)
INITIAL*

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2. I am aware that there are inherent dangers, hazards and risks (collectively "Risks") associated with "Equine Activities" and injuries resulting from these "Risks are a common occurrence. I am aware that the "Risks" of "Equine Activities" mean those dangerous conditions which are an integral part of "Equine Activities", including but not limited to: (a) the propensity of any equine to behave in ways that may result in injury, harm or death to persons on or around them and to potentially collide with, bite or kick other animals, people or objects; (b) the unpredictability of an equine's reaction to such things as sounds, sudden movement, tremors, vibrations, unfamiliar objects, persons or other animals and hazards such as subsurface objects; and (c) the potential for other participants to behave in a negligent manner may contribute to injury to themselves or others, including failing to act within their abilities to maintain control over an equine. (d) the potential of natural or man-made hazards being present that can cause me harm, including communicable disease*

I HAVE READ & UNDERSTAND THE ABOVE STATEMENT(S)
INITIAL*

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3. I freely accept and fully assume all responsibility for all "Risks" and possibilities of personal injury, sickness, disease, medical payments death, property damage or loss resulting from the Infant Participant's participation in "Equine Activities".*

I HAVE READ & UNDERSTAND THE ABOVE STATEMENT(S)
INITIAL*

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4. I agree that although the "Host" has taken steps to reduce the "Risks" and increase the safety of the "Equine Activities", it is not possible for the "Host" to make the "Equine Activities" completely safe. I accept these "Risks" and agree to the terms of this waiver on behalf of the Infant Participant, even if the "Host" is found to be negligent or in breach of any duty of care or any obligation to myself or the Infant Participant in my participation in "Equine Activities".*

I HAVE READ & UNDERSTAND THE ABOVE STATEMENT(S)
INITIAL*

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5. In addition to consideration given to the "Host" for the Infant Participant's participation in "Equine Activities", I and my heirs, next of kin, executors, administrators and assigns (collectively our "Legal Representatives") agree: (a) to waive all claims that the Infant Participant has or may have in the future against the "Host"; (b) to release and forever discharge the "Host" from all liability for personal injury, death, property damage, or loss that I, the Infant Participant, or our "Legal Representatives" might suffer as a result from the Infant Participant's participation in "Equine Activities" due to any cause, including but not limited to negligence (failure to use such care as a reasonably prudent and careful person would use under similar circumstances), breach of any duty imposed by law, breach of contract or mistake or error in judgement of the "Host"; and (c) to be liable for and hold harmless and indemnify the "Host" from all actions, proceedings, claims, damages, costs demands, including court costs and costs on a solicitor and own client basis, and liabilities of whatsoever nature or kind arising out of or in any way connected with the Infant's participation in "Equine Activities."*

I HAVE READ & UNDERSTAND THE ABOVE STATEMENT(S)
INITIAL*

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6. I agree that this waiver and all terms contained herein are governed exclusively and in all respects by the laws of the Province or Territory of Canada in which "Equine Activities" are provided by the "Host". I hereby irrevocably submit to the exclusive jurisdiction of the courts of that Province or Territory of Canada and I agree that no other court can exercise jurisdiction over the terms and claims referred to herein. Any litigation to enforce this waiver will be instituted in the Province or Territory of Canada in which "Equine Activities" are provided by the "Host".*

I HAVE READ & UNDERSTAND THE ABOVE STATEMENT(S)
INITIAL*

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7. I confirm that I have had sufficient time to read and understand this waiver in it's entirety. I understand that this agreement represents the entire agreement between the "Host", myself as Parent/Guardian and the Infant Participant, and it is binding on myself, the Infant Participant and my "Legal Representatives".*

I HAVE READ & UNDERSTAND THE ABOVE STATEMENT(S)
INITIAL*

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Infant Participant's Name*

First NameLast Name
Infant Participant's Date of Birth*

MonthDayYear
Date
Parent/Guardian's Name*

First NameLast Name
Parent/Guardian's Date of Birth*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Signature*

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Please verify that you are human*
RIDER MEDICAL PROFILE
Contact Information
Name

First NameMiddle NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Cell Phone
Please enter a valid phone number.
Email
example@example.com
Emergency Contact Information
1. Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Second Phone Number
Please enter a valid phone number.
Relationship
2. Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Second Phone Number
Please enter a valid phone number.
Relationship
3. Contact Name

First NameLast Name
Phone Number
Please enter a valid phone number.
Second Phone Number
Please enter a valid phone number.
Relationship
Personal Information
Health Card Number
Name on Health Card Number
Height of Participant
Weight of Participant
Any known allergies? If yes, please elaborate
Any permanent or temporary disabilities? If yes, please elaborate
Any past known medical conditions? If yes please elaborate
Does the participant have braces or other dental devices? If yes, please elaborate
Does the participant wear a medical alert bracelet? If yes, please elaborate
Late date of tetanus vaccination:

MonthDayYear
Date
Blood Type if Known
Does the participant have any of the following? Please check all that apply

ArthritisAsthmaChronic NosebleedsDiabetesDiphtheriaDislocating Joint(s)DizzinessEpilepsyFaintingHeadachesHeart TroubleHerniaSkin ConditionStomach ProblemsSwollen/Painful JointsTrick or Lock KneePrevious BreaksWear Glasses
If you checked any of the above boxes, please elaborate and describe any modifications that will contribute to the comfort of the participant while riding:
Does the participant take any medications? If yes, please list them
Any additional information:
Should be Empty:

Acknowledgement of Risk & Release of Liability - Under the Age of Majority

RIDER MEDICAL PROFILE

Contact Information

Emergency Contact Information

Personal Information