Waiver - Risk Release & Hold Harmless Agreement

Reason for visit*

New Volunteer OrientationVeterans Administration ProgramSelf-Care Saturday SessionNational Charity RoundtableNational Charity LeagueCompany Volunteer DayCompany Team Building EventFundraising EventOpen House EventOne-Time Visit

Company Name*

Event Name*

How did you hear about Henry's Home?*

I give Henry’s Home permission to use any pictures or videos of me.*

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Take a Photo of your Driver License*

REQUIREMENTS

I understand there might be other animals besides horses on the grounds, including cats, dogs, pigs, ducks and donkeys. I agree to assume any and all risks of being around them, feeding and touching them.
I understand that if I am bringing out a minor [child under the age of 18] I am 100% responsible for their supervision and safety.
I give Henry’s Home permission to run a background check on me at their discretion.
I agree to give Henry’s Home a copy of my driver's license (required to drive a vehicle on the property).

If you have any problems with the above requirements, please see a member of the leadership team.

Emergency contact name*

Emergency contact phone number*

Please enter a valid phone number.

REVIEW AND SIGN BELOW

I, the participant, acknowledge the risk involved in riding and working around horses, dogs and other animals which may include bodily injury from using, riding, training or being in close proximity to them. I agree to assume any and all risks, including, without limitation but not limited to, the risks of death, bodily injury, property damage, falls, kicks, bites, collisions with vehicles, horses or stationary objects, the unavailability of medical care while in the woods, or the negligence or deliberate act of another person.

I understand that horseback riding is a RUGGED ADVENTURE RECREATIONAL SPORT ACTIVITY, whether in an arena or out on a trail. I understand that spending time with a horse in any equine activity, including petting and grooming, can be dangerous due to the nature of this type animal with an extremely sensitive need to flee if necessary. And I understand that clearing brush, building fences and buildings, general land management and working with tools and machinery and on trails can also be dangerous.

I understand that no horse is completely safe, and Henry’s Home makes no representations or guarantees regarding the safety, training or suitability of any horse. A horse may divert from its training and act according to its natural survival instincts and may abruptly change directions or speed up, trip, fall, stop short, shift its weight, buck, rear, kick, bite, spook, or run from what it perceives to be a danger if it is frightened or provoked or for no reason whatsoever (horse-eating monsters, right?).

I understand that the saddle girth or cinches may loosen during a ride and that I am responsible for alerting the instructor/volunteer/herdmate to help me tighten it to prevent the saddle from slipping while I am riding if I need assistance. I understand that Henry’s Home requires me to wear a protective helmet that meets or exceeds the quality standards of the SEI CERTIFIED ASTM STANDARD F 1163 Equestrian Helmet requirement. The wearing of such a helmet may reduce the severity of some head injuries and may prevent my serious injury or death as a result of a fall or other occurrence. I agree to bring my own helmet or to use one provided by Henry’s Home.

I understand that I [or my estate] am solely responsible for any emergency or ongoing medical treatment that may be required due to an injury that occurs while I am participating in any equine, building or other activities on the Henry’s Home property at 14638 Perry Rd, Conroe. I and/or my own accident/medical insurance company shall pay for all such incurred. expenses.

Consent*

By checking this box, I agree to use an electronic signature for this agreement, and I confirm it is an electronic representation of my signature for purposes of this agreement

Signature*

By signing, I acknowledge that I have read and understand and voluntarily agree to this waiver and release. just type initials

Date of Signature*

Date

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