Waitlist Registration Form

We are excited to have your child join us at the Ranch! Below are a few items to note about our Sessions:

• One of our main purposes of our sessions is to honor the relationship between the child and the Mentors. Therefore we will not disclose any information from the session unless it is life threatening or if we feel they are unsafe.
• You are welcome to stay with the child during the session, however we ask to give us space for an opportunity to build a relationship with your child.
• Please let us know if your child is unable to attend a session as soon as possible. This will give us the opportunity to find another child, who is on a waiting list, to be at the Ranch.
• If your child is experiencing any cold/flu-like symptoms, unfortunately, they will need to cancel and re-schedule.

Please fill out the information below. This is confidential information and is not shared outside the Ranch.

~RHR Team

 

In consideration of the risk of injury while participating in Reclaiming Hope Ranch Session or Activity, and as consideration for the right to participate in the Activity, I hereby, for myself, my heirs, executors, administrators, assigns, or personal representatives, knowingly and voluntarily enter into this waiver and release of liability and hereby waive any and all rights, claims or causes of action of any kind whatsoever arising out my my participation the the Activity, and do hereby release and forever discharge Reclaiming Hope Ranch and Reichen’s Farm, located at 8645 NW Old Cornelius Pass Rd, Hillsboro, Oregon 97124, their affiliates, managers, members, agents, attorneys, staff, volunteers, heirs, representatives, predecessors, successors and assigns, for any physical or psychological injury, including but not limited to illness, paralysis, death, damages, economical or emotional loss, that I may suffer as a direct result of my participation in the aforementioned Activity, including traveling to and from an event related to the Activity.

I AM VOLUNTARILY PARTICIPATING IN THE AFOREMENTIONED ACTIVITY AND I AM PARTICIPATING IN THE ACTIVITY ENTIRELY AT MY OWN RISK.  I AM AWARE OF THE RISKS ASSOCIATED WITH TRAVELING TO AND FROM AS WELL AS PARTICIPATING IN THIS ACTIVITY, WHICH MAY INCLUDE, BUT ARE NOT LIMITED TO, PHYSICAL OR PSYCHOLOGICAL INJURY, PAIN, SUFFERING, ILLNESS, DISFIGUREMENT, TEMPORARY OR PERMANENT DISABILITY (INCLUDING PARALYSIS), ECONOMIC OR EMOTIONAL LOSS, AND DEATH.  I UNDERSTAND THAT THESE INJURIES OR OUTCOMES MAY ARISE FROM MY OWN OR OTHERS’ NEGLIGENCE, CONDITIONS RELATED TO TRAVEL, OR THE CONDITION OF THE ACTIVITY LOCATION(S).  NONETHELESS, I ASSUME ALL RELATED RISKS, BOTH KNOWN OR UNKNOWN TO ME, OF MY PARTICIPATION IN THIS ACTIVITY, INCLUDING TRAVEL TO, FROM AND DURING THIS ACTIVITY.

I agree to indemnify and hold harmless Reclaiming Hope Ranch and Reichen’s Farm against any and all claims, suits or actions of any kind whatsoever for liability, damages, compensation or otherwise brought by me or anyone on my behalf, including attorney’s fees and any related costs, if litigation arises pursuant to any claims made by me or by anyone else acting on my behalf.  If Reclaiming Hope Ranch and Reichen’s Farm incurs any of these types of expenses, I agree to reimburse Reclaiming Hope Ranch and Reichen’s Farm.

I acknowledge that Reclaiming Hope Ranch, Reichen’s Farm and their directors, officers, volunteers, representatives and agents are not responsible for errors, omissions, acts or failures to act of any party or entity conducting a specific event or activity on behalf of Reclaiming Hope Ranch and Reichen’s Farm.

I acknowledge that this Activity may involve a test of a person’s physical and mental limits and many carry with it the potential for death, serious injury and property loss.  The risks may include, but are not limited to, those caused by terrain, facilities, temperature, weather, lack of hydration, condition of participants, equipment, vehicular traffic and actions of others, including but not limited to, participants, volunteers, spectators, coaches, event officials and event monitors, and/or producers of the event.

I ACKNOWLEDGE THAT I HAVE CAREFULLY READ THIS “WAIVER AND RELEASE” AND FULLY UNDERSTAND THAT IT IS A RELEASE OF LIABILITY.  I EXPRESSLY AGREE TO RELEASE AND DISCHARGE Reclaiming Hope Ranch and Reichen’s Farm AND ALL OF ITS AFFILIATES, MANAGERS, MEMBERS, AGENTS, ATTORNEYS, STAFF, VOLUNTEERS, HEIRS, REPRESENTATIVES, PREDECESSORS, SUCCESSORS AND ASSIGNS, FROM ANY AND ALL CLAIMS OR CAUSES OF ACTION AND I AGREE TO VOLUNTARILY GIVE UP OR WAIVE ANY RIGHT THAT I OTHERWISE HAVE TO BRING A LEGAL ACTION AGAINST Reclaiming Hope Ranch and Reichen’s Farm FOR PERSONAL INJURY OF PROPERTY DAMAGE.

To the extent that statute or case law does not prohibit releases for negligence, this release is also for negligence on the part of Reclaiming Hope Ranch and Reichen’s Farm, its agents and employees.

In the event that I should require medical care or treatment, I agree to be financially responsible for any costs incurred as a result of such treatments.  I am aware and understand that I should carry my own health insurance.

In the event that any damage to equipment or facilities occurs as a result of my or my family's willful actions, neglect or recklessness, I acknowledge and agree to be held liable for any and all costs associated with any action of neglect or recklessness.

This Agreement was entered into at arm’s length, without duress or coercion, and is to be interpreted as an agreement between two parties of equal bargaining strength.  Both the Participant and Reclaiming Hope Ranch and Reichen’s Farm agree that this Agreement is clear and unambiguous as to its terms, and that no other evidence will be used or admitted to alter or explain the terms of this Agreement, but that it will be interpreted based on the language in accordance with the purposes of which it is entered into.

In the event that any provision contained within this Release of Liability shall be deemed to be severable or invalid, or if any term, condition, phrase or portion of this agreement shall be determined to be unlawful or otherwise unenforceable, the remainder of this agreement shall remain in full force and effect, so long as the clause severed does not affect the intent of the parties.  If a court should find that any provision of this agreement to be invalid or unenforceable, but that by limiting said provision it would become valid and enforceable, then said provision shall be deemed to be written, construed and enforced as so limited.

By signing this agreement, I acknowledge the contagious nature of COVID-19 and voluntarily assume the risk that I may be exposed to or infected by COVID-19 by my mere presence within this establishment and that such exposure or infection may result in personal injury, illness, permanent disability, and death. I understand that the risk of becoming exposed to or infected by COVID-19 may result from the actions, omissions, or negligence of myself and others, including, but not limited to, employees, volunteers, and program participants and their families. I hereby release Reclaiming Hope Ranch and Reichen’s Farm from any and all claims arising from or in connection with any direct COVID-19 impact while visiting.  

 

I Agree to all of the above.

 

I hereby certify that I am the parent or guardian of the child listed in this application and do hereby give my consent without reservation to the foregoing on behalf of this individual.