2026 WAIVER, AGREEMENT AND RELEASE AND HOLD HARMLESS STATE OF MINNESOTA (one per adult)

2026 WAIVER, AGREEMENT AND RELEASE AND HOLD HARMLESS STATE OF MINNESOTA

(one per adult)

READ CAREFULLY BEFORE SIGNING

You MUST be 18 years of age or older to continue. MUST BE COMPLETED BY EVERYONE VISITING THE FARM REGARDLESS OF PARTICIPATION.
THIS IS FOR THE CALENDAR YEAR 2026.

I agree to this Waiver, Agreement, and Release and Hold Harmless (hereafter, “Agreement”) with Century Hills Stables LLC (hereafter referred to as “Stable”) as a condition for their allowing me and the persons identified below (if any), to do any or all of the following at any time and at any location: enter Stable’s premises, land, and facilities, barns, arenas, paddocks, pastures, and surrounding land; be near horses, ponies, mules, or donkeys (hereafter, “equines”), work with, handle, ride, drive, and/or receive instruction or guidance related to riding, driving, handling and/or working with equines. This Agreement also applies to my handling or being near livestock or pets (cats, dogs, rabbits, etc). (All of these activities, individually and collectively, will be referred to as “The Activities” throughout this Agreement.)

Your Name (OR parent or legal guardian's name)*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number (Cell)*

Please enter a valid phone number.

Phone Number (Alternate)

Please enter a valid phone number.

Your Date of Birth *

Date

Your Email*

Confirmation Emailexample@example.com

I was invited (if unsure, click Yes to view options and if none apply, click NO)?*

YESNO

Event:*

I am a Guest of a Boarder or Lessee?*

YESNO

I am a GUEST OF (first and last name)*

First NameLast Name

If I was NOT invited and I am NOT a guest of a boarder, please explain your visit, as all visits are by appointment only?*

Do you have any minor child/ren or legal wards?*

YESNO

To the fullest extent allowed by law, I also make this agreement on behalf of the following who is/are my minor child/ren or legal ward(s) under the age of 18:

Minor Child/ren or Legal Wards*

All parts of this Agreement apply to me and each of the children or legal wards listed above. (WE will collectively call ourselves “I,” or “my” throughout this Agreement.)

IT IS AGREED AS FOLLOWS:

1. I understand that although I am signing this Agreement today, I also intend for it to be valid and legally binding now and at all times in the future when I engage in any or all of The Activities at any location.

2. INHERENT RISKS OF EQUINE, LIVESTOCK and PET ACTIVITIES. I understand that anyone riding, driving, handling, working with, or even near an equine, livestock or pet at any location can suffer bodily and other injuries. Among other things, equines, livestock and pets are unpredictable by nature. For example, when frightened, angry, or under stress, the natural instincts of an equine are to jump forward or sideways, back up quickly, or run away from real or perceived danger by trotting or galloping. Equines also have the ability to kick, buck, rear up, spin around, strike, or bite. I know that equines can do these and other things without warning. I also understand that all equines, even if they have no history of hurting anyone, are powerful and have the potential to be dangerous to people, equines, and other animals.

I also understand that riding, driving, handling, working with, or even being near an equine or livestock can expose me to dangers or conditions that are an integral part of livestock activities, including: (1) the propensity of livestock to behave in ways that may result in death or injury to persons on or around them, such as kicking, biting, bucking , or charging; (2) the unpredictability of livestock’s reaction to things like sound, sudden movement, unfamiliar objects, persons, or other animals; (3) natural hazards such as surface or subsurface conditions; or (4) collisions with other livestock or objects. I understand that these risks and dangers inherent in equine, livestock or pet activities can occur with or without negligence on part of Stable, and I expressly agree to assume these risks. I also understand that these are just some of the risks, and I agree to assume others that are not mentioned in this Agreement. I am NOT relying on Stable to list all possible equine or livestock-related risks in this Agreement or any time, now or in the future.

3. LIABILITY WAIVER AND RELEASE/EXPRESS ASSUMPTION OF RISK. As lawful consideration for being allowed to engage in any or all of The Activities, now and in the future and at any location, I (on behalf of myself and my spouse, parents, heirs, representatives, assigns, minor child/ren or legal wards) agree to each of the following: (a) Stable and his/her/its/their respective officers, directors, members, managers, employees, agents, heirs, family members, assigns, representatives, affiliated persons, and others acting on their behalf (hereafter referred to collectively as “The Released Parties”) shall not be liable for any losses, injuries, or damages that I may sustain as a result of engaging in any of The Activities at any time or at any location; and (b) I fully and forever release, waive, and discharge all claims, demands, damages, legal actions, causes of action, or rights of action (present or future) against the The Released Parties whether the claims are known, unknown, anticipated or unanticipated, and whether caused by their ordinary negligence, a violation of a state Equine Activity Liability Act, a violation of a livestock activity liability act, or other legal liability resulting from or arising out of my engaging in The Activities at any time and at any location. The term “damages” means, for example, medical expenses any and all claims or losses because of bodily injuries, mental/emotional injuries, property damages, death, expenses, and/or personal property damages. This Agreement is intended to apply and be binding regardless of whether I am riding, driving, handling or near equines. (In accordance with Minnesota law, however, I am not releasing The Released Parties from loss, injury, or damage that is directly caused by gross negligence, willful or wanton misconduct, reckless misconduct, or intentional misconduct on part of The Released Parties.)

By providing my initials below I agree to the statement in number 3 above.*

4. INDEMNITY AGREEMENT. To the fullest extent permitted by law, I also agree to indemnify and hold harmless The Released Parties against any and all claims, demands, actions, liabilities, losses, or suits that are brought against The Released Parties (or either of them) which are in any way connected with my/our participation in any of the Activities at any time and at any location, including claims that allege acts or omissions of The Released Parties that are negligent or in violation of a state Equine Activity Liability Act. The indemnity agreement shall apply regardless of whether or not injury, death, or damage incurred by others was caused by the ordinary negligence of The Released Parties and includes reimbursement of attorney fees and costs incurred by The Released Parties.

By providing my initials below I agree to the statement in number 4 above.*

5. ASTM/SEI Helmet/Headgear. I understand that I should purchase and wear properly fitted and secured ASTM-standard/SEI-certified protective headgear that is designed for use when riding, driving, handling, or near equines. I am NOT relying on Stable to provide a helmet/headgear for me, to check any helmet or strap that I may wear, or to monitor my compliance with this suggestion at any time. If I choose to wear a helmet/headgear, if I choose not to wear a helmet/headgear, and the type of helmet/headgear I may wear are my decisions.

**MINORS ARE REQUIRED TO WEAR A HELMET WHILE RIDING.

6. EMERGENCIES. Adult person(s) to Contact in Case of Emergency:

Emergency Contact Name (list another adult - not yourself)*

First NameLast Name

Emergency Contact Phone Number*

Please enter a valid phone number.

Relationship: *

7. Minnesota law applies to this Agreement, and I agree that this Agreement shall be enforced to the greatest extend permitted under Minnesota law. If any clause conflicts with applicable law, only that clause will be null and void but the remainder shall stay in full force and effect. This Agreement can only be modified in writing and signed by me and Faith Chamberlain (on behalf of Stable). I agree to pay any attorney fees and costs for The Released Parties (or either of them) to enforce this Agreement, and I agree to indemnify and hold harmless The Released Parties for such fees and costs.

NOTICE OF INHERENT RISKS OF LIVESTOCK ACTIVITIES PURSUANT TO MN ST § 604A.12:

“Inherent risks of livestock activities” means dangers or conditions that are an integral part of livestock activities, including: (1) the propensity of livestock to behave in ways that may result in death or injury to persons on or around them, such as kicking, biting, bucking, or charging; (2) the unpredictability of livestock's reaction to things like sound, sudden movement, unfamiliar objects, persons, or other animals; (3) natural hazards such as surface or subsurface conditions; or (4) collisions with other livestock or objects. Under Minnesota law, a nonprofit corporation, association, or organization, or a person or other entity donating services, livestock, facilities, or equipment for the use of a nonprofit corporation, association, or organization, is not liable for the death of or an injury to a participant resulting from the inherent risks of livestock activities.

8. MEDICAL TREATMENT. The Stable, its owners, employees, and associates, have my permission to initiate emergency first aid treatment for my children, my equine and myself in case of an accident. They also have my permission to authorize emergency medical treatment by qualified medical personnel for my children or myself and veterinary treatment by qualified veterinary personnel for my equine.

By providing my initials below I agree to the statement in number 8 above*

9. I agree to abide by all Stable rules and guidelines posted.

By providing my initials below I agree to the statement in number 9 above*

10. PROMOTIONAL RELEASE. I understand that photographs and/or videos may be taken of myself, my children with equine, livestock or pets and that such photographs/videos may be used in the Stable or Century Hills Inc (farm) literature, website, social media or other types of promotional material.

PROMOTIONAL RELEASE CONSENT*

YES, I hereby give permission for myself or my child/ren to be photographed and/or videotaped and for such photographs/videos to be used in the Stable or Century Hills Inc (farm) literature, website, social media or other types of promotional material.NO, I do not give permission for myself or my child/ren to be photographed and/or videotaped and for such photographs/videos to be used in the Stable or Century Hills Inc (farm) literature, website, social media or other types of promotional material.

11. ALSO, I REPRESENT (please check each box below):

Read each statement thoroughly*

I AM AT OR OVER 18 YEARS OF AGE;I AM OF SOUND MIND AND AM NOT SUFFERING FROM SHOCK OR UNDER THE INFLUENCE OF ALCOHOL, DRUGS, OR INTOXICANTS THAT AFFECT MY ABILITY TO READ AND UNDERSTAND THIS AGREEMENT;I HAVE READ THIS ENTIRE AGREEMENT (ALL FIVE PAGES), AND I FULLY UNDERSTAND IT;I INTEND FOR THIS AGREEMENT TO BE VALID AND BINDING TODAY AND AT ALL TIMES IN THE FUTURE;I HAVE HAD THE OPPORTUNITY TO ASK STABLE QUESTIONS ABOUT THIS AGREEMENT AND TO DISCUSS IT;BY SIGNING THIS AGREEMENT, I ACKNOWLEDGE THAT IF ANYONE IS HURT OR PROPERTY DAMAGED BY PARTICIPATION OF MYSELF AND/OR MY MINOR CHILD/REN IN ANY OF THE ACTIVITIES, I MAY BE FOUND BY A COURT OF LAW TO HAVE WAIVED MY RIGHT TO BRING A LAWSUIT AGAINST ANY OR ALL OF THE RELEASED PARITIES; ANDALL OF THE INFORMATION THAT I HAVE PROVIDED IS TRUE AND ACCURATE.

By providing my initials below I agree to all seven statements I check marked in number 11 above *

Confirmation:

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN
ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL
MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS
BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.

Signature*

Printed Name*

First NameLast Name

Today's Date*

NOTICE OF INHERENT RISKS OF LIVESTOCK ACTIVITIES PURSUANT TO MN ST § 604A.12:

“Inherent risks of livestock activities” means dangers or conditions that are an integral part of livestock activities, including: (1) the propensity of livestock to behave in ways that may result in death or injury to persons on or around them, such as kicking, biting, bucking, or charging; (2) the unpredictability of livestock's reaction to things like sound, sudden movement, unfamiliar objects, persons, or other animals; (3) natural hazards such as surface or subsurface conditions; or (4) collisions with other livestock or objects. Under Minnesota law, a nonprofit corporation, association, or organization, or a person or other entity donating services, livestock, facilities, or equipment for the use of a nonprofit corporation, association, or organization, is not liable for the death of or an injury to a participant resulting from the inherent risks of livestock activities.

STOP.....Important message: Once you click SUBMIT you should receive the following message:

Thank you! Your submission has been receive. (with a green circle and white check mark above it).

In addition, you will receive an email with a copy of your waiver. If you do not receive the THANK YOU message, then click the SUBMIT button again as it has not been submitted.

Thank you!!

Please verify that you are human*

CENTURY HILLS STABLES LLC