• Liability Release & Assumption of Risk Form

    Please read carefully, then sign to acknowledge your understanding and agreement.
  • RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND HOLD HARMLESS AGREEMENT

    READ THIS AGREEMENT CAREFULLY BEFORE SIGNING. YOUR SIGNATURE INDICATES THAT YOU UNDERSTAND AND AGREE TO ITS TERMS. BY SIGNING THIS AGREEMENT, YOU (AND YOUR CHILD, IF APPLICABLE) ARE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR RECOVER DAMAGES IN THE EVENT OF INJURY, DEATH, ILLNESS, OR PROPERTY DAMAGE ARISING FROM PARTICIPATION IN ACTIVITIES AT TINY VOICE THERAPY SERVICES AND THE FARM PROPERTY.

  • I,        , on behalf of myself and/or my minor child        , residing at                  , hereby acknowledge and agree as follows:

  • For purposes of this Agreement, "Activities" include, but are not limited to:

    • Horseback riding and horse handling
    • Hippotherapy and equine-assisted services
    • Speech-language therapy sessions
    • Volunteer activities
    • Camps, classes, groups, and educational programs
    • Farm tours and recreational activities
    • Interactions with horses, goats, pigs, chickens, ducks, peacocks, dogs, cats, and other animals located on the property
    • Being present on the farm property, barn areas, pastures, riding areas, parking areas, and surrounding grounds

    ACKNOWLEDGEMENT OF ANIMAL RISKS
    I understand that horses and other animals are inherently unpredictable. Animals may, without warning, bite, kick, buck, rear, stumble, trip, scratch, peck, push, head-butt, run, jump, make sudden movements, or otherwise behave in ways that may cause injury, illness, emotional distress, property damage, or death.

    I acknowledge that even well-trained animals may react unexpectedly to sounds, people, equipment, weather conditions, other animals, or environmental stimuli.

    ACKNOWLEDGEMENT OF FARM RISKS
    I understand that participation in Activities on a farm property involves inherent risks including, but not limited to:

    • Uneven ground
    • Mud, gravel, rocks, holes, and slippery surfaces
    • Fences, gates, barns, and animal enclosures
    • Farm equipment and tools
    • Hay, feed, dust, and allergens
    • Insects and wildlife
    • Weather-related conditions
    • Physical exertion associated with Activities

    I acknowledge that these conditions may result in falls, injuries, illnesses, allergic reactions, property damage, or death.

    ASSUMPTION OF RISK
    I voluntarily choose to participate, or allow my child to participate, in Activities and knowingly assume all risks associated with such participation, whether known or unknown, foreseeable or unforeseeable.

    I understand that participation may involve risks of serious bodily injury, permanent disability, illness, emotional distress, and death.

    MEDICAL RESPONSIBILITY
    I certify that I (or my child) am physically able to participate in Activities. I understand that it is my responsibility to consult with a physician or other healthcare provider regarding participation.

    I authorize emergency medical treatment if deemed necessary and understand that all related costs shall be my responsibility.

    RELEASE OF LIABILITY
    I hereby release, waive, discharge, and covenant not to sue Elizabeth Nielsen, Tiny Voice Therapy Services, LLC, property owners, instructors, therapists, volunteers, employees, independent contractors, agents, affiliates, and representatives (collectively referred to as the "Released Parties") from any and all claims, liabilities, demands, actions, damages, costs, expenses, or causes of action arising from participation in Activities, including claims resulting from injury, illness, death, or property damage.

    RELEASE FOR NEGLIGENCE
    To the fullest extent permitted by Illinois law, I release the Released Parties from liability arising from their ordinary negligence in connection with Activities, including but not limited to supervision, instruction, therapy services, animal selection, animal handling, property maintenance, equipment use, and program operations.

    INDEMNIFICATION
    I agree to indemnify, defend, and hold harmless the Released Parties from and against any claims, liabilities, damages, costs, expenses, or attorney fees arising from my actions or the actions of my child while participating in Activities.

    HELMETS AND SAFETY EQUIPMENT
    I understand that approved riding helmets are required for all horseback riding and horse-related activities. I understand that safety equipment may reduce, but cannot eliminate, the risk of injury.

    PHOTO AND VIDEO RELEASE 
    I grant permission for photographs and videos of myself and/or my child to be used for educational, promotional, social media, website, or marketing purposes unless I provide written notice declining such use.

  • Photo and video release
  • 10. GOVERNING LAW
    This Agreement shall be governed by and interpreted under the laws of the State of Illinois. If any provision is found unenforceable, the remaining provisions shall remain in full force and effect.

    11. ACKNOWLEDGEMENT
    I acknowledge that I have carefully read this Agreement, fully understand its contents, understand that I am waiving certain legal rights, and sign it voluntarily.

  • Date
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  • Format: (000) 000-0000.
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