Clone of Windsong Farm Barn Day Event Registration

26358 Augusta Hwy Ridgeville, SC 29472

(843) 830-3964 or (843) 830-3662

Windsong Farm Riding Lessons Information

Riding lessons are based on availability.

Event cost $70

We accept children 4 and up.

Necessary Equipment:

Closed toe shoes
Insulated water bottle

We have helmets available for use when your child is riding. You may provide your own if you prefer, but bicycle helmets are not sufficient.

Philippians 4:13

Child's Name

First NameLast Name

Child's Age:

Birth Date

MonthDayYear

Child's Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Parent/Guardian Information

Name

First NameLast Name

Home Number

Format: (000) 000-0000.

Cell Number

Format: (000) 000-0000.

E-mail

example@example.com

Lesson Details

Please specify if you prefer weekly or every other week lessons.

Choose all options that would fit your schedule for hour-long riding lessons.

If "other" please specify.

Emergency Information

#1) Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Format: (000) 000-0000.

Alt. Phone Number

Format: (000) 000-0000.

#2) Emergency Contact's Name

First NameLast Name

Relationship

Phone Number

Format: (000) 000-0000.

Alt. Phone Number

Format: (000) 000-0000.

Does the child have any allergies, chronic illness, or medical conditions? If yes, please describe. This includes physical and mental challenge.

Is the child prescribed an inhaler? If yes, please explain any instructions.

Informed Consent and Acknowledgement

I hereby give my approval for my child’s participation in any and all activities prepared by Windsong Farm. In exchange for the acceptance of said child’s candidacy by Windsong Farm, I assume all risk and hazards incidental to the conduct of the activities, and release, absolve and hold harmless Windsong Farm and all its respective officers, agents, and representatives from any and all liability for injuries to said child arising out of traveling to, participating in, or returning from event sessions.

In case of injury to said child, I hereby waive all claims against Windsong Farm including all coaches and affiliates, all participants, sponsoring agencies, advertisers, and, if applicable, owners and lessors of premises used to conduct the events. There is a risk of being injured that is inherent in all sports activities, including horseback riding. Some of these injuries include but are not limited to, the risk of fractures, paralysis, or death.

Photo and Video Release

By participating in events at Windsong Farm, I acknowledge and agree that photographs, video recordings, and other visual or audio media may be taken during the events. I grant Windsong Farm, its representatives, and authorized partners permission to use my image, likeness, voice, and/or that of my participating child(ren) in photographs, videos, social media, websites, advertisements, promotional materials, and other marketing communications related to Windsong Farm.

I understand that these images and recordings may be edited, reproduced, published, displayed, and distributed for promotional and marketing purposes without additional notice, approval, or compensation. I waive any right to inspect or approve the finished materials in which the images or recordings appear.

By signing this agreement, I confirm that I am the parent or legal guardian of any participating minor child(ren) and have the authority to provide this consent on their behalf.

By signing below, I acknowledge that I have read, understand, and agree to the terms of this Photo and Video Release.

Name of Parent or Guardian

First NameLast Name

Signature of Parent or Guardian

Date

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.

Windsong Farm Riding Lessons Registration