Describe your abilities/difficulties in the following areas (include assistance required or equipment needed):

If over 18, you may select the checkboxes below, as acknowledgement and acceptance of these terms.

Confidentiality Policy

It is the policy of Equine Assisted Therapy Alaska to treat all information concerning participants, donors, volunteers, employees, and other associated organizations or associated members, their business and financial records, as confidential.  “Confidential” means that you are free to talk about Equine Assisted Therapy Alaska and about your program and your position, but you are not permitted to disclose clients’ names or talk about them in ways that will make their identity known. No information may be released without appropriate authorization.All records dealing with specific individuals must be treated as confidential. General information, policy statements, or statistical material that is not identifiable with a specific individual or organization is not considered confidential. All EATA members are responsible for maintaining the confidentiality of information for all members of EATA, including staff, volunteers, donors, and other associates.

EATA Policies Regarding

Equine-Related Activities & Barn Behaviors

1. Equine Assisted Therapy Alaska prohibits and WILL NOT tolerate the following behaviors and activities on the premises:
   1. Abusive, threatening, loud or violent behavior.
   2. Alcohol and illegal drug use.
   3. Smoking and/or use of open flame in the barn or on the Equestrian Center grounds.
   4. Running or screaming in, near, or around the barn or horses.
   5. Unapproved photography, audiovisual recording, and/or solicitation of participants without approval of the Program Director and the participant and/or his/her legal guardian.
2. All participants, volunteers, and community members on the grounds, be advised and adhere to the following rules:
   1. Do not drink the water out of the hoses. Use water or beverages provided in the office area.
   2. Keep dogs leashed while on the premises and do not bring them into the barn aisles.
   3. Check-in/check-out with a staff member when on the premises for EATA activities.
   4. Parents/Caregivers must supervise his/her children at all times, esp. non-riders during lessons.
   5. NO ONE may handle, feed, pet, ride, lead, or enter an area with horses, unless supervised by or given permission by EATA staff.
   6. NO ONE may park outside the designated parking areas (main parking lot), unless authorized by EATA staff.
   7. NO ONE may provide a ride, in a personal vehicle, to a participant of the program.
   8. NO ONE may provide a ride, in a personal vehicle, to a minor volunteer of the program without a signed and dated written consent of a parent or legal guardian
   9. Everyone must have a completed, signed, and dated registration packet and/or liability form to participate, in any activity near or around the horses.
   10. Barn aisles must be kept clean and free of hazardous obstructions.
   11. Report all accidents, injuries, or hazardous conditions to a staff member as soon as possible.
3. All riders (participants, volunteers, employees, etc.) must:
   1. Wear an ASTM/SEI approved helmet while mounted.
   2. Wear weather-appropriate clothing and long pants.
   3. Wear hard-soled shoes (tennis shoes are okay, no bare feet or sandals).
   4. Use safety stirrups and tack in good repair.
4. All Staff/Volunteers must:
   1. Side Walkers must have emergency dismount training prior to participating in a session.
   2. Horse Leaders must have approval from the Program Director prior to leading for a session.
   3. Instructors will routinely check all tack and equipment for safety.

PARTICIPANT/PARENT/GUARDIAN RELEASE & INDEMNITY AGREEMENT FOR RIDING AND GROUNDWORK INSTRUCTION

The Undersigned assumes the unavoidable risks inherent in all horse related activities, including bodily injury and physical harm to rider, horse and spectator. In consideration, therefore, for the privilege of riding instruction or equine related therapy provided for the participant, do acknowledge the risks and  potential  risks  of  horseback riding.  I  feel  that  the  possible  benefits  to  myself/my  son/my  daughter/my  ward  are  greater than the risk assumed. I hereby,  intending  to  be  legally  bound  for  myself,  my  heirs  and  assigns, executors or administrators, waive and release forever, all claims for damages against Equine Assisted Therapy Alaska, a non-­‐profit organization, the Municipality of Anchorage,  the  William  Clark  Chamberlin  Equestrian  Center,  and  the  Anchorage   Horse Council,  their  officers,  Board  of  Directors,  employees,  contractors,   representatives,  instructors, therapists, aides, volunteers, successors or assigns, and further release them from liability or responsibility for accident, damage, injury, illness, death or other loss what-­‐ so-­‐ever to the Undersigned or to any family member or spectator accompanying the Undersigned on the premises.

The Undersigned further agrees to defend all claims and suits and indemnify the releases/indemnities against all claims for bodily injury, personal injury, death, mental or physical condition, or property damage sustained by any person, including the Undersigned and the Rider, or any releases/indemnities caused or alleged to have been caused directly or indirectly by an act, omission, accident, occurrence, condition, negligence or gross negligence of the Undersigned or Rider or any releases/indemnities arising out of the riding or driving instruction, including the related activities with the Rider’s assigned horse such as grooming, saddling and harnessing.