English Horseback Riding Lessons
2636 Outlet Road ,Lansdowne,Ontario
K0E 1L0.
Telephone 613 659 2039

ACKNOWLEDGMENT of RISK and RELEASE of LIABILITY-"For Participants Not 18 Years Old"

Please Print Clearly.

Infant's Participant's Name_______________________________________Date of Birth__________________  Infant's Address________________________________________________City__________________________ Prov___________________________________________________________Postal________________________ Guardian's Name________________________________________________Date of Birth__________________ Guardian's Address______________________________________________City__________________________ Prov___________________________________________________________Postal________________________  THE GUARDIAN MUST READ AND UNDERSTAND PRIOR TO THE INFANT PARTICIPATING IN EQUINE ACTIVITIES.                                                                                                                                                       To Charleston Lake Riding School, their directors, employees, officers, volunteers, buisiness operators, and site property owners.(all of them collectively called the HOST).

Initial each item below after Reading and Understanding the Item. (at the side of each paragraph)

______1) I am the Parent and/or Legal Guardian of the Infant Participant named above and am executing this form on behalf of the infant participant in my capacity as parent and/or guardian and with the intent that this form be binding on myself and infant Participant for all legal purposes.

_____2) I understand there are inherent DANGERS<HAZARDS<and RISKS.(collectively  called RISKS) associated with Equine Activities and injuries resulting from these "RISKS" are a common ocurrence.

_____3) I Acknowledge that the inherent 'RISKS' of Equine Activities mean those DANGEROUS conditions which are an integral part of Equine Activities, including but not limited to:              >the propensity of any equine to behave in ways that might result in injury, harm or death to persons on or around them and to potentially collide with bite or kick other animals, people, or objects;             >the unpredictability of an equine's reaction to such things as sounds, sudden movement, tremors, vibrations, objects, persons or other animals and hazards such as subsurface objects;                           >the potential for other participant(s) to act in a negligent manner that might contribute to injury to themselves or others, such as failing to act within their ability to maintain control over an equine.

_____4) I Freely Accept and Fully Assune All Responsibility for the inherent "RISKS" and the possibility of personal injury,death,property damage or loss which might result from the infant being a articipant.

_____5) I Acknowledge that it remains my Sole Responsibility for the safety of the infant participant and for the infant to participate within his/her own limits.

_____6) In addition to consideration given for the infant to participate in Equine Activity, I and my heirs, executors, administrators and assigns(collectively called my "Legal Representatives") agree;                                                                                                                  >To Waive all claims that I or the infant participant might have against the "HOST" ; and,                                                                                                                        >To Release the "HOST" from Any and ALL liability for loss damages, injury, or expense that I , the infant Participant or our "Legal Representatives" might suffer as a result of the infant's Participation due to any cause including any NEGLIGENCE ON THE PART OF THE "HOST";AND,                                                                                                     >To HOLD HARMLESS AND INDEMNIFIY the "HOST" from any and all liability for property damage or personal injury to the infant Participant or to any third party which might result from the infant's Participation. 

Before signing this form I read it(as indicated by my initials above) and I state that I understandit, I futher state I am aware that signing this form waives certain legal rights I and/or the infant Participant  and/or our "Legal Representatives" might have against the "HOST"

SIGNED This____________________day of_______________20______________________________ 

                _________________________________________   __________________________________________        (Print Name of Host Witness to signing & Initialing)     (Signature of Participant) 

    ___________________________________  _________________________________________                          (Signature of HOST Witness)                 (Parent or Guardian Signature)