Monterey Bay Horsemanship & Therapeutic Center and Monterey Bay Academy

RELEASE OF LIABILITY AND HOLD HARMLESS AGREEMENT

PARTICIPANT:_ _ _ _ _ ___ _____ __TELEPHONE:_____ _ _ _

ADDRESS:___ _ _ _ _ _ _ _ ___ _ _ _ ______-,----_ _ _ _

CITY & STATE:

CALL VISIT POS SCHEDULE BOOKLET PHONE LIST SIGN IN CARD

I acknowledge that horseback riding, vaulting, horse handling, exercising, turn-out, general barn activities, maintenance, and repairs are activities that carry inherent risks of injury to my horse and myself and damage to my property. I acknowledge that the most safety conscious instructor and facility may have an accident occur, while on the premises or ill a riding lesson, without any negligence by either party; knowing these facts, I nevertheless choose to participate in horse activities. I am responsible for the supervision, safety, and well being of any guests or family members who may accompany me. If riding, by signing this release, I agree to join the MBHTC riding center, which is a non-profit organization.

I hereby release Monterey Bay Horsemanship & Therapeutic Center (MBHTC) and Monterey Bay Academy (MBA)' Anne Phipps and any other board or staff members, or volunteers from all liability for any act of negligence or want of ordinary care on the part of Independent Instructors and MBHTC and MBA, or any of its agents, employees, members, volunteers, or contractors. In consideration of my participation in events organized or sponsored by MBHTC or MBA, I waive, release, and discharge MBHTC and MBA, Independent Instructors, and their employees, contractors, volunteers, directors, officers, agents, members, representatives, heirs, executors, and assigns from any and all claims of liability for injury or damage to myself, any animals, or property arising out of my participation. This agreement is binding upon my executors, heirs, and assigns. .

I expressly waive any rights I may have under California Civil Code 1542, which states: "A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing the release, which, if known by him, might have materially affected his settlement with the debtor." I realize that in any dispute, it is MBHTC not MBA, or its owners or associates who hold any and all responsibility.

I agree that I will indemnify and hold harmless Independent Instructors, MBHTC, MBA, and their employees, contractors, officers, directors, members, volunteers, and agents against all claims, demands, and courses of action, including court cost, and actual attorney fees arising from any proceeding or lawsuits brought by or prosecuted for my benefit, in which this release is upheld.

The parties to this Agreement mutually agree that any and all disputes arising in connection with this Agreement shall be settled and determined by binding arbitration conducted in accordance with the then existing rules ofthe . American Arbitration Association by one or more arbitrators appOinted in accordance with said rules. Said arbitration shall take place in Santa Cruz County, in the state of California . MBHTC, MBA: _____ _ _ ____ ___ _ Instructor:___ _ _ _ ___ _ _____ ___ _ ___ ___

MBHTC,MBA, its employees, volunteers, agents, contractors, or members shall not be liable for any damage to person, horse, or property that may occur frorn any cause or as a result of fire, flood, earth quake, escape, state of health, injury, or death.

ASTM approved helmet, long pants, and heeled boots are required by all mounted riders.

I have inspected MBHTC, MBA riding facilities, grounds, arenas, and pastures and accept their condition as safe for horses & riders.

I acknowledge that I have read this Release of Liability and know and understand its contents .

. ?!~~~~~r.~: ............. .......................................... .............. p.a.t~; ...... . .. .................... . PARENT OR LEGAL GUARDIAN MUST COMPLETE THIS SECTION

I, the undersigned parent or guardian or the above participant, in consideration of my minor's participation at MBHTC and MBA, a non-profit organization. I agree that the terms and conditions of this Release of Liability shall be binding as to damage or injury to my minor, our animals, and property ariSing out of his/her participation there. I acknowledge that I have read this Release of Liability and know and understand its contents. NAME:.___ ____ _ _ ______ ___ _ _ ___TELEPHONE:_ ______ _____ ADDRESS: C1TY/STATE:_ _ __________

SIGNATURE:________ _____________DATE:_ _____________

Mon~ere!:j .5a!:j Horsemanship & Therapeutic Center

Horsemanship Lesson Policy and Agreement

Lesson fees are per month and eire to be received by Monterey Bay Horsemanship & Therapeutic Center (MBHTC) by the 10th of each month. A late fee of $10 will be applied to fees received after the 10th. Returned checks will be charged a $25 service fee. Fees are tobe paid monthly regardless of attendance or vacations in order to keep the quality of our program of one horse per student. Missed lessons may be made up however notification of foreseeable absences would be appreciated.

Lesson contracts are from September through August (or whenever the rider first joins the program through August). A nonrefundable registration fee of $30 is payable with-the first monthly payment. A written notice of withdrawal from the program must be submitted 30 days in advance which will terminate the contract for the current period and leave you in good standing for the next contract period (which means you will not need to pay another registration fee if you decide to return).

MBHTC reserves the right to reschedule lessons or change horses as necessary. The rider agrees to wear a helmet at all times while on horseback and to respect and adhere to the rules of the barn and Monterey Bay Academy . The rider also agrees to listen to all instruction given by instructors and volunteers to help m"lintain the highest safety standards.

Nameofstudent___________________~----------------------DOB-------------Address,____________________________________________________________~-----

Home Phone.-.:...______ ________Cell/other____________ Allergy/Medical Condition, ______________________________

Date of last Tetanus Shot,__________ Physician,_______________________Phone.____________

Dentist Phone.___ ___________ Insurance Company's Name ______________________________

Policy Number ____________________________________________

. ·Student's Signature Date

Name of Parent/Guardian,_____________________________

Address (if different)______________________________ Phone #s: Home _____________ ce\l/pager__-'--~________

Work Email______________________

Parent/Guardian Signature Date Photo Release (optional) I hereby consent to and authorize the use and reproduction by MBHTC of any and all photographs and other audiovisual materials taken of me/my son/daughter/my ward for promotional printed materials, educational activities or for any other use for the benefit of the program .

Student/Parent/Guardian's Signature Date