Waiver and Release of Liability
Sign in to Google to save your progress. Learn more

Horseback riding and related activities are inherently dangerous because of the size and nature of the animals involved and as such, and in consideration of myself or my child’s use of the grounds and arenas leased by Kinch Enterprises, Inc. trading as Brandywine Farms/Stables, hereinafter referred to as Brandywine, located at 13705 Bundle Road, Chesterfield, VA, I hereby waive, release and forever discharge any and all rights and claims for personal injury or damages which I/my child may have or which may hereafter accrue to me and/or my child against, Ariel and Hunter Kinch and/or John and Terry Kinch, Kinch Enterprises, Inc., its shareholders, partners, heirs, agents, representatives, employees, officers, and/or sponsors, for any and all injuries, illnesses or damages which may be sustained by me or my child or my horse in connection, or arising out of boarding my horse or participating in riding instruction on or off the property, party rides, pony rides, trail rides and/or the use of the grounds or arenas operated by Kinch Enterprises, Inc.

I/my child recognize that horses are unpredictable animals, and that there are significant risks of injury inherent and associated with horses and horse related activities, including, but not limited to, trailering, loading, boarding, riding, catching, grooming, saddling, feeding, and caring for horses. Knowing of the inherent risks, dangers, and rigors involved in such horse activities, I/my child certify that I/my child understand the risks associated therewith, that I/my child am/is fully capable of participating in said activities, and that I/my child do so at my/her/his own risk. I further recognize that I/my child or any animals that I bring/have at the farm could come into contact with viruses or communicable diseases while at the farm and agree to take sole personal responsibility for My/My child’s/My animals safety in this regard, holding Kinch Enterprises, Inc. harmless from all such risks and/or liabilities resulting from my decisions.

I/my child agree to wear AHSA approved protective headgear while riding in any activities on the grounds or in the arenas. I further agree to provide myself/my child with AHSA/Pony Club of America approved protective headgear, and to require my child to wear such headgear at all times while riding on the grounds or in the arenas. I also will provide hard soled shoes or boots with a 1/4 inch heel and tread on the bottom and straight-legged pants/jeans.

I assume full responsibility for any and all risks of bodily injury, death, loss of or injury to personal property, and any and all expenses associated therewith, both for myself/my child, and for my horse. I further agree to be responsible for all

damage or injury caused by myself/my child or horse to the Brandywine Farms property and shall indemnify and hold Kinch Enterprises, Inc., its shareholders, officers, agents, employees, partners and assigns harmless from any such damage or injury caused by myself, my child, or my horse during any activity including onsite or hauling to offsite events.

I authorize Brandywine Farms to seek medical attention to myself/my child should he/she suffer an accident resulting from any cause while on the premises of Brandywine Farms and that I shall be liable for any costs attendant to thereto. I fully understand that neither hospitalization nor medical insurance coverage is provided by Brandywine Farms.

I acknowledge receipt of a Brandywine Farms brochure and understand and agree to all policies within. I also

understand there are inherent risks to non-participating persons from feeding, petting, or being around the horses and will restrain non-participating persons from entering the barn & paddocks or feeding horses. If said non-participating persons are

injured in any manner or way while I am on Brandywine Farm’s premises, I agree to assume all responsibility for said injury and will be governed in the same manner as I am governed in this waiver with regard to a participating person.

Warning: The Code of Virginia will govern this agreement and that under the code of VA, (Title 3.1 Chapter 27.5 & 3.1-796. 130-133), equine activity sponsors and equine professionals are not liable for injury or death of a participant arising out of riding, training, driving, grooming, or riding as a passenger upon an equine, including rides, trips, and hunts however informal or impromptu and whether or not a fee has been paid to participate in the activity. Expressly you assume all liability for any injury or damage that may occur for any reason whatsoever while participating or being on this farm.

This waiver is valid without re-execution, unless terminated in writing by the parent, guardian or responsible party Horse Rental/ Guided Trail Ride Agreement And Liability Release:

A. Registration of Riders. In consideration of the signing of this agreement, I, the signatory/parent/legal guardian, of the minor rider, hereby agree to hire from Brandywine a horse, tack and equipment, personnel and trail for the purpose of horseback riding today and on all future dates. This waiver is valid without re-execution, unless terminated in writing by the parent, guardian or responsible party.

IMPORTANT NOTICE - Anyone with any physical/mental limitations or who are pregnant are not allowed to participate in this ride.

page1image40521376 page1image40521792 page1image40522000

B. Agreement Scope and Definitions - This agreement shall be legally binding upon the registered rider and the parent/legal guardian thereof, estate, assigns, including all minor children, and personal representatives, and it shall be interpreted according to the laws of the Commonwealth of Virginia. Any dispute by the rider shall be litigated in the County of Chesterfield, Virginia. In any clause, phrase or word which is in conflict with state law, then that single part is null and void. The term “HORSE” herein shall refer to all equine species. The term “HORSEBACK RIDING” herein shall refer to riding or otherwise handling of horses or ponies, whether from the ground or mounted. The term “RIDER” shall herein refer to a person who rides a horse mounted or otherwise handles or comes near a horse from the ground. The terms “I”, “Me”, “MY” shall herein refer to the above registered rider and the parents or legal guardians thereof if a minor.

C. Activity Risk Classification - I understand that Horseback riding is classified as RUGGED ADVENTURE RECREATIONAL SPORT ACTIVITY, and that there are numerous obvious and non-obvious inherent risks always present in such activity despite all safety precautions. According to NEISS (National Electronic Injury Surveillance Systems of United States Consumer PRODUCTS), horse activities rank 64th among the activities of people relative to injuries that result in a stay at U.S. hospitals. Related injuries can be severe, requiring more hospital days and resulting in more lasting residual effects than injuries in other activities. I/WE further understand that applicant may be participating in a “WILDERNESS EXPERIENCE” and that the meaning of this term is defined as follows: THE PURSUIT OF ADVENTURE TYPE ACTIVITY IN A WILD, RUGGED, AND UNCULTIVATED AREA OR REGION, AS OF FOREST and/or HILLS and/or MOUNTAINS and/or PLAINS and/or WETLAND, WHICH WOULD LIKELY BE UNINHABITED BY PEOPLE AND INHABITED BY WILD ANIMALS OR MANY TYPES AND SPECIES TO INCLUDE, BUT NOT LIMITED TO MAMMALS, REPTILES, AND INSECTS, WHICH ARE NOT TAME, MAY BE SAVAGE AND UNPREDICTABLE IN NATURE AND ALSO WANDERING AT THEIR WILL.

D. Nature of Brandywine Horses. I understand that upon mounting a horse and taking up the reins, the rider is in primary control of the horse. The rider’s safety largely depends upon his/her ability to carry out simple instructions, and his/her ability to remain balanced aboard the moving animal. It is understood that the rider shall be responsible for his/her own safety, and that of an unborn child if the rider is pregnant. This stable does not allow known pregnant women to ride.

E. Rider Responsibility. I understand that Brandywine is not responsible for total or partial acts, occurrences, or elements of nature than can scare a horse, cause it to fall, or react in some other unsafe way. Some examples are: thunder, lightning, rain, wind, water, wild and domestic animals, insects, reptiles, which may walk, run or fly near, or bite or sting a horse or person. And irregular footing on out of door groomed or wild land, which is subject to constant changes in condition according to weather, temperature, and natural and man-made changes in landscape.

G. Carry-on Objects and Shape Noises. I understand the rider must not carry loose items on rides which may fall, blow away, flap in the wind, bounce, or make sharp noises, possibly scaring a horse. Some examples are: cameras, sunglasses or hats not securely fastened under chin, toys, purses. Riders must not make sharp loud noises, such as screaming or yelling, which may scare a horse.

H. Saddle Girths-Natural Loosening. I understand that Saddle girths (saddle fasteners around horses’ belly) may loosen during a ride. If a rider notices this, he/she must alert the nearest guide as quickly as possible so action can be taken to avoid slippage of saddleand a potential fall from the animal. Rider understands that Brandywine will not be liable whether rider notices the loosening of the girth or not and the Rider further recognizes that he/she must assume the risk of this natural consequence if it does occur and injury is suffered.

I. Protective Headgear required. I, and on behalf of my child and or legal ward, have been issued a helmet from this stable and protective headgear may not be a perfect fit for each riders head and I will be responsible for securing it on head at all times.

J. Liability Release - That in and for consideration of Brandywine allowing my participation in this activity, under the terms set forth herein, I, the rider, for myself and on behalf of my child and/or legal ward, heirs, administrators, personal representatives or assigns, do agree to hold harmless, release and forever discharge Brandywine, its owners, shareholders, agents, employees, officers, directors, representatives, assigns, members, owners of premises and trails, affiliate organizations, insurers, and others acting on its behalf (hereinafter, collectively referred to as “ASSOCIATES”) of and from all claims demands, causes of action and legal liability, whether the same be known or unknown, anticipated or unanticipated, due to Brandywine’s and/or its Associates ordinary negligence; and I do further agree that except in the event of Brandywine’s gross negligence and willful and wanton misconduct, I shall not bring any claims demands, legal actions and causes of action, against Brandywine, to include while riding, or otherwise being near horses owned by or in the care, custody and control of Brandywine, whether on or off the premises of Brandywine.

I have read this document, its acknowledgment of risk, assumption of risk, and responsibility and release of liability. I understand by signing this document I will be waiving valuable legal rights. Do not sign before reading this form in its entirety.

Please type full name as an acknowledgment of reading this document and accepting the risks in which it outlines.

*
Required
Full name of Rider (and Parent/Guardian if persons are under 18) *
Address and Phone Number *
Date Signed *
MM
/
DD
/
YYYY
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy