PARTCIPANT AGREEMENT, RELEASE AND
ASSUMPTION OF RISK
In consideration of the
services of Jorgenson Enterprises and or Gerhard Jorgenson, their agents,
owners, officers, volunteers, participants, employees and all other persons or
entities acting in any capacity on their behalf (hereinafter collectively
referred to as JE). I hereby agree to release indemnify, and discharge JE, on
behalf of myself. My spouse, my children, my parents, my heirs, assigns
personal representative and estate as follows:
1.
I acknowledge that
an equestrian activity entails known and unanticipated risk that could result
in physical or emotional injury, paralysis, death, or damage to myself, to
property, or to third parties. I understand that such risks simply cannot be
eliminated without jeopardizing the essential qualifies of the activity.
I am aware and understand that there are
inherent DANGERS, HAZARDS, and RISKS, (collectively called RISKS) associated
with Equine Activities. I acknowledge
that these Inherent “RISKS” of Equine Activities mean those DANGEROUS
conditions, which are an integral part of Equine Activities, including but not
limited to:
1)
The propensity of any equine to behave in
ways that may result in injury, harm or death to person on or around them
and/or damage to property in their vicinity;
2)
The unpredictability of an equine’s
reaction to such things as sounds, sudden movement and unfamiliar objects,
persons or other animals;
3)
The equine’s response to certain hazards
such as surface or subsurface objects;
4)
Collisions with other equines, animals,
people, and objects;
5)
The potential of any participant to act in
a negligent manner that may contribute to injury to the participant or others,
such as failing to maintain control over the equine or to act within his or her
ability.
Furthermore, JE employees have
difficult jobs to perform. They seek safety, but they are not infallible. They
might be unaware of a participant’s fitness or abilities. They might misjudge
the weather or other environmental conditions. They may give incomplete
warnings or instructions, and the equipment being used might malfunction.
1.
I expressly agree
and promise to accept and assume all of the risks existing in this activity. My
participation in this activity is purely voluntary, and I elect to participate
in spite of the risks.
2.
I hereby
voluntarily release, forever discharge, and agree to indemnify and hold
harmless JE from any and all claims, demands, or causes of action, which are in
any way connected with my participation in this activity of my use of JE
equipment of facilities, including any such claims which allege negligent acts
or omissions of JE.
3.
Should JE or
anyone acting on their behalf, be required to incur attorney’s fees and costs
to enforce this agreement, I agree to indemnify and hold them harmless for all
such fees and costs.
4.
I certify that I
have adequate insurance to cover any injury or damage I may cause or suffer
while participating, or else I agree to bear the costs of such injury or damage
myself. I further certify that I am willing to assume the risk of any medical
or physical condition I may have.
5.
In the event that
I file a lawsuit against JE, I agree to do so solely in the state of WA, and I
further agree that the substantive law of WA shall apply in that action without
regard to the conflict of law rules of the state. I agree that if any portion
of this agreement is found to be void or unenforceable, the remaining document
shall remain in full force and effect.
By signing this document, I
acknowledge that if anyone is hurt or property is damaged during my
participation in this activity, I may be found by a court of law to have waived
my right to maintain a lawsuit against JE on the basis of any claim from I have
released them herein.
Signature of Participant: _______________________________________
Print Name ______________________________________
Address:
____________________________________________________________________________________________________
Phone: ________________________________________ Date ______________________________
PARENT’S OR GUARDIAN’S
ADDITIONAL INDEMNIFICATION (Must be completed for participants under the age of
18)
In consideration of
_________________________(print minor’s name) (“Minor”) being permitted by JE
to participate in its activities and to use its equipment and facilities, I
further agree to indemnify and hold harmless JE from any and all claims which
are brought by, or on behalf or Minor, and which are in any way connected with
such use or participation by Minor.
Riders under the age of 14 are
required to wear a helmet at all times during the activity. Riders between the
ages of 14 and 18 may waive the use of a helmet through the approval of his or
her legal guardian.
I acknowledge that I have been
offered the use of a helmet. I accept __________ or decline __________.
Signature of Participant: _______________________________________
Print Name ______________________________
Date
_____________________________