Clinic Form

(CASH ONLY AFTER THIS DATE) You may call to advise us your attending and pay by credit card and this will hold your spot for reservation.

WILD HORSE FOUNDATION

www.wildhorsefoundation.org

P. O. Box 692, Franklin, Texas 77856

979-676-1650 

PARTICIPANTS RELEASE OF LIABILITY AND INDEMNITY AGREEMENT

I understand that being around horses is inherently dangerous because they are living creatures and are not predictable.

UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE) AN EQUINE PROFESSIONAL IS NOT LIABLE FOR ANY INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES.

In consideration for being allowed entry into and participating in activities  (the “Activities”) associated with the Wild Horse Foundation, Inc., the undersigned hereby releases and discharges the Wild Horse Foundation, their insurance carriers, their legal representatives; their present and former corporate parents, subsidiaries, affiliates, predecessors, and successors, their present and former directors, officers, employees, agents and representatives, and the respective heirs, administrators, executors, successors, and assigns of any of the foregoing, Wild Horse Foundation, from any and all claims, causes of action, suits, or demands for personal injury, death or property damage, accrued or to accrue in the future known or unknown, relating to or arising out of any negligent, grossly negligent and/or intentional acts on the part of the Wild Horse Foundation undersigned in connection with the undersigned entry into and participation in the activities. The undersigned further agrees, on behalf of himself/herself and on behalf of any and all of his/hers heirs, successors and assigns, to expenses and legal fees incurred in defending the same, made by, through or against the undersigned or on his/her behalf, relating to or arising out of any negligent, grossly negligent and/or intentional acts on the part of the Wild Horse Foundation and the undersigned in connection with the undersigned’s entry into participation in the activities. I further agree to venue in Harris County, Texas for all purposes. The undersigned warrants that he/she has read this agreement and fully understands it to be a release of all claims, known or unknown, present or future, that he/she has or may have against Wild Horse Foundation.

The undersigned GRANTS PERMISSION to be PHOTOGRAPHED or INTERVIEWED in connection with the activities.  The undersigned understands that any such photograph or interview may be used by the Wild Horse Foundation or television, film, video, visual, graphic or printed media. The undersigned agrees to RELEASE and INDEMNIFY the Wild Horse Foundation with respects to any Claims related to the usage of such photographs or interviews by the Wild Horse Foundation or any media. Participants may not take photographs without written permission from the WHF.

I HAVE READ THE RELEASE OF LIABILITY AND INDEMNITY AGREEMENT, FULLY UNDERSTAND ITS TERMS, UNDERSTAND THAT I HAVE GIVEN UP SUBSTANTIAL RIGHTS BY SIGNING IT, AND SIGN IT FREELY AND VOLUNTARILY WITH ANY INDUCEMENT.

SIGNATURE:                                                                                                                                                                        AGE                       

PRINTED NAME:                                                                                                                                                                 DATE:                    

ADDRESS:                                                                                                                                                           

FOR PARENTS/GUARDIANS OF PARTICIPANTS OF MINORITY AGE

(UNDER AGE OF 18 AT DATE THIS AGREEMENT IS SIGNED)

This is to certify that I, as parent/guardian with legal responsibility for the above named person, do consent and agree to his/her release as provided above of all the Wild Horse Foundation parties, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Wild Horse foundation parties from any and all liabilities incident to my minor child’s involvement of participation in these programs as provided above. EVEN IF ARISING FROM NEGLIGENCE, GROSS NEGLIGENCE OR INTENTIONAL ACTS OF THE WILD HORSE FOUNDATION PARTIES, to the fullest extent permitted by law.

SIGNATURE:                                                                                                     DATE               

PARENT/GUARDIANS

PRINTED NAME OF PARENT/GUARDIAN:                                                                                 

 

Wild Horse Foundation

Registration Form 

Franklin, Texas

You may call to advise us your attending and pay by credit card and this will hold your spot for reservation.

Please make sure you have appropriate safety head gear, most western shops may have these in stock.

Name: Address:
City: State / Zip:
Telephone:

Day

Evening

Email:
  • Workshop Participant Individual with Horse (includes meal, breakfast, lunch plus hay and grain for horse and stall)
$350.00
  • Workshop Participant, Individual without Horse (includes meal, breakfast and lunch)
$175.00
          Workshop Participant daily fee $100.00
  • Spectator(s) (1/2 day) (No meal)
$50.00
Payment:   check   cash   cashiers check   money order TOTAL
Signature: Date:
Please download and submit the release form with your registration form.

NAME ON CREDIT CARD AS IT APPEARS: __________________________________________________

(VISA OR MC ONLY) CARD NUMBER: _______________________________ EXPIRATION DATE: ____/_____/_____

AMOUNT OF DONATION, $_____________. ______  PLEASE WRITE OUT AMOUNT:

_______________________________________________________________________________

SIGNATURE:____________________________________________________________________

 

Please mail payment and forms to:

Wild Horse Foundation

P O Box 692

Franklin, Texas 77856

For additional information contact:

Susan Calhoun

scalhoun@wildhorsefoundation.org

979-676-1650 

 

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