"Horses are our passion and passion leads to making YOUR dreams come true."
I hereby grant permission for the following actions or activities related to my/my minor’s participation in the activities.
____I give permission to receive individual instruction at the farm and horse shows including limited physical contact to assist in instruction.
_____I give permission for individual meetings between my child and the trainers/instructors if related to the training and instruction of my child at the farm and horse shows including limited physical contact to assist in instruction.
_____I give permission to communicate directly with my child via TEXT MESSAGES at the following phone number if said communication is related to training and instruction. This in below information.
_____I give permission to communicate directly with my child via EMAIL at the following email address if said communication is related to training and instruction. This in below information.
_____I give permission to communicate directly with my child via SOCIAL MEDIA, including Facebook, Twitter, Instagram and Snapchat if said communication is related to training and instruction.
_____I do not wish to be copied on each communication between my child and the trainers/instructors. Text messages, Email, Social Media.
_____I do want to be copied on communication between my child and the trainers/instructors at the following. Phone number or email address.
_____I give permission for my child to ride in any vehicle designated by Stable, its owners, trainers, instructor, managers and/or adult volunteers, while participating at horse shows if related to training and instruction.
_____I give permission for my child to stay overnight at the residence of a stable trainer/instructor, which residence is designed by Stables as appropriate and safe, while participating in training and instructing related activities. I understand my child will not share a room or sleeping arrangements with Stable’s trainer/instructors or adult volunteers. I understand that I am allowed to inspect said residence and visit at any time during which my child is in residence.
______I understand that petting Horses/Dogs/Cats or other animals that are at the Stable without permission, for the Health of the animal, feel free to look but please refrain from petting any animals without asking the Stable management first. Good Hygiene practices are always recommended. Washing your hands often or the frequent use of hand sanitizers helps to protect the animals.
______I understand that the Stable cancellation policy— Cancellation Policy-the stables requires 24 hour notice to cancel any riding program/horse adventure. Failure to give 24 hour notice will result in forfeiture of the program time and fee. No refund or credit will be given for failure to cancel or complete a lesson session. Parent/Guardian must do so, by phone call 608-833-3635, email neva@Lstables.com.
Increment Weather Plan--If there is bad weather we will follow the Madison protocol.
______I under, if I am boarding or using a horse owned by me or any acquaintance of mine the Stable in connection with Activities. I warrant and represent that such horse has the proper temperament and health for the Activities.
Policies - Code of Conduct:
______I have read Policies -code of Conduct page about Horse Lover’s rules, Family, Property, Stables and Programs.
Cell phones are not allowed in the stables at anytime unless authorized by the owner or instructor of the barn. Please leave your cell phone in your car or you may check it in at the stable store. We are very strict about this policy, because we want to ensure the safety of all riders and horses.
Waiver of Liability:
In consideration for my/minor’s participation in the activity. I hereby waive all claims or causes of action, including ordinary negligence, against Stables, its owners, trainers, instructors, managers, employees, agents and/or volunteers, arising out of my/minor’s participation in the activity however, wherever and whenever that same my occur.
I understand that this waiver is meant to be as broad and inclusive as permitted by the laws of Wisconsin, and agree that if any portion is held invalid, the remainder of the waiver shall continue in full legal force. I further agree that the venue for any legal proceeding shall be within the 5 years of your start date at the Stables. Wisconsin Statues NOTICE 895,481(1)(E): A person who is engaged for compensation the rental of equines or equine equipment or tack or in the instruction of a person in the riding or driving of an equine or being a passenger upon an equine is not liable for the injury or death of a person involved equine activities resulting from the inherent risks of equine activities, as defined in section.
Consent to Use of Emails/Videos/Photos:
_____, I understand my/my minor’s picture can be taken or that I/my minor can be filmed while participating in activities at Stable or when representing Stable at events. I hereby grant to Stable and its owners, trainers, instructors, managers, employees, agents, volunteers, photographers and/or videographers the right to take, use, publish, and copyright photograph(s) and videos of me/my minor in press releases, advertisements, publication, and/or promotions by Stable, including its website and/or social media websites, such as Facebook, Instagram, Twitter and/or YouTube, maintained by Stable and/or it’s agents and individual employees. I hereby release Stable, its owners, trainers, instructors, managers, employees, agents, volunteers, photographers and/or videographers, from any and all claims or demands arising out of or in connection with said photography or videography or the publications of said photographs and videos.
Helmet Opt-Out for Riders over 18:
_____ I expressly acknowledge that is the policy of Stable that ASTM/SEI certified helmets are MANDATORY for any rider under that age of 17 and under, UNLESS EXPRESSLY WAIVED. I expressly acknowledge that I understand the risks associated with not wearing as ASTM/SEI approved riding helmet. I am voluntarily choosing not to wear to wear a helmet and expressly assume any additional associated risk, because I’m over the age of 18 & over.
Protective Headgear Offering
I, for myself and on behalf of my child and/or legal ward, have been offered protective headgear (riding helmet) by Instructor or have provided for myself protective headgear. Student understands that the wearing of such headgear while mounting, riding, dismounting and otherwise being around horses, may prevent or reduce severity of some head injuries, and may even prevent death as the result of a fall or other occurrence. It is understood that Instructor provided headgear may not be of perfect fit for each Student head, and that once provided I/WE will be responsible for securing the helmet on Student head at all times. Minors MUST wear protective headgear.
PROTECTIVE HEADGEAR ACCEPTANCE
I/WE request to wear protective headgear which Instructor provides.
I/WE will provide MY/OUR own headgear. I/WE accept full responsibility for MY/OUR safety in this decision.
I give permission to Stable owners, managers, trainers, instructors, employees and agents to seek emergency medical treatment for the participant(s) in the event they are unable to reach any parent or guardian. I agree that I will be responsible for any financial debt incurred by said action.
I recognize the treat of exposure to tetanus that exists in the presence of livestock and acknowledge my responsibility to obtain inoculation and maintain protection against tetanus, a disease endemic to horses.
The following is a list of all insurance information, restriction, allergy and medication information necessary for me/my minor to receive appropriate medical care:
Horse Day Camps:
I understand that a non-refundable/nontransferable deposit for $350.— Per week must accompany this form to insure the camper place in the session(s) I have indicated. The final payment is due the first day of the session. If final payment is not made, I will lose my deposit, and La Fleur Stables/Madison Riding Academy may accept a child from a waiting list. All fees must be paid in advance and are not refundable for missed days or sessions.
Session Changes/Cancellation / Policy: A written two-week advance notice must be received by the stables to cancel any course (fax, email, and hand-written notices are all acceptable). Failure to submit written Cancellation two weeks in advance will result in the liability of all fees paid and owed for that course. Families may add camps or change their choice of week of camps at any time up to the end of the business Day Wednesday the week prior to which it will take effect. Requests to add or change a course must also be received in writing. (fax, email, and hand-written notices are all acceptable)
*Session will begin on the dates that you signed up. Please arrive 5-10 minutes ahead of the
Schedule start time in order to complete your registration for the start of event.
Your Confirmation Letter will include a list of items to bring and a detailed agenda. This will be sent to
you (via email unless specified above).
A. REGISTRATION OF RIDERS AND AGREEMENT PURPOSE
In consideration of the payment of a fee and the signing of this agreement, I the following listed individual/s, and the parents or legal guardians thereof if a minor, do hereby agree to receive from said stable and instructor/s a week long day camp session of horse handling and/or riding or driving instruction on or with one or more of stable owned or used horse/s, on or with equipment owned by or used by said stable.
Page 1 of 3 Write Initials below after reading each section. Parents or guardians must also initial.
(1) The term “Day Camp Session” herein shall refer to handling, ground work, riding and/or driving of stable owned or used horse(s) by student and/or instructor for the purpose of education. Day Camp sessions are 9am – 3pm for 1 week (Monday- Friday or pick days)
(2) The term “Student” refers to the person/s receiving Lessons as listed above.
(3) The term “Stable” refers to the above listed stable
(4) The term “instructor” refers to the above listed name
AGREEMENT SCOPE AND TERRITORY AND DEFINITIONS
This agreement shall be legally binding upon me the registered rider, and the parents or legal guardians thereof if a minor, my heirs, estate, assigns, including all minor children, and personal representatives; and it shall be interpreted according to the laws of the state and county in which THIS STABLE'S physical location. Any dispute by the rider shall be litigated in and venue shall be the county in which THIS STABLE is physically located. If any clause, phrase, or word is in conflict with state law, then that single part is null and void. The term "HORSE' herein shall refer to the horse/s described in page 1 of this agreement. The term "RIDER" shall herein refer to the listed rider on page 1 of this agreement who rides, handles, or comes near the HORSE. The term "INSTRUCTOR" shall herein refer to instructor listed on page 1 of this agreement. The term "Day Camp Session" herein shall refer to ground and mounted instruction given to the RIDER by the instructor in exchange for money or an agreed upon barter. The terms "I", "ME", "MY", shall herein refer to the above listed rider and the parents or legal guardians thereof if a minor.
ACTIVITY RISK CLASSIFICATIONS
I understand that: horseback riding is classified as RUGGED ADVENTURE RECREATIONAL 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 on other activities. I/WE further understand that applicant/s may have mounted or ground lessons that may encounter one or more of the following but not limited to: woods, rough terrain, hills, water, jumps, traffic, wild animals, and other horses.
Please initial ________
NATURE OF STABLE HORSES
I understand that: INSTRUCTOR follows a rigid safety program. Yet, no horse is a completely safe horse. Horses are 5 to 10 times larger, 20 to 40 times more powerful, and 3 to 4 times faster than a human. If a rider falls from a horse to the ground it will generally be at a distance of from 3.5 to 5.5 feet, and the impact may result in injury to the rider. Horseback riding is the only sport where a much smaller, weaker predator animal (human) tries to impose its will on another much larger, stronger prey animal with a mind of its own (horse) and each has a limited understanding of each other. If a horse is frightened or provoked it may divert from its training and act according to its natural survival instincts which may include, but are not limited to: Stopping short; Changing directions or speed at will; Shifting its weight; Rearing; Bucking: Kicking; Biting; or Running from danger.
Please initial _________
I have read and understand the Events participation agreement and the payment / refund policy for programs at the Stables. Will return the required forms on time. I also understand that when riders attend an event at their own risk and will not hold the Stable, its owners or employees liable in case of accident or injury to there or their possessions. I agree to the code of behavior.
*Please return this entire form
& with what payment is required.
Madison Riding Academy LLC
3440 Meadow Road Verona, WI 53593
Events will be filled on FIRST COME,
FIRST SERVE basis, so sign up early!
SEE YOU SOON!
I, _______________, the legal guardian or parents of ___________________, agree to the following with participate respect to participation by either of us in actives related to riding/driving instruction and coaching at La Fleur Stables LLC - Madison Riding Academy LLC - Hippoi Institute Ltd., (hereinafter referred to as “Stable”)
I acknowledge that Stable, its Owners, trainers, instructors, managers, employees, agents, volunteers and/or other participants and clients are not responsible for any injury (or loss of property) to any person while participating in horse related activities, special events such as camps, demonstrations or horse shows, or in any other way related to horse riding/driving at Stable or related venues for any reason, including ordinary negligence on the part of Stable, its owners, trainer, instructors, managers, employees, agents, volunteers and/or other participants and clients.
Consent to Participation:
I consent to my/my minor’s participation in the activity and acknowledge that I fully understand that my/my minor’s participation may involve risk of serious injury, illness or death including losses which may result not only from my/my minor’s own actions or inactions but also from the negligence of others and/or the condition of the facilities, equipment, or areas where the activity is being conducted. I understand that if I have any risk concerns, I shall discuss them completely with Stable, its owners, managers, employees, agents or volunteers before I sign this agreement and before my/my minor’s participation begins.
Assumption of Risks:
Knowing and understanding the risks involved with participation in this activity, I hereby voluntarily and willingly assume full and complete responsibility for all losses and damages, including injury, illness and death, resulting from my/my minor’s participation in the activity, including transportation to and from the activity. I agree I am financially responsible for any losses and damages resulting from my/my minor’s participation in the activity.
I acknowledge that I am aware Safe Sport training is available for me/my minor that Stable’s trainers and instructors have completed same. In 2019, the Stables policies will go into effect. The new policies are part of a congressional requirement mandating United State Equestrian Federation (USEF), as well as other amateur sports organizations and governing bodies, to implement policies and procedures that limit one-on-one interactions between minor athletes and adults who are not their parent/legal guardian. We designed these policies to work for equestrian sport, but please recognize that they are based on the uniform policies developed by the U.S. Center for SafeSport that will further protect minor athletes, under federal law. If a child is left alone with adult that isn't their parent/guardian they must have permission and pay the "DAYCARE" fee packages.
Looking forward to seeing you're all soon