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**This is an exact copy of the waiver the Host/Hostess & Homeowners will sign on the day of the event.**
For______________________________ Party, On
_______________(Date)
To be held at: _____________________________________________
Please Read Carefully Before Signing.
READ and initial each paragraph and sign at bottom.
(An adult parent, legal guardian or legal
representative or responsible party must initial and sign if any
participant is under age 18.) Event/Activity Sponsor & Administrators
DO NOT Assure Your Safety!
* I acknowledge that I am the parent/ legal
representative or guardian for a minor (s), or am acting as a
host/hostess to my invited adult and minor guests, and am
responsible party for any guest participant(s).
_____
(Initial)
*I
will be responsible for all costs/damages incurred by any participant(s) or any participant's family members for all sums,
injuries or property damage that I or my guest(s) or family may
incur, and that I have accident medical insurance coverage in
force for any injuries that I or my family or guest(s) may incur._______(Initial)
* I acknowledge that I will be
responsible for my/our negligent acts, the negligent acts of my
guests and family members and for the acts of any animals that
we bring. I/we carry personal liability insurance coverage,
which is now in full force and affect that will indemnify
Mini-Connection, their owners and others, acting
on their behalf.
_______(Initial)
* I acknowledged that all participants
and guests should wear ASTM- standard/SEI- certified equestrian
helmets while participating in the hand guided pony rides and
activities. I am understand that the wearing of such headgear
while participating in equine activities may reduce the severity
of participants' head injuries in the event of a fall or other
equestrian-related accident.
_____(Initial)
* I acknowledge that my guests and
family are participating in a Mini-Connection
activity totally at our own risk for injuries or property damage
that we may incur.
______
(Initial)
* I acknowledge that I, and any
participants, hereby release and hold harmless and agree to
indemnify Mini-Connection for any
damages, costs or other expenses incurred by Mini-Connection, any sponsor, their owners, and others
acting on their behalf from any claims, legal liability, legal
actions or rights for damages, for any accident or injuries
which may occur to me/us or our animals at this activity and/or
event. _____
(Initial)
* This agreement is made to waive any legal
claims that I/we may have any right to bring against
Mini-Connection, any sponsor, their owners, and
others acting on their behalf to the fullest extent allowed by
law. This agreement also is made to indemnify and fully protect
Mini-Connection, their owners, and others
acting on their behalf for any harm or damage caused by me/us or
our animals in consideration for allowing my/our participation.______
(Initial)
* I was advised to read or have read the
provisions of Chapter 773 of the Florida Statutes dealing
with Equine Activities.______
(Initial)
* I understand an Equine Activity
Sponsor is not liable for any injury to or the death of a
participant resulting from the inherent risks of equine
activities and no participant nor any participant's
representative shall have any claim against or recover from any
equine activity sponsor for injury, loss, damage, or death of
the participant resulting from any of the inherent risks of
equine activities. F.S. 773.02
_______
(Initial)
The undersigned, as a
participant/parent/legal guardian or legal
representative/agent/responsible party, being of legal age and
fully competent to contract, have read and understand this
agreementand have initialed each of the above paragraphs for the purposes and intent expressed above. DATED in Brevard County, Florida, this ______ day of _______________.
A RIDING HELMET IS A RECOMMENDED SAFETY GEAR FOR ALL PARTICIPANTS. (Please Choose One) I am requiring my guests and participants to wear a safety helmet. _______ (Initial) I am not requiring my guests and participants to wear a safety helmet. _______ (Initial)
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