Koinonia Camp & Conference Center
Home
Summer Camp Sessions
Retreats & One Day Events
Gallery
Newsletter
Forms
Camper Scholarship Form
One Day Event Form
Weekend Retreat Registration Form
Volunteer Staff Application
Equine Program Forms
>
Equine Release Form
Contact Us
Join In!
Give Your Time
Give Your Talents
Give Your Treasures
Donate
Camp Store
Ministry Partners
Benevolent Businesses
Partnering Ministries
About Us
Duck Race & BBQ Auction Fundraiser
*
Indicates required field
Date
*
Name
*
First
Last
Email
*
Phone Number
*
By and between Koinonia Camp & Conference Center, hereinafter referred to as MANAGER, and the participant filling out this form, hereinafter referred to as PARTICIPANT, for consideration received, and in return for the use today, and on all future dates of the property, facility and services of Manager, participants, participant’s heirs, assigns and representatives of, hereby agree as follows:
Inherent risk and Assumption of Risk
. The undersigned acknowledges there are Inherent risks associated with equine activities. The inherent risks include but are not limited to, the propensity of equines to behave in ways such as running, bucking, kicking, biting, shying, rearing, falling or stepping on, that may result in injury, harm, or death to persons on or around them; the unpredictability of the equines reactions to things such as sounds, sudden movements and unfamiliar objects, persons or other animals; certain hazards such as surface and subsurface conditions; collisions with other animals; the limited availability of emergency medical assistance; and the potential of a participant to act in a negligent way that may contribute to injury to the participant or others, such as failing to maintain control over the animal, not acting within the participant’s ability, or not following instructions. Participant acknowledges that horses, by their very nature are unpredictable and subject to animal whims. Participant assumes all responsibility in connection there in, and expressly waives any claims for any injury of loss arising therefrom. Participant agrees to abide by and follow Manager’s rules and regulations which shall be stated, posted and/or available from time to time. Participant further acknowledges that the behavior of any animal is contingent to some extent upon the ability of the participant. Participant assumes all risks therefore and warrants a full and fair disclosure of the participant’s abilities has been made to manager.
I have ridden:
*
Never
Being Lead
More than once
Often
check all that apply to you
Gaits I have ridden
*
Walk
Trott
Canter
Gallop
check all that apply for you
Participant expressly releases manager from any and all claims for personal injury or property damage, even if caused by negligence on the part of the manager (if allowed by the laws of the state of Ohio) by manager, representatives or employees.
Warning
Under Ohio law, an equine activity sponsor, equine activity participants, equine professional, veterinarian, farrier, or other person is not liable in damages in a tort or other civil action for harm that an equine activity participant allegedly sustains during an equine activity and that results from inherent risks associated with the activity pursuant to Ohio revised code annotated 2305.321 (2001)
Release of Liability
Participant agrees to hold harmless, indemnify, and defend manager against, and hold harmless from, and all claims, demands, causes of action, damages, orders, judgments, costs or expenses, including attorney’s fees., whether actually incurred or not, which may in any way arise from or in any way be connected to the participants use of or presence upon the property of the manager or the facilities thereof.
In the event that the participant is using participants own horse(s), or a horse(s) not owned by manager, participant warrants said horse shall be free of infection, contagions or transmittable diseases. Manager reserves the right to refuse access of use of any horse upon the premises that does not appear to manager to be in good health, or is dangerous or in any way deemed undesirable by manager.
Any action brought under this agreement shall be brought within (1) year of the incident of accident giving rise to said claim. Participant agrees damages shall be limited to $250 in property damage, actual expenses incurred, and a maximum of $10,000 for damages such as pain and suffering.
Participant agrees to waive any applicable statutes in this jurisdiction whose purpose, substance and/or effect, is to provide that a general release shall not extend to claims, material or otherwise, which the person giving the release does not know or suspect to exist at the time of executing said release.
Participant's Name
*
Address
*
Line 1
Line 2
City
State
Zip Code
Country
Signature of Rider or Parent/Guardian
*
Submit
Home
Summer Camp Sessions
Retreats & One Day Events
Gallery
Newsletter
Forms
Camper Scholarship Form
One Day Event Form
Weekend Retreat Registration Form
Volunteer Staff Application
Equine Program Forms
>
Equine Release Form
Contact Us
Join In!
Give Your Time
Give Your Talents
Give Your Treasures
Donate
Camp Store
Ministry Partners
Benevolent Businesses
Partnering Ministries
About Us
Duck Race & BBQ Auction Fundraiser
Live Chat Support
×
Connecting
Submit
You:
::content::
::agent_name::
::content::
::content::
::content::