Overland Morgan Horse Farm 

Robert M. & Michelle Vanderbosch

10456 Shay rd., Dansville NY 14437

Waiver of Liability Statement

   Name of Rider(s)_______________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________

Home Phone-______________________________________________________________________________________________________

Address-________________________________________________________________________________________________________

City-___________________________________________________________________________State________Zip-_________________

The undersigned recognizes that despite the exercise of reasonable safety precautions injury is possible whenever one engages in the physical of horseback riding. A horse, despite all precautions, may act unpredictably.

 WARNING

You are assuming all risk by participation in this domestic animal activity.

Inherent risks of domestic animal activities include, but shall not be limited to: 

1.) The propensity of a domestic animal to behave in ways i.e., running, bucking, biting, kicking, shying, stumbling or falling or stepping on, that may result in an injury, harm or death to persons on or around them.

2.) The unpredictability of a domestic animal's reaction to such things as sounds, sudden movement of familiar objects, persons or other animals. 

3.) Certain hazards such as surface and subsurface conditions.

4.) Collisions with other domestic animals or objects and; 

5.) The potential of participant to act in a negligent manner that may contribute an injury to the participant or others, such as failing to maintain control over the domestic animal or non action with such participants ability. 

  The undersigned for themselves and for the rider do hereby agree to assume the risk of the rider participating in the horseback riding and further do covenant and agree to hold Over Land Morgan Horse Farm, its owners, agents and all property owners or their family members free and harmless from any and all claims, demands, damage, or liability, for injuries sustained, or damaged suffered while preparing or participating in horseback riding/carriage rides or from using the facilities at Overland Morgan Horse Farm and general riding such as in on trails. Except to the extent that such injury or damage was caused by willful, wanton or intentional conduct of the directors, owners or agents of Overland Morgan Farm. 

  It is further understood and agree that Overland Morgan Horse Farm does not insure the horse against injury and does not accept responsibility for any damage done or medical costs incurred. This agreement is binding on the heirs, executors, administrators, and assigns of the undersigned. 

Minors are required to wear SEI certified ASTEM standard F1163 equestrian helmet at all times (provided) when mounted upon a horse and you must wear a boot or shoe of adequate heel length (minimum of one inch) while a participant in horseback riding(also provided)

  I have signed read and agree with the terms of this waiver of Liability

 Signature _______________________________________________________________________________Date___________________

Parent signature_______________________________________________________________________________Date_________________