After School Program Registration and Waiver Form

4PM – 7PM
7 years and older
$60.00 + HST / evening = $542.40 (HST included)



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RIDING INFO FOR SARAH PARKS HORSEMANSHIP:

To match you with your ideal horse or pony, please provide your approximate:*

PLEASE READ AND AGREE TO THE FOLLOWING 2 SECTIONS BEFORE SUBMITTING YOUR REGISTRATION FORM:

SECTION ONE:

I desire my child to participate in the After-School Program (operated by Sarah Parks) for the 8 week session, including all activities unless I advise otherwise in writing. The price of the program is $542.40 ($480.00 + HST) for a 8 week session or $60.00 per session (HST included) if a “one time” session is arranged with the Coordinator. I agree that if my child fails to complete the program, the fee will not be refunded.


Sarah Parks Horsemanship may periodically photograph participants during sessions for the purpose of sharing photographs through photo albums, electronic media, or for the purposes of promotional material and/or public relations. Please indicate your permission to publish photographs for any of the above purposes by checking one of the following:


I understand that registrations are received on a first come, first serve basis and that payment in full is required to reserve my spot in the program. Payment can be received by etransfer, cash or cheque. (sorry - no credit cards or debit) * Please make cheques payable to Sarah Parks and mail to: 7150 County Rd 20, RR#5, Amherstburg, On, N9V OC8.

I have notified the Coordinator of any pre-planned vacation. In the event that my child cannot attend the program and an alternative date cannot be arranged I am aware that my fee will not be reimbursed.


- we will be breaking in between activities, bring snacks and plenty to drink to refuel and stay hydrated.

We will be outdoors in the elements so bring what you need to stay warm and comfortable in the evenings. Come with extras that help dress you for the weather, and that may include gloves, sweaters or jackets, and rain boots. Hats and sunscreen are encouraged year round.

Boots or shoes with a heel are recommended. Rain boots or runners are acceptable. Absolutely no open-toed shoes are to be worn at any time. Long pants or sweat pants are acceptable to wear but we do not advise wearing nylon or slippery pants. We will supply riding helmets. (Riders can bring their own if they have them.)

SECTION TWO: CONSENT AND WAIVER OF LIABILITY

To SARAH PARKS HORSEMANSHIP, their directors, employees, officers, volunteers, business operators, and site property owners. (all of them collectively called the HOST)

Initial (check box) each item below After Reading and Understanding the item:

I am the Parent and/or Legal Guardian of the infant Participant named above and am executing this form on behalf of the infant Participant in my capacity as parent and/or guardian and with the intent that this form be binding on myself and infant Participant for all legal purposes.

I Understand there are Inherent DANGERS, HAZARDS and RISKS, (collectively called RISKS) associated with Equine Activities and injuries resulting from these “RISKS” are a common occurrence.

I Acknowledge that the Inherent “RISKS” of Equine Activities mean those DANGEROUS conditions which are an integral part of Equine Activities, including but not limited to:
• The propensity of any equine to behave in ways that might result in injury, harm or death to persons on or around them and to potentially collide with, bite or kick other animals, people, or objects.
• The unpredictability of an equine’s reaction to such things as sounds, sudden movement, tremors, vibrations, unfamiliar objects, persons or other animals and hazards such as subsurface objects.
• The potential for other participant (s) to act in a negligent manner that might contribute to injury to themselves or others, such as failing to act within their ability or to maintain control over an equine.

I Freely Accept and Fully Assume All Responsibility for the Inherent “RISKS” and the possibility of personal injury, death, property damage or loss which might result from the infant being a Participant.

I Acknowledge that it remains my Sole Responsibility for the safety of the infant Participant and for the infant to Participate within his/her own limits.

In addition to consideration given for the infant to Participate in Equine Activity, I and my heirs, executors, administrators and assigns (collectively called my “Legal Representatives”) agree:
• To Waive All Claims that I or the infant Participant might have against the “HOST”; and
• To Release the “HOST” from Any and All Liability for any loss, damages, injury, or expense that I, the infant Participant or our “Legal Representatives” might suffer as a result of the infant’s Participation due to any cause including any NEGLIGENCE ON THE PART OF THE “HOST”; and
• To HOLD HARMLESS AND INDEMNIFY THE “HOST” from any and all liability for property damage or personal injury to the infant Participant or to any third party which might result from the infant’s Participation.

Before checking the "I agree" box on this form, I read it (as indicated by my checked boxes above) and I stated I understand it. I know that checking the "I agree" box on this form, waives certain legal rights I and/or the infant Participant and/or our “Legal Representatives” might have against the “HOST”.

Do Not Sign until you Understand All Items Above.

Rider Participant Signature:

Guardian Signature: