Rider Information & Agreements Form

Riders Name

First Name

Last Name

Riders Date of Birth

Riders Height

Riders Weight

Riders Experience

Please List Number of Months/Years of Riding Experience & Riding Style (English, Western or Both)

Email Address

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Name of Parent/Guardian if Under 18 Years of Age

First Name & Last Name, If 18 Years of Age or Older, Please Enter N/A

Riders Allergies

Please List All Allergies Separated by Commas

LIABILITY RELEASE, PLEASE READ CAREFULLY

The undersigned recognizes that horse boarding, riding, training, breeding and related activities are by their nature hazardous and enters into such activity voluntarily and agrees to assume the risks inherent in such activities. I/We hereby agree to assume all responsibility and risk from the participation in equestrian activities at Far West Farms and further agree to hold Far West Farms and its teachers, counselors, trainers and employees free from all damages or liability for any injury to person or property arising as a result of this participation. Riders Signature & Date (Parent/Guardian if Rider is Under 18 Years of Age)

MEDICAL RELEASE, PLEASE READ CAREFULLY

The undersigned, parents of students, a minor, do hereby consent to any x-ray examination, anesthetic, medical or surgical diagnosis or treatment and hospital service that may be rendered to said minor under the general or specific instructions of any physician or hospital. It is understood that this consent is given in advance of any specific diagnosis or treatment which may be required, but is given to encourage the Far West Farms’ staff, and such physician to exercise their best judgment as to the requirements of such diagnosis or treatment. The undersigned shall pay all fees for doctors, hospitals, ambulances and other medical charges reasonable and necessarily incurred. Riders Signature & Date (Parent/Guardian if Rider is Under 18 Years of Age)

PHOTO RELEASE, PLEASE READ CAREFULLY

Far West Farms requests permission to display photos/images/videos of you and/or your child on the Far West Farms website - farwestfarms.com, as well as our Youtube and social media accounts. In granting this permission you understand that Far West Farms may use photos/images/videos of you and/or your child for purposes such as celebrating achievements and publicizing events, as deemed appropriate by Far West Farms staff. You further understand that you and/or your child’s name or other personally identifiable information will not be used with any photo/image/video. You sign this release form with the knowledge that any photos/images/videos posted on the Far West Farms website and social media can be downloaded and reprinted by various news organizations, including print, electronic and broadcast media, and therefore, release Far West Farms from any liability arising from use of you and/or your child’s photos/images/videos in Far West Farms web and social media postings. You further understand that if you wish to not consent to this agreement, you may do so by selecting the "I Do Not Grant Permission" checkbox below. Please note, that signature and today's date is still required in order to complete this section of the form. Riders Signature & Date (Parent/Guardian if Rider is Under 18 Years of Age)

Photo Release Consent

I Grant Permission

I Do Not Grant Permission

ACKNOWLEDGEMENT OF AGREEMENT

I WAS GIVEN AND HAVE READ THE FAR WEST FARMS POLICY ON RIDING LESSONS, CANCELLATIONS, RESCHEDULING & THE LATE POLICY, WEIGHT HEIGHT & AGE RESTRICTION, AND THAT RIDING SCHOOL HALF LEASES ARE AVAILABLE. Riders Initials (Parent/Guardian if Rider is Under 18 Years of Age)