Trademark Stables, LLC.

6429 1/2 Old Jenks Road

Apex, North Carolina 27523 

Application / Waiver of Riding Privileges 

 

Rider's Name: ___________________________ DOB:____________ Age:______ 

                                                                                          Sex:______

Address: __________________________________________________________

Telephone: _______________ (Home) ________________ (Work)

                    _______________ (Cell) 

Email: ________________________________________________ 

Parent/Guardian: ___________________________________________________________

Previous Riding Experience: Years: ________ Level of Competition: ____________________

Own a Horse / Pony: ___ (Y/N)  Lease a Horse/ Pony: ___(Y/N)

         If so, how long? ____                    If so, how long? ____

Describe Experience: _______________________________________________________

________________________________________________________________________

Please list and describe any physical limitations / conditions which might limit or affect your 

participation in horse riding activities. Please give full details including but not limited to; 

Asthma, Back Problems, Diabetes, and Migraines:

________________________________________________________________________

________________________________________________________________________

________________________________________________________________________

Primary Physician: _________________________Phone Number:____________________

Health Insurance: Insurance information is required of all participants and evidence thereof 

must be provided before a person is permitted riding privileges or enrolled in a riding program. 

Insurance Company: ________________________________________________________ 

Address: ______________________________Telephone Number: ___________________

Name of PolicyHolder: ______________________________________________________

Group #: ______________________________ Policy #: ____________________________ 

 

Signature of Particpant: _____________________________________________________ 

 

Signature of Parent/Guardian: _________________________________________________

 

ACKNOWLEDGMENT OF RISKS, ACCEPTANCE OF 

RESPONSIBILTY, AND WAIVER OF CLAIMS

I recognize that there is a significant element of risk involved in horseback riding and the handling of horses. I state that I am fully capable of participating in such activities and I certify that I have no physical conditions, which might interfere with my capability to participate in horseback riding. Knowing the inherent risks, damages, and rigors involved in horseback riding, I assume responsibility for myself / my child for bodily injury, death, loss of personal property and all expenses thereof, which may occur as a result of my / my child's participation in the handling of horses and/or horseback riding and waive any and all claims which may result therefrom. 

I recognize that the risk of serious injury is increased by not wearing certified helmet while horseback riding. I agree to wear a certified protective helmet all times and understand that ALL students are required to wear Certified helmets any time mounted on a horse. 

I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me / my child during the entire period of my participation in handling of horses and / or taking of horseback riding lessons upon the premises of Trademark Stables, LLC. / Jennifer Lafforthun / Ethel Hodges shall not be liable and under direction of Trademark Stables on off-site locations. 

Signature of participant or parent / guardian if under 18. 

This is the _________ day of ________________________, 20___. 

 

WARNING! Under North Carolina law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 99E of the North Carolina Statutes.

S 99E-2 Liability Except as provided in subsection (b) of this section, an equine activity sponsor, an equines professional, or any other person engaged in equine activity, including a corporation or partnership, shall not be liable for an injury to or the death of a participant resulting from inherent risks of equine activities and, except as provided in subsection (b) of this section, no participant or participant's representative shall maintain action against or recover am equine activity sponsor, an equine professional, or any other person engaged in an equine activity for injury, loss, damage, or death of the participant resulting exclusively from any of the inherent risks of equine activities.     

 

___________________________________________________ Participant 

 

___________________________________________________ Parent / Guardian

Trademark Lesson Packages|Trademark Barn Rules|Trademark Riding Waiver|Trademark Boarding Agreement|Trademark Pricing Sheet|Camp 2006|Track out camp