Safety Equipment Acknowledgment Release Form

(For Participants Under theAge of Majority)

Clinic Dates:
 Infant Participants Name:
Clinic Location:
Infant Date of Birth:
 Infant Participants Address:
 Parent/Guardian's Name:
Parent/Guardian Date of Birth:
 Parent/Guardian Address:
No person riding without a helmet designed for equine activities will be allowed to participate in equine activities prior to reading and signing this form. Parent/Guardian must Read and Understand prior to the Infant Participating in Equine Activities
TO: The Horse Ranch 2005 Inc. / Glenn Stewart (Also known as “HR” for this document)
ACKNOWLEDGMENTS AND STATEMENTS OF PARENT/GUARDIAN
Check each box below after Reading and Understanding each item:
Before signing this form I read it (as indicated by my initials above) and I state that I understand it. I further state I am aware that signing this form, waives certain legal rights I and/or the infant Participant and/or our “Legal Representatives” might have against the “HR”.
Do Not Sign until you Understand All Items Above
Name of Parent/Guardian

Signature Of Parent/Guardian

Address:

34131 Township Road 262, Cochrane, Alberta

T4C 1A2

Canada

Business Hours

Mon:
8:00 AM – 9:00 PM
Tue:
Wed:
8:00 AM – 9:00 PM
8:00 AM – 9:00 PM
Thur:
8:00 AM – 9:00 PM
Fri:
Sat;
8:00 AM – 9:00 PM
8:00 AM – 9:00 PM
Sun:
8:00 AM – 9:00 PM