Release and Waiver of Liability Assumption of Risk and Indemnity Agreement.

This waiver must be completed in full by any adult (18+) that intends on visiting Blazing Saddles Farm or obtaining our services off the property for any reason.

Adults must sign the waiver for themselves AND for the children that accompany them (if that applies). Those who visit may not have any children accompanying them but they still must sign a waiver for themselves.

Do not fill out the waiver as your child - add your child's name at the end of the waiver as the guardian takes responsibility for said child

First Name (Adult OR Parent/Guardian)

Last Name (Adult OR Parent/Guardian)

Date of Birth (Adult OR Parent/Gaurdian DOB)

Phone

Under Massachusetts law, an equine professional is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities, pursuant to section 2D of chapter 128 of the General Laws.

By signing this form, I hereby acknowledge that I have familiarized myself with the activities that I, my children, and children under my care, will be allowed to participate in, and that I do hereby acknowledge and agree that I will participate in these activities without restriction or limitation. Regardless of the temperament or size of the horse, I recognize the inherent risks involved in riding and working with horses and animals, including but not limited to:

Bites, kicks, abrasions or contusions from horses, or being thrown or bucked off.
Scratches or other injury from stalls or enclosures, grooming tools, or equine tack.
Allergic reactions to animals, hay, or other allergens.
Tripping in holes or on materials or equipment
Slipping, falling, or otherwise being injured in the barn, in stalls, or on the grounds, which can be slippery, muddy, wet, or contain or present other hazards.
Moving parts in equine drawn cart - Other animals (goats, cows, rabbits, chickens, etc) may intentionally or playfully mouth or accidentally scratch, bite, kick, or buck if startled.

I fully understand these risks and consent to waiver, and am acting on behalf of all persons or children in my care, having obtained permission and consent on their behalf prior to any pony ride or petting zoo activity if they are not present at time of. Every safety precaution is taken and helmets are required by riders, and although unlikely, horses may “spook” or other animals may become startled from unforeseen interferences resulting in aforementioned risks. Listen to directions from staff!

Initials

I hereby specifically forever waive and release DBA Blazing Saddles and its principals and agents from any liability for injury arising out of the inherent risks from riding, working or participating in pony rides and/or with horses and/or farm animals.

I understand that I am responsible for every child aged 17 or younger that I list below whether they are accompanied by me or another adult.

Yes

1. List the First and Last Names of All Children You Are Responsible For and Their Date of Birth.
2. Write the Date of the Event You Are Attending.

Thanks for submitting!

Printable Versions

GOOGLE DOCUMENT

Release and Waiver of Liability Assumption of Risk and Indemnity Agreement.

1. List the First and Last Names of All Children You Are Responsible For and Their Date of Birth. 2. Write the Date of the Event You Are Attending.

Printable Versions

1. List the First and Last Names of All Children You Are Responsible For and Their Date of Birth.
2. Write the Date of the Event You Are Attending.