Twisted L Horsemanship LLC

Riding Instruction/Clinic Liability Waiver

This form must be completed by and for each individual who wishes to participate in equine activities under instruction of Twisted L Horsemanship LLC (Jessica and Dustin Lunsford). Please read this form in its entirety before signing, as we cannot guarantee your safety, and

serious injury can result from participation in equestrian activities.

Host Facility

Facility Owner/Representative

and Jessica and Dustin Lunsford (Instructors) of Twisted L

Horsemanship LLC assume no responsibility for any injury, loss, damage or death to human or equine.

Address of Host Facility/Event:

Participant Information

Name of Participant

Age (if under 21)

Equine Experience

Does the participant have any physical or mental health conditions that might affect his/her ability to participate in equine sports? If yes, describe:

I, (participant or guardian of minor)

agree that, in the event of an injury to THE RIDER OR HORSE, my insurance or myself will be responsible for covering any associated costs.

In consideration of payment of a fee and the signing of this agreement, I,

Short answer

(participant or guardian of minor) do hereby

voluntarily request and agree to participate in equine activity instructed by Twisted L Horsemanship LLC (Jessica and Dustin Lunsford), and that this student will participate with his/her own horse, for instructional or training purposes, today and on all future dates.

I, (participant or guardian of minor)

UNDERSTAND THAT:

Any participant under the age of 18 is REQUIRED to wear a helmet while mounted to participate in any clinic/lesson/training session instructed by Twisted L Horsemanship LLC

All participants are REQUIRED to wear proper footwear with heel when mounted to participate in any clinic/lesson/training session instructed by Twisted L Horsemanship LLC

No participant under the age of 18 may handle a stallion under the instruction of Twisted L Horsemanship LLC

Any horse brought onto host facility property must be accompanied by a current Negative Coggins Test

Twisted L Horsemanship LLC (Jessica or Dustin Lunsford) reserve the right to refuse participation of any person or horse deemed deliberately destructive or dangerous to self, other animals, or other participants at any point before, during, or after a Clinic or Lesson

I further attest that all statements relating to the applicant's physical

condition, experience level and relationship to parent or guardian are in fact true and accurate.

I agree to hold harmless Twisted L Horsemanship LLC, Jessica and Dustin Lunsford,

Host Facility

and

Facility Representative

SIGNATURE OF PARTICIPANT (OR GUARDIAN IF MINOR)

NAME OF PARTICIPANT (OR GUARDIAN IF MINOR)

DATE