Elk Haven Equestrian Center
Liability Release and Agreement for this Facility

Please read carefully, print, and bring it pre-signed for when you arrive.

I HAVE READ THE RULES AND THE LIABILITY FORM ABOVE AND AGREE TO ABIDE BY THE RULES AND AGREE TO THE LIABILITY FORM!

Printed name__________________________________    Address ______________________________________  City ____________________  Zip _________

email ________________________________________  Emergency contact name __________________________ Phone ________________________________
If you are a child under the supervision of the adult named above, check child and sign to indicate to indicate that you are familiar with the rules and liability agreement.  If you are an adult, you check adult and sign.  If you are supervising minors, you are to initial after each child you are supervising signifying that you have gone over the rules and liability form with them.  Please note that you are responsible for them at all times they are on the premises.

__ Child __ Adult  Signature _____________________________________ Date _________________________ If minor, adult's initials _____________

__ Child __ Adult  Signature _____________________________________ Date _________________________ If minor, adult's initials _____________

__ Child __ Adult  Signature _____________________________________ Date _________________________ If minor, adult's initials _____________

__ Child __ Adult  Signature _____________________________________ Date _________________________ If minor, adult's initials _____________

__ Child __ Adult  Signature _____________________________________ Date _________________________ If minor, adult's initials _____________