The minor whose name is listed below has my permission to participate in all activities at the Bar SZ Ranch, including riding horses and working with all animals. The undersigned agrees to hold the Bar SZ Ranch, its officers and employees thereof, harmless from any claim for injury to the below named minor arising out of or in any way connected with the program.
I (we) the undersigned parent, parents or legal guardian of
List each medication, the dosage, time taken each day, and the reason for taking
If none, fill in N/A
“I RECOGNIZE THAT THE BAR SZ RANCH IS DANGEROUS AND CONTAINS RISK OF PERSONNEL INJURY, DEATH, DISABILITY, PROPERTY DAMAGE OR LOSS (“DAMAGES”). I ASSUME ANY AND ALL RISKS associated with my child’s participation in the Bar SZ Ranch Program, including, but not limited to, strenuous physical activity or exertion; striking or being struck by objects or persons; slipping; and exposure to heat, cold, and humidity. Such risks may result in injuries that include, but are not limited to, sprain, strain, or tear of muscles or ligaments; fracture or dislocation or joints or bones; head or facial injuries; spinal cord or internal injuries; or drowning. I know that these risks, hazards, and dangers include, but are not limited to, falling, slipping, or colliding with other users, staff or spectators. I understand that these risks, hazards, and dangers are further increased when other persons, whether or not of the same level of experience, are present at the same time using the same facilities. ALL SUCH RISKS ARE KNOWN AND APPRECIATED BY ME.”
I give the Bar SZ Ranch permission to make photographs, videotapes, films or other likenesses of me, my child or legal ward. I hereby grant to Bar SZ Ranch the unrestricted right to copyright any of the above-mentioned materials containing images of me, my child or legal ward as well as the unrestricted right to use and reuse them, with their caption information, in whole or in part, in any manner, for any purpose and in any medium now known or hereinafter invented. These rights include, but are not limited to, the right to publish, copy, distribute, alter, license and publicly display these materials and images for editorial, trade, marketing and/or advertising purposes, I also grant to Bar SZ Ranch and its licensees the unrestricted right to use and disclose my name in connection with use of the above materials.
I understand and agree that I will not be paid for any use described above.
I also waive, and release and discharge the Bar SZ Ranch, its officers, employees and/or agents from, any and all claims arising out of or in connection with any use of the materials , caption information and images described above, including any and all claims for libel, defamation and/or invasion of privacy or publicity. I realize I cannot withdraw my consent after I sign this form and realize this form is binding on me and my heirs, legal representative and assigns.