REGISTRATION AND PHOTO RELEASE FORM

Client/Rider:  Date of Birth:  Age:

Address:   City:  State:

Email:

Home Phone:   Work Phone:  Emergency Phone:

Parent or Guardian:

Address: Phone:

School or Institution Currently Attending:

In Case Of Emergency Contact:  Phone:

In Case Of Emergency Contact:  Phone:

LIABILITY RELEASE:

 (Client/Rider's Name) would like to participate in the Paradise Ranch horseback riding program. I acknowledge the risks and potential for risks of horseback riding. However, I feel that the possible benefits to myself/my child/ my ward are greater than the risk assumed. I hereby, intend to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damages against Paradise Ranch, it's owners, instructors, therapists, aides, volunteers and/or employees for any and all injuries and/or losses I/my child/ my ward may sustain while participating in the horseback riding program at Paradise Ranch.

 I AGREE (Check box to acknowledge risks and waive damages against Paradise Ranch)

Signature:  Relationship:  Date:

PHOTO RELEASE: (Optional)

I hereby consent to and authorize the use and reproduction by Paradise Ranch of any and all photographs and any other audiovisual materials taken of me/ my child/ my ward for promotional printed material, educational activities, or for any other use for the benefit of the program.

 I AGREE (Check box to authorize photo release)

Signature:  Relationship:  Date: