Guest Waiver, Release, and Indemnity Your Name * Name of person completing form. First Name Last Name Your Email * Your Phone * (###) ### #### Your Address * Address 1 Address 2 City State/Province Zip/Postal Code Country You are completing this form for: * Yourself A minor (under age 18) Guest Name * Enter your name if you checked "yourself" above. Enter the minor's name if you checked "A minor" above. First Name Last Name Guest date of birth * MM DD YYYY Guest's Emergency Contact Name * First Name Last Name Guest's Emergency Contact Phone * (###) ### #### Waiver Agreement * By signing this agreement GUEST is giving up certain legal rights, including the right to recover damages in case of injury, death, or property damage, arising out of observation of or participation in equine activities with Peace of Mind Dressage, LLC and/or Peace of Mind Farm, LLC. This waiver, release, and indemnity agreement is intended to be given for the benefit of PEACE OF MIND DRESSAGE, LLC (d/b/a Peace of Mind Equestrian Academy, POM Equestrian Academy, Peace of Mind Equestrian, POM Equestrian, POM Dressage, Peace of Mind Dressage), whose principal place of business is 15012 Clover Hill Road, Waterford, VA 20197 (hereafter “PROPERTY”), and its officers, directors, owners, managers, employees, agents, and successors in interest. All of the foregoing are hereinafter jointly and severally referred to as “POM DRESSAGE.” This waiver, release, and indemnity agreement is also intended to be given for the benefit of PEACE OF MIND FARM, LLC, whose principal place of business is 15012 Clover Hill Road, Waterford, VA 20197, and its officers, directors, owners, managers, employees, agents, and successors in interest. All of the foregoing are hereinafter jointly and severally referred to as “POM FARM.” GUEST (identified above) is a person who may, frequently, once, more than once, and/or from time to time, visit and/or utilize the farm facilities and services for equestrian activities, including but not limited to observing, visiting, riding, boarding, stabling, training, lessons, showing, entertaining guests, accompanying another person engaging in equestrian activities, riding a tractor, and any and all types of activities associated directly or indirectly with equestrian activities with POM DRESSAGE and/or POM FARM. If GUEST is a minor (under the age of 18 years), the term GUEST as used herein includes the minor and the undersigned parent(s) and guardian(s), jointly and severally. For receipt of any services and/or for observation of or participation in any activities at PROPERTY and/or with POM DRESSAGE, in addition to any fees charged or consideration provided for in a separate agreement(s), providing and making available services and facilities to GUEST, GUEST hereby, for himself/herself and for his or her heirs, and legal representatives, expressly agrees to the following: 1. GUEST hereby assumes any and all risks involved in arising from GUEST’s use of or presence upon PROPERTY or any other location or facilities when observing or participating in a POM DRESSAGE and/or POM FARM sponsored activity, when interacting with a horse owned by or leased by or otherwise controlled by POM DRESSAGE, including, without limitation, the risks of death, bodily injury, property damage, falls, kicks, bites, collisions with vehicles, tractors, horses, or stationary objects, fire, or explosion, the unavailability of emergency medical care, allergies, faulty equipment or tack, and/or the negligence or deliberate act any person. It is the responsibility of GUEST to carry full and complete insurance coverage on his/her horse, his/her personal property, and himself/herself or minors under his/her care. 2. GUEST agrees to hold POM FARM and POM DRESSAGE harmless and not liable and hereby releases POM FARM and POM DRESSAGE from any and all liability whatsoever, and agrees not to sue POM FARM and POM DRESSAGE on account of or in connection with any claims, causes of action, injuries, damages, costs, or expenses arising out of GUEST’s use of or presence upon PROPERTY or any other location or facilities when participating in or observing a POM DRESSAGE and/or POM FARM sponsored activity, including without limitation, those based on death, negligence, faulty equipment or tack, deliberate acts, bodily injury, property damage, and/or consequential damages. 3. GUEST agrees to waive any protection afforded by any statute or law whose purpose, substance, and/or effect is to provide that a general release shall not extend to claims, material or otherwise, which the person giving the release does not know or suspect to exist at the time of executing the release. GUEST acknowledges that horseback riding, the handling of a horse, or being in close proximity to a horse is an inherently dangerous activity and involves risks that may cause serious injury and in some cases permanent disability or death. GUEST hereby assumes all risk associated with equine activities including all intrinsic dangers, whether apparent or unforeseeable. GUEST acknowledges that this waiver is required, in part, due to the unpredictable nature and behavior of horses, regardless of their training or past performance. 4. GUEST agrees to indemnify, defend, and hold harmless POM FARM and POM DRESSAGE against, and hold it harmless from, any and all claims, causes or action, damages, judgments, costs, or expenses, including reasonable attorneys’ fees which in any way arise from GUEST’s or a third party’s use of the facilities and/or horses at POM DRESSAGE and/or POM FARM, or which may arise from GUEST’s or a third party’s presence upon POM FARM and/or POM DRESSAGE property, and/or from participation in a POM FARM and/or POM DRESSAGE sponsored activity, program, or show. 5. GUEST agrees to abide by all POM FARM and POM DRESSAGE rules and regulations, which may be communicated in any manner by POM FARM or POM DRESSAGE (e.g., verbally). 6. GUEST agrees to indemnify, defend and hold harmless POM FARM and POM DRESSAGE for any injury, sickness or death of any horse(s) GUEST brings to or keeps at PROPERTY. GUEST agrees to indemnify and hold harmless POM FARM and POM DRESSAGE against any and all claims, including third party claims for any injury, sickness and/or death to any horse(s) which are the result of or associated with the training or care of the horse(s). 7. POM FARM and POM DRESSAGE reserve the right to refuse to allow GUEST to enter PROPERTY for any reason, and/or to use GUEST’s horse upon PROPERTY and/or to use GUEST’s horse in any POM FARM or POM DRESSAGE sponsored activity for any reason. 8. GUEST agrees that POM DRESSAGE may use, for marketing and promotional purposes, including on social media, any and all photos POM DRESSAGE or a third party takes of GUEST and/or any person accompanying GUEST while GUEST or person accompanying GUEST is at PROPERTY and/or observing or participating in a POM DRESSAGE sponsored equine activity. GUEST agrees to hold POM DRESSAGE harmless and not liable for any and hereby releases POM DRESSAGE from any and all liability whatsoever, and agrees not to sue POM FARM and POM DRESSAGE on account of or in connection with any claims, causes of action, injuries, damages, costs, or expenses arising out of POM DRESSAGE’s use of said photos. 9. This agreement is made and entered into in the State of VIRGINIA and shall be enforced and interpreted under the laws of this state. Should any clause be in conflict with the state law, then that clause shall be severed from this contract, and the remaining clauses and provisions of this contract shall be enforceable. When POM FARM and POM DRESSAGE and GUEST, and GUEST’s parent or guardian if GUEST is a minor, sign this agreement, it will then be binding on all parties, subject to the included terms and conditions. 10. GUEST acknowledges that this document contains the entire agreement between the parties and is binding upon heirs, legal representatives, and assigns of the parties hereto. 11. This agreement is independent of any agreement for the use of facilities or services which may now exist or which may be entered into in the future and shall be deemed applicable to and part of any such agreement. This agreement may not be canceled, terminated, or otherwise changed or modified except by an instrument in writing executed by POM FARM and POM DRESSAGE and the GUEST. I HAVE READ, UNDERSTOOD, AND AGREED TO EACH PROVISION OF THIS AGREEMENT. SIgnature * Thank you and welcome to Peace of Mind Equestrian Academy.