Application and Waiver
APPLICATION

NAME:____________________________________

SESSION DATES:_______________ ___________

BIRTHDATE:______________________________

ADDRESS:_____________________ ___________

EMAIL:____________________________________

PHONE #:__________________________________

EQUINE EXPERIENCE:________________________

EMERGENCE CONTACTS:

                                                                               

ALLERGIES:

____-_______________________________________

MEDICATION:

____________________________________________

FAVORITE FOOD:___________________________

SPECIAL INTERESTS:________________________

ANYTHING ELSE YOU WOULD LIKE US TO KNOW:

                                                                                   

****WARNING****

UNDER KENTUCKY LAW, A FARM ANIMAL ACTIVITY SPONSOR, OR FARM ANIMAL
PROFESSIONAL, OR OTHER PERSON DOES NOT HAVE THE DUTY TO ELIMINATE ALL RISKS
OF PARTICIPATION IN FARM ANIMAL ACTIVITIES. THERE ARE INHERENT RISKS OF INJURY OR
DEATH THAT YOU VOLUNTARILY ACCEPT IF YOU PARTICIPATE IN FARM ANIMAL ACTIVITIES.

IT IS EXPRESSLY UNDERSTOOD THAT ALL RIDING OR DRIVING OR SPECTATING
UNDERTAKEN BY ME, MY CHILD/CHILDREN, OR OUR GUESTS ON THE PREMISES OF
BRANNON FARMS SHALL BE AT MY SOLE RISK. THE FARM'S OWNERS AND EMPLOYEES,
AND ANY INSTRUCTORS AND THEIR EMPLOYEES SHALL NOT BE LIABLE FOR ANY CLAIMS,
DEMANDS, INJURIES OR DEATH, DAMAGES, ACTIONS OR CAUSES OF ACTION,
WHATSOEVER, TO MY PERSON OR PROPERTY.

I HAVE READ THE ABOVE WARNING REQUIRED BY KRS 247.4027.

I, AND ANY PERSON ACCOMPANYING ME, AGREE TO COMPLY WITH THE RULES AND
REGUATIONS OF BRANNON FARM AS THEY PRETAIN TO RIDERS AND GUESTS OF THE
FACILITY.

I HEREBY GIVE MY PERMISSION FOR THE STABLES TO SEEK MEDICAL ATTENTION FOR
MYSELF OR GUEST IN EVENT OF AN ACCIDENT OR EMERGENCY.

I HEREBY GIVE MY PREMISSION TO THE MEDICAL FACILITY TO ORDER XRAYS, ROUTINE
TESTS, INJECTIONS, AND TREATMENT FOR THE HEALTH OF MYSELF OR MY GUESTS.



SIGNATURE OF RESPONSIBLE
PARTY____________________________________________________

SIGNATURE & NAME FOR MINOR CHILD TAKING LESSONS OR PARTICIPATING IN
ACTIVITIES____________________________________________________________________

DATE: ________________________________________________________