Waiver of Liability and Release Are you over the age of 18?* Yes No In order to proceed, the Parent/Guardian that agrees to supervise you at all times when you are at any Sand Dancing Pty Ltd property must have previously completed a Waiver of Liability and Release for themselves. Please enter the Sand Dancing Waiver number issued to the responsible Parent/GuardianParent/Guardian Waiver Number* Please remember that horse riding and being on a farm are dangerous activities Please read the following carefully I (and guardian) fully understand(s) and acknowledge(s) that: Horse riding on a working farm is a dangerous activity and people can be injured doing it Horses can act in an unpredictable or changeable way, especially if frightened or hurt Hazards and obstructions can exist when being involved with horses, including any and all outside influences, including local wildlife and insects disturbing the horse Riding arenas and the rest of the facilities are shared spaces and other riders and/or horses may act in an unpredictable or dangerous way whilst I am sharing the facilities Riding gear and equipment can break and fail The surface and ground can be rough and uneven, especially after wet weather My horse could throw me or brush me up against a wall, fence, trees or other objects Machinery used on a farm is potentially dangerous There are many other general dangers Injury or death may arise from these dangerous activities I agree that: I will ride at the farm at my own risk The proprietor/instructor and all other employees of Sand Dancing Pty Ltd are not liable for any injury, death, loss or damage which may occur to me or my property during the time I spend on the farm I ride horses whether such liability arises out of expenses or implied term or at common law or in any other way I will pay due regard for the safety of other riders, employees and instructors I will always wear a safety helmet, suitable clothing and riding boots when riding I will follow any and all instructions given by employees for the safe handling of horses on the property I agree that while I am on the property I will not: Take or use any drug, except prescription drugs Drink alcohol before or during a horse ride Enter any enclosed paddock or riding arena unless requested, directed or supervised by an employee If you wish to assume responsibility for the risks involved in riding and handling horses, then please complete and submit the followingName* First Last Email* Phone*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial 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GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Emergency Contact Name*Emergency Contact Number*Health* I am in good health I have the following physical disabilities and/or chronic illness or conditions: Please describe any conditions:Riding Experience* Very Experienced Experienced Less than 20 hours Never ridden Terms of ServiceI (and guardian) fully understand(s) and acknowledge(s) that: - Horse riding on a working farm is a dangerous activity and people can be injured doing it - Horses can act in an unpredictable or changeable way, especially if frightened or hurt - Hazards and obstructions can exist when being involved with horses, including any and all outside influences, including local wildlife and insects disturbing the horse - Riding arenas and the rest of the facilities are shared spaces and other riders and/or horses may act in an unpredictable or dangerous way whilst I am sharing the facilities - Riding gear and equipment can break and fail - The surface and ground can be rough and uneven, especially after wet weather - My horse could throw me or brush me up against a wall, fence, trees or other objects - Machinery used on a farm is potentially dangerous - There are many other general dangers - Injury or death may arise from these dangerous activities I agree that: - I will ride at the farm at my own risk - The proprietor/instructor and all other employees of Sand Dancing Pty Ltd are not liable for any injury, death, loss or damage which may occur to me or my property during the time I spend on the farm - I ride horses whether such liability arises out of expenses or implied term or at common law or in any other way - I will pay due regard for the safety of other riders, employees and instructors - I will always wear a safety helmet, suitable clothing and riding boots when riding - I will follow any and all instructions given by employees for the safe handling of horses on the property I agree that while I am on the property I will not: - Take or use any drug, except prescription drugs - Drink alcohol before or during a horse ride - Enter any enclosed paddock or riding arena unless requested, directed or supervised by an employee I agree to the Terms of Service Acknowledgement* I take full responsibility for providing my own horse and equipment I take full responsibility for the correct fitting and safety of my equipment By submitting this form I acknowledge that I have read, understand and agree to abide by all the conditions and requirements in this agreement Upon clicking the Submit button below, I hereby acknowledge that I have read and fully understand the meaning of this form. I confirm I am not under the influence of drugs or alcohol. I understand that I give a complete and unconditional release of all liability of the proprietors, instructors and employees of Sand Dancing Pty Ltd to the greatest extent possible under the law of New South Wales. In the event I and/or the child mentioned above suffer any death, personal injury or loss or damage of possessions, I agree to indemnify the proprietors, instructors and employees of Sand Dancing Pty Ltd against all claims made by any other person against the proprietors, instructors and employees of Sand Dancing Pty Ltd in respect of any injury loss or damage arising out of or in connection with riding and being a guest on the property.CAPTCHADate* DD slash MM slash YYYY
