Circle B Stables                                                                     Release and Waiver For consideration in the form of participation in horse back riding, horse back riding instruction or supervision, the Handicapped Assisted Riding Program, the daily care of horses, and/or incidental activities related to horses, including barrel racing, and including but not limited to any other activities which I might engage in, including the Youth Camp program, either before, during or after engaging in said activities (the “Activities”) and other valuable consideration, I the undersigned, by my signature below, do hereby voluntarily release, waive, hold harmless and/or discharge  Circle B Stables, it’s owners, manager, employees, agents, servants and successors, the owners of the real property and all persons directly, or in any way relating to: •        My voluntary participation in the “Activities” including but not limited to all Youth Camp activities,swimming fishing, crafting, hiking, horseback riding lessons and instruction, and all that follows in this form. •        My presence at the farm •        Any and all risks to my personal health and well-being which I will be subjected to by virtue of my participation in the “Activities”  Any other activities of any conceivable kind related directly or indirectly to the “Activities” This Release and Waiver is meant and intended to include all such personal injuries, conscious suffering, emotional distress, property damage and/or personal claims. I understand that there is an inherent risk involved in any equine activity.  I have read and thoroughly understand that Ohio’s Equine Liability Act, (2305.321) specifically defines the term “inherent risk of an equine activity” to mean a “danger or condition that is an integral part of an equine activity, including, but not limited to, any of the following”: •        “The propensity of an equine to behave in ways that may result in injury, death or loss to persons on or around the equine •        The unpredictability of equine’s reaction to sounds, sudden movements, unfamiliar objects, persons, or other animals •        Hazards, including, but not limited to, surface or subsurface conditions •        A collision with another equine, another animal, a person, or an object •        The potential of an equine activity participant to act in a negligent manner that may contribute to injury, death or loss to the person of the participant or to other persons, including, but not limited to, failing to maintain control over an equine or failing to act within the ability of the participant” I understand that before I sign this document, I have the right to review this Release and Waiver with whomever I should so choose, including legal counsel, and my insurance/health care provider. I have full health care insurance that I maintain current and active and my health care  provider is agreeable to covering my medical expenses in the event an injury occurs during equine related activities, and, any and all Youth Camp activities with Circle-B-Stables, at the stables or elsewhere, be it a horse show or other related activity off the premises. In the event that my provider refuses coverage, I will assume sole responsibility for any and all medical bills incurred. My signature below, indicates that I have full knowledge of the consequences of my executing this document.   Moreover, by my signature below, I expressly acknowledge that I have not been pressured, coerced, or otherwise forced by Peniel (Penny-L) Equine Center, Circle B Stables, and Tom, Mindy or Erin Baker to execute this full Release and Waiver, and have the full mental capacity to understand the consequences of my release of Peniel Equine Center, Circle B Stables Tom, Mindy and Erin Baker from any and all claims that conceivably would relate to my participation in any activities at the farm. In the event  I breach this contract, I agree to pay all legal fees for both parties involved.  I have read and understand this Release and Waiver of my rights to sue, I understand the risks involved in an equine activity, Ohio Statute 2305.321, and that this is part of a legal and binding contract to provide a service for recreational activity which leaves me no legal recourse.  I fully agree not to involve in any way, shape or form, Circle B Stables, Tom, Mindy or Erin Baker, their insurance carrier, mortgage company or other, in any action, be it civil, criminal, verbal, written or otherwise, brought on by my attorney, insurance provider or other.     Dated this _________ day of  ______________, __________. ____________________________ In the event that the undersigned is under the age of   Signature of Participant                   eighteen (18), the signature of a parent or guardian is required. ____________________________         _________________________    ___________________________ Printed Name of Participant                        Parent/Guardian signature                  Address ____________________________         _________________________    ___________________________ Participant’s Date of Birth                       Printed Name                           Phone