Triple H Ranch & Therapeutic Horsemanship

Riding in the Moment Registration Form

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Select the session(s) you are registering for:

Section 1: Photo/Video Release

During Riding in the Moment, horse camps, lessons, and other programming, we have some great photo/video opportunities. Triple H Ranch & Therapeutic Horsemanship would like your permission to use these photos/videos in print, social media, and online to promote our programs. 

I understand and consent that photos/videos taken during Riding in the Moment, horse camps, lessons, or other programming of the person listed on this application may be used and reproduced for promotional materials, educational activities, exhibitions, or for any other use for the benefit of the program, including printed, electronic, social, and news media.

I understand that it is my responsibility to update this form if I no longer wish to authorize the above uses. I understand that there will be no payment to participate in this release. 

Please check one below.

Section 2: Safety Rules

Triple H Ranch & Therapeutic Horsemanship strives to provide a safe experience for all of our clients/participants and requires that all clients/participants, families, guests, and volunteers abide by our safety regulations.

Please review and sign our safety rules. 

• Parents/caregivers must keep siblings, friends, and relatives of the rider in the designated “Family Waiting or Viewing Areas” while on the property.

• Parents/caregivers are responsible for participants before and after arena/therapeutic riding time. Parents/caregivers will meet their participant in the “Family Waiting Area” after they have dismounted the horse. 

• A volunteer will come to the “Family Waiting Area” to get the participant at the start of the lesson. Clients/participants should NOT enter the barn aisle area or tack room without their volunteers. 

• Parents/caregivers must remain on the Triple H Ranch premises during therapeutic riding and/or equine-assisted activities in designated areas. 

• NO PETS allowed on the property. If a participant with a disability has a Service Animal, please contact us to discuss the situation before bringing it to Triple H Ranch. 

• NO SMOKING, ALCOHOL, OR DRUGS ARE ALLOWED ON THE PROPERTY. 

• For training and safety purposes, we ask that volunteers and participants NEVER HAND FEED THE HORSES. 

• Hitting or kicking horses is NEVER allowed and will result in dismissal from the program.

• NO guns, knives, weapons, or violence of any kind are allowed on the Triple H Ranch premises. This is a zero-tolerance rule. Violators will be asked to leave and not allowed to return. 

• Please do not climb or lean on any fences, gates, or doors. Fences are electric- STAY OFF! 

• No visitors or volunteers are allowed on the property of Triple H Ranch outside of business hours without prior approval. 

• To ensure the safest programming conditions, we ask that children and visitors refrain from screaming, running, or ball playing on the premises. Only the participant and staff/volunteers are allowed in the teaching arena, unless the instructor asks a parent to enter. 

• Attire: Participants must wear a helmet at all times during the riding lesson. Long pants are recommended for both riders and volunteers. 

• All riding participants must wear closed-toe shoes with a heel. 

• All volunteers, parents/guardians, and guests are asked to wear closed-toed shoes while on the property. NO sandals, flip-flops, Crocs, Clogs, open-toed, or open-heeled shoes are allowed. Please keep a pair of appropriate shoes and socks in the car if needed.

  
  

  I have read and understand the Triple H Ranch & Therapeutic Horsemanship Safety Policy. 

Section 3: Release and Waiver of Liability

EQUINE RELEASE AND WAIVER OF LIABILITY, 

ASSUMPTION OF RISK, AND INDEMNITY AGREEMENT 

I hereby enter into this agreement in consideration of my / my child’s / my ward's ability and permission to ride OR use any Horse owned by Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., whose address is 5405 N. Kennedy Rd. Milton, WI 53563 

IMPORTANT NOTICE 

BY SIGNING THIS AGREEMENT YOU ARE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO RECOVER DAMAGES IN CASE OF INJURY, DEATH, OR PROPERTY DAMAGE, ARISING OUT OF YOUR RIDING OR USE OF THE OWNER’S HORSE AND/OR PARTICIPATION IN EQUINE ACTIVITIES AT Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., INCLUDING INJURY, DEATH, OR PROPERTY DAMAGE ARISING OUT OF THE NEGLIGENCE OF YOU OR Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc.

READ THIS AGREEMENT CAREFULLY BEFORE SIGNING IT. YOUR SIGNATURE INDICATES YOUR UNDERSTANDING OF AND AGREEMENT TO ITS TERMS. 

By signing this form, I hereby acknowledge on behalf of myself / my child/ my ward that I have familiarized myself with the activities that I will be allowed to participate in, and that I do hereby acknowledge and agree that I will participate in these activities without restriction or limitation. I recognize the inherent risks involved in riding and working with horses, being around goats and any other animals on premises, including but not limited to: 

• Bites, kicks, abrasions, or contusions from horses or other animals.

• Being thrown, falling off, or bucked off by horses. 

• Scratches, cuts, bruises, or other injuries from stalls or enclosures, fencing, or gates. 

• Scratches or other injuries from grooming tools, barn cleaning tools, equine equipment, tack, helmets, or boots, or any other equipment inside & outside of the barn. 

• Allergic reactions to animals, hay, or other allergens. 

• Tripping in holes or on materials or being injured by, on, or around equipment, machinery, fencing, or gates.

• Slipping, falling, or otherwise being injured in the barn, in stalls, in the arenas, or on the grounds, which can be slippery, muddy, wet, icy, snowy, or contain or present other hazards.

I hereby specifically forever waive and release Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., and its principals and agents, and family from any liability for injury arising out of the inherent risks from riding, working, or participating in a stable environment and/or with horses, as well as from the active negligence of Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., its principals, and agents.

By signing this agreement, I hereby acknowledge that although there may be supervision during my time spent at Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., there will not be a nurse or medical attention on the premises, and Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., and its principals and agents, and family bear no responsibility for my health or medical care. 

I agree to indemnify, save and hold harmless Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., and its principals and agents and family from and against any loss, liability, damage, attorneys’ fees, or costs that they may incur arising out of or in any way connected with either my presence or participation at Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., or any acts or omissions of Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., principals or agents or family. 

By signing this Agreement, and by initialing the paragraph below, I hereby acknowledge my complete understanding, agreement, and consent to my presence and/or participation in the activities at Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., without restriction, without liability to Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., its principals or agents or family, and with full knowledge and understanding of the disclosures, waivers, and releases herein.

If I am present at and participate in the activities of Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., I do so at my own risk, and I hereby acknowledge and agree that Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., and/or any of its principals and agents or family or minor children shall bear no responsibility or risk associated with injuries that could arise from my presence or participation at Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., Use of your own riding helmet is the helmet owners responsibility as to the condition, age & suitability of the helmet and not that of  Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., volunteers, staff, employees, principals, agents or family.

As a volunteer/participant at Triple H Ranch, I acknowledge the risks and potential risks of a horseback-riding program and related equine activities. However, the potential benefits to me and the clients/other participants I work with outweigh the risks I assume. I hereby, intending to be legally bound, for myself, my heirs and assigns, executors or administrators, waive and release forever all claims for damage against Triple H Ranch & Therapeutic Horsemanship, Foundation, Inc., instructors, therapists, volunteers, officers, directors, and/or employees for any injuries and/or losses I may sustain while participating in the Triple H Ranch programs.

Per Wisconsin Law relating to the limitation of civil liability regarding equine activities:

NOTICE A PERSON WHO IS ENGAGED FOR COMPENSATION IN THE RENTAL OF EQUINES OR EQUINE EQUIPMENT OR TACK OR IN THE INSTRUCTION OF A PERSON IN THE RIDING OR DRIVING OF AN EQUINE OR IN BEING A PASSENGER UPON AN EQUINE IS NOT LIABLE FOR THE INJURY OR DEATH OF A PERSON INVOLVED IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES, AS DEFINED IN SECTION 895.481(1)(E) OF THE WISCONSIN STATUTES.