Release and Hold Harmless Agreement
 
The Participant acknowledges the inherent risks which are involved in riding, driving, and working around horses. These risks may include, but are not limited to, damage to personal property, illness, bodily injury, trauma, or death resulting from a fall or while riding, driving, or being in close proximity to horses.
 
The Participant further understands that both horse and rider can be injured in the normal course of events while driving, hacking, schooling, or competing, and therefore agrees to indemnify and hold harmless Cypress Keep, its owners, employees, and its guest instructors, and further release them from any liability or responsibility for any accident, injury, damage, or death to the Participant or any property or horse the Participant owns, or to any family member or spectator accompanying the Participant while on the premises of Cypress Keep. The
 
 
Signature of Participant                                                                                     Date
 
Printed Name of Participant
 
Signature of Parent or Legal Guardian (if Participant in under 18 years of age)
 
 Address                                               City                  State                            Zip code
 
 Home Telephone                                              Work Telephone
 
Email Address or other contact information
 
Horse Name                                      Breed                 Color               Gender       Age
 
Accession Number on Coggins Test                              Date of Test
 
Please print this form from your browser, fill it out, and bring with your original Coggins certificate to your event at Cypress Keep. You can also download this form to your Microsoft Word.
Click here to Go Back to the equestrian page.
 
Cypress Keep Services     cypresskeep.com
 John Porter  and Erika Matulich      4909 Stanley Road    Plant City, Florida 33565
 [email protected]   (813) 982-2200 [phone]   (813) 982-9709 [fax]