January 20 -22, 2009 - Rodrigo Costa Matos Dressage Clinic - Release and Consent

RELEASE AND CONSENT

 

I, ______________________________, voluntarily have chosen to participate in and ride my horse in the Rodrigo Matos Riding Clinic on _______________________, organized by Louise Levesque, and held at Silver Sands Equestrian Center, and I knowingly, execute this Release and Consent.

I hereby expressly release, discharge and hold harmless,  Louise Levesque and Silver Sands Equestrian Center, their appointees, employees, volunteers, agents, or its successors in interest, from any and all injuries, damages, claims, causes of action, lawsuits or judgments of any kind or nature that I may have, known or unknown, or that any person claiming through me may have or claim to have against Louise Levesque and Silver Sands Equestrian Center, their appointees, employees, volunteers, agents,  or successors in interest, created by or arising out of, or during, or following my  participation in the Rodrigo Matos Riding Clinic, or  resulting therefrom,  through any act or omission to act by anyone, whether they be the undersigned,   Louise Levesque or Silver Sands Equestrian Center., their appointees, employees, volunteers, agents, successors in interest or whomsoever.

It is my intention that this Release be binding on my heirs, legal representatives and assigns, and that its coverage extend to the appointees, employees, volunteers, agents or successors in interest of Louise Levesque and  Silver Sands Equestrian Center.

This instrument is a complete waiver and release of any claim I have as a result of my participation in the Rodrigo Matos Riding Clinic.

 

 

 

 

_________________________

Date Signed

 

_______________________________________

Signature

 

_______________________________________

Print Name

 

_______________________________________

Address

_______________________________________

 

 

_______________________________________

Telephone Number

 

 

 




GET THE LATEST NEWS DELIVERED TO YOUR MAILBOX