Personal Information

Participant Name *

Date of Birth *

Month

Day

Year

SK Health Card Number

Parent or Guardian Name *

Mailing Address

City

Province

Postal Code

Phone

Email Address *

Emergency Contact Name *

Emergency Contact Phone *

Medical Conditions (if applicable)

Allergies (if applicable)

Current Medications (if applicable)

Recent Injuries or Surgeries (if applicable)

Have you had prior experience with horses or bodywork sessions?HorsesBodyworkNone

What are your goals for participating in our activities or wellness sessions?

Equine Activities Waiver and Release of Liability

WARNING: This agreement will affect your legal rights. Read it carefully.

I conﬁrm that I have reached the age of majority in the province in which I am participating in “Equine Activities”. *I agree

As the parent or guardian of the child participant, I confirm that I have reached the age of majority in the province where the Equine Activities are taking place. I am signing this waiver on their behalf, with the intention that it be legally binding on both myself and the child participant for all purposes. *I agree

I am aware that there are inherent dangers, hazards, and risks (“Risks”) associated with equine activities, including but not limited to: • The unpredictability of equines' behavior. • The potential for injury, harm, or death due to collisions, bites, or kicks. • The negligence of other participants or the presence of natural/man-made hazards. *I agree

I freely accept and assume all responsibility for personal injury, illness, death, or property damage resulting from my and/or my child's participation in equine activities. *I agree

I release the “Host” from all liability, including negligence, breach of duty, and error in judgment. *I agree

I understand this waiver is governed by the laws of the province in which the equine activities occur. *I agree

I grant permission for the use of my and/or my child's photos/videos for promotional purposes. *I agree

I confirm I have read and understood this waiver in its entirety. *I agree

Rules Agreement

I agree to follow all the rules, including:

Wearing an approved helmet (ASTM/SEI) when mounted.
Ensuring children are supervised.
Respecting farm animals and property.
Wearing closed-toe footwear when handling horses.
No dogs on the property.
No running or shouting around horses.
Cleaning up after myself and my horse.
Asking questions when uncertain.
Parking in designated areas.

Bodywork (Hands On & Energetic) / TRE Waiver

I understand that bodywork/TRE (Tension & Trauma Releasing Exercises) sessions are not a substitute for medical care. I acknowledge that:

Sessions may involve hands-on or energetic techniques.
I will communicate any discomfort during sessions.
Results vary and are not guaranteed.
The practitioner is not liable for any adverse reactions.

Signature *

Date

March 16, 2025

Personal Information Form
Waivers and Rules Agreement