intake-form | Rock Hill Farm Llc

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ROCK HILL FARM LLC RELEASE AND HOLD HARMLESS AGREEMENT

One form per Adult Rider or per Adult who is responsible for minor riders.

First name of Responsible Adult

Last name

Address

Phone

Names of Minors who will be riding (if any)

Emergency Contact Name

Emergency Contact Phone

Please list all of your medical conditions & preferences

How did you hear about us?

By signing this document, I acknowledge the inherent risks and voluntarily assume full responsibility for any injury, damage, or loss that may result from my participation. I hereby waive and release the business, its owners, and its staff from any and all liability, past, present, and future, relating to the services provided.

Signature

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