Dated:
Participant Name:
Cell Phone: Alternate Phone:
Participant Release & Photo Release
Known by all present:
The undersigned understands and agrees that there is inherent risk of injury in all equine-related
activities, both mounted and non-mounted. It is understood that horses may stumble, bite, run, or
make unpredictable movements
which may cause a participant to be injured by or fall from the horse. I am willing and able to
accept full responsibility for my own safety and welfare. I do hereby release and discharge Al's
Horse Academy, its instructors, staff, volunteers and horse owners from any and all responsibility
or liability to me in connection with any injuries suffered by me as a result of my
activity/participation involving Al's Horse Academy horses/ponies, and property.
PHOTO/VIDEO RELEASE: I hereby grant Al's Horse Academy permission to use any and all photographs,
slides and any other audiovisual materials in which I may appear for
the express purpose of promoting Al's Horse Academy programs and I do not expect, nor shall I
receive any monetary reimbursement for this authorization.
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