I am aware of the fact that horseback riding, and all
horse related activities at and around the farm, entail risks to person and
property. I hereby request to join in these activities, for which I shall be
solely responsible; this after having considered these risks (and I am aware
that these risks exist, even when all safety rules are obeyed. I am also aware
of the fact that horses have an unpredictable nature) have decided to
accept them in full.
Knowing that you shall not be liable with respect to me
in any manner or form for damage and loss liable caused to my person and / or my
property in the course of riding horses or handling horses or being in the
proximity of horses. And consequently hereby waive action or claim against
the farm and against your employees or the farm owner, due to any damage
which is liable to be caused to my person and/or my property in connection with
the horseback riding, or any activities connected with the farm, even if related
to negligence or omission by the farm workers' employees or owners. I am aware I
must be completely healthy.
I am aware that I must be over the age of 18 in order to
sign this form. I am aware of the factthat I am not insured, but have the option of insuring myself personally.
I read and understand the English language. I, the undersigned (signing of my
own free will) declare that I have read and understood the above, as well as the
safety instructions and I agree to all.
Declaration on behalf of
minor:
all the
above is known to me, and after considering these hazards, have decided
to fully assume them upon myself. And I hereby waive also of behalf of the minor
any claim raised against you, in witness hereof I have set my
signature.
שם
משפחה של החותם
Family name
of the undersigned
שם
פרטי של החותם
Private name of the
undersigned
תעודת
זהות
I.D.
כתובת
\ טלפון
Phone/Address
חתימה
Signature
שם
המשתתף
(ימולא
אם המשתתף קטין, והורה\משגיח חותם עבורו)
Name of
participant (18+),or guardian, ora parent of participating
minor.
