Equestrian Center Waiver

Please complete this waiver (required annually) to participate in any Ken-Caryl Ranch Equestrian Center programs.

"*" indicates required fields

Participant Name*

First Last

Participant Date of Birth*

Participant Age*

Would you like to include another participant (same family)?

Participant Name 2

First Last

Participant 2 Date of Birth

Participant 2 Age

Are any of the participants under 18 years of age?*

Yes

Parent/Guardian Name

First Last

Email address*

Phone*

Second Parent/Guardian Name

First Last

2nd Parent/Guardian Email

2nd Parent/Guardian Phone

Address*

Street Address City State Zip

Emergency Contact (in case parent/guardian cannot be reached)*

First Last

Emergency Contact Phone*

Any pre-existing health conditions?

Participant's level of experience with horses:*

Lesson Program

Picnic with the Ponies Camp (ages 6-8)

Equestrian Summer Camp (ages 8+)

None

Experience at other equestrian facility

Click here for KCR Equestrian Center Facility Rules

Particpant or Parent/Guardian Signature*

I am either the participant OR the legal guardian of the above minor(s) and have read the above AGREEMENT. I give my unqualified permission and consent to: the RELEASE, WAIVER, ACKNOWLEDGEMENT OF RISK, INDEMNIFICATION AND HOLD HARMLESS AGREEMENT on behalf of myself and the named minor(s); and my or his/her participation in all Ken-Caryl equine activities. I/my child is in good health and has the necessary ability to participate in equine activities. I ACKNOWLEDGE I HAVE RECEIVED AND READ THE EQUESTRIAN CENTER FACILITY RULES at the link above. I give permission to KCRMA to use my child's photograph in Ken-Caryl Ranch publications.

Do you agree to storage of your data?*

By submitting this form, you hereby agree that we may collect, store and process your data that you provided.

Yes

Equestrian Center Waiver

Equestrian Center Waiver

Click here for KCR Equestrian Center Facility Rules

Contact Info

Administration:

Ranch House:

Community Center:

Facility/Parks Emergency:

Park Rangers:

Waste Connections: