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* Month Day Year Participant Age*Participant Weight*Our horses have a weight limit of 180lbs. Additionally, some of our horses are older or smaller so they can't even take a rider that heavy, and rider weight helps us assign horses more appropriately.Please enter a number less than or equal to 180.Would you like to include another participant (same family)?NoYesParticipant Name 2 First Last Participant 2 Date of Birth Month Day Year Participant 2 AgeParticipant 2 Weight*Our horses have a weight limit of 180lbs. Additionally, some of our horses are older or smaller so they can't even take a rider that heavy, and rider weight helps us assign horses more appropriately.Please enter a number less than or equal to 180.Are any of the participants under 18 years of age?* Yes No Parent/Guardian Name First Last Email address* Phone*Second Parent/Guardian Name First Last 2nd Parent/Guardian Email 2nd Parent/Guardian PhoneAddress* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific 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 RulesParticpant 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. Δ
