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366 Pay Lake Rd. Partridge, KY 40862
(606)-589-6910 office, (606)-733-5620 cell
Informed Consent-Liability Release for 
“The Stables At Creekside Glen”
a ministry under Meridzo Center, Inc.

 

I am aware and understand that participating in horse camps, arena rides, trail rides, pony rides and/or any equestrian related activities, involve a potential risk of physical injury. I understand that the program is physically demanding and potentially dangerous. I agree and hereby state that I am solely responsible for my own participation and for my own physical and emotional well-being. I an aware and understand that arena rides, pony rides, trail rides and all of the other program activities are strictly voluntary, and it is my own choice to participate to whatever degree I deem appropriate, after due consideration of my own physical health, physical abilities, and medical condition.  I further state that in choosing to participate, I am not under the influence of any chemical substance including alcohol. I willingly and knowingly assume for myself, my heirs, family members, executors, administrators, and assigns, all risk of physical injury and emotional upset which may occur during or after participating in any aspect of the program and hereby agree to hold “The Stables At Creekside Glen” and “Meridzo Center, Inc.”, their staff, instructors, facilitators, and agents harmless for any liability arising out of my participation in the program. I have read the foregoing and wish to participate at my own risk.

I have read the posted Kentucky Statute KRS5247.4027 and understand there are inherent risks of injury that I accept while participating in this activity.

 

I also give permission for my child and those I am responsible for to have their pictures taken and give permission for these pictures to be used by The Stables at Creekside Glen for promotional purposes.

*I am responsible for the following participants under the age of 18:

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