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Equest Center for Therapeutic RidingEquest Center for Therapeutic Riding
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Home » Forms » Participant Liability and Release Form

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Details

Area Of Participation(Required)
Birthdate(Required)
Please enter participant’s birthdate
Name(Required)
Address(Required)

Identity

Gender Identity
Please check to answer

Ethnicity

Ethnicity
Please select any, if applicable

Education

Please answer if known.

Financial Responsibility

Person or organization responsible for payments
Billing Address(Required)

Photo Release

Photo Release Consent(Required)
I consent to and authorize the use and reproduction by Equest Center of any and all photographs, videotape, audio tape and any other audio visual materials taken of me, or as applicable, my son, daughter or ward to promote or benefit the Equest Center or recreational horseback riding, forever waiving any compensation for such use.

Release of Liability section

Release of Liability statement(Required)
I, NAME OF PARTICIPANT/VOLUNTEER (as entered/detailed in this electronic document) would like to volunteer (at no charge) to assist one or more therapeutic riding clients with equine activities conducted by the EQUEST CENTER FOR THERAPEUTIC RIDING, INC. (“EQUEST CENTER”), a Michigan non-profit corporation. Accordingly, in consideration of being on the premises of the Equest Center, being near horses at the Equest Center, and allowed to participate/assist in equine activities at Equest Center, I acknowledge and agree as follows:

Equestrian activities are, by their very nature, a risk activity. Equestrian activities involve known and unanticipated risks which could result in physical or emotional injury, paralysis or permanent disability, death, and property damage. Risks include, but are not limited to, death, paralysis or serious injury as a result of falls while riding horses; broken bones, bruises and other bodily injuries caused by contact with horses, such as being bitten by, kicked by or stepped on by horses; medical conditions resulting from physical activity; and damaged clothing or other property. I understand such risks simply cannot be eliminated, despite the use of safety equipment, without jeopardizing the essential qualities of the activity.

On behalf of myself, my heirs, representatives and assigns and, as applicable, my ward or my minor child, I hereby assume full responsibility for and all risks associated with activities at the Equest Center. I fully understand there are risks and dangers associated with participation in equine activities which could result in serious bodily injury and/or death and/or property damage.

I release and discharge the Equest Center; including its officers, directors, employees, agents, instructors, contractors, riders, and other volunteers (“Released Parties”), from all lawsuits, actions, damages, claims and liability whatsoever, including, without limitation, death, and property damage or loss, which arise from or are in any way related to engaging in any activity at the Equest Center. I intend that my release and discharge includes all claims for damages resulting from the negligent act or omission of the Equest Center, including any Released Parties, excepting only the sole gross negligence or sole willful and wanton misconduct of these parties.

I further agree that this release and discharge of liability applies regardless of the legal cause of action on which my claim is based, including contract, strict liability, negligence, tort, or an alleged violation of the Michigan Equine Liability Act (PA 1494 No. 351).

I have adequate insurance to cover any injury or damage I may suffer or cause while participating in this activity, or else I agree to bear the costs of such injury or damage myself. I am willing to assume, and bear the costs of, all risks that may be created, directly or indirectly, by any physical condition that I have that may interfere with my safety while at the Equine Center.

I agree that this release of liability shall be governed by Michigan law and I acknowledge that the release exceeds the provisions of the Michigan Equine Liability Act because I am releasing the Released Parties for all damages, liability and causes of action, except only those for sole gross negligence or sole willful and wanton misconduct. WARNING: I UNDERSTAND THAT UNDER THE MICHIGAN EQUINE ACTIVITY LIABILITY ACT, AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT INAN EQUINE ACTIVITY RESULTING FROM AN INHERENT RISK OF THE EQUINE ACTIVITY.

I have read and understand this release of liability. My participation in this activity is purely voluntary and I elect to participate despite the risks. In addition, if at any time I believe that event conditions are unsafe or that I am unable to participate due to physical or medical conditions, then I will immediately discontinue participation. I hereby sign this release freely, knowingly and without coercion by anyone.
Clear Signature
If a Minor, the parent/guardian of Participant
Include prescription, over-the-counter, name, dose, and frequency.

Describe your abilities/difficulties in the following areas:

Include assistance or equipment needed.
i.e. mobility skills such as transfers, walking, wheelchair use, driving/bus riding.
i.e. work/school including grade completed, leisure interests, relationship/family structure, support systems, companion animals, fears/concerns, etc.
Why are you applying for participation? What would you like to accomplish?

Community Connections

Many businesses and organizations will allow Non-Profit Organizations such as Equest Center to apply for specific grant monies if we serve an employee or a family member of an employee in our program, or if an individual is involved with Equest Center on a volunteer basis.

We would be most appreciative if you would share your connections in the community. It could have a major impact on our center.

Thank You.

Names and Connections
Name of Link
Linked to Business or Organization
 
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© 2025 Equest Center for Therapeutic Riding.

Close Menu
  • About Us
    • Board of Directors
    • Staff
    • History
    • Testimonials
    • Fact Sheet
    • Brochures
    • Facility Grounds
    • Equest Apparel
  • Programs
    • Our Programs
    • Therapeutic Riding
    • Horsemanship Day Camp
    • Sensory Riding Trail
    • Horses for Heroes
    • Vocational & Job Training
    • Deaf and Hard of Hearing Equine Program
    • Adaptive Carriage Driving
    • Equine Assisted Reading & Literacy Program
    • Horses as Healers
    • Senior Saturdays
    • PATH International Instructor Training
  • Calendar of Events
    • Upcoming Events
    • 2026 Amway River Bank Run
    • Black & Blue Ball
    • Easter With the Equest Bunny
    • Equest Derby
    • Trailblazers Luncheon
    • Holiday Horse Show
  • Our Horses
    • Meet Our Horses
    • Gallery
  • Volunteer
    • Volunteer Orientations
    • Horses & Hands
    • Internships
    • Lead Volunteers
    • Volunteer Handbook
  • Donate
    • Giving Tuesday
    • Make a Gift to Equest
    • Sponsor a Horse or Rider
    • Equine Donations
    • Donations In Kind
    • Smarter Ways to Give
      • Annual Giving
      • Memorials & “In Honor of” Donations
      • Gifts of Stock
      • Planned Giving
      • Matching Gift Opportunities

Equest Center for
Therapeutic Riding, Inc.

3777 Rector Ave.NE,
Rockford, MI 49341
T: 616-866-3066