Wide Stride Equestrian Center

Pumpkins and Ponies

Unicorn Party at
Wide Stride Equestrian Center

Thank you for choosing Wide Stride Equestrian to help you further you and your horse’s education. We are excited to have you! Please take a moment to give us your information, agree to our terms and conditions, and complete our rider release form.

Step 1: Rider Information

First Name of Rider *

Last Name of Rider *

Preferred Name *

Date of Birth of Rider *

City *

State *

Postal code *

Address *

Height of Rider *

I understand that the maximum weight limit is 200 pounds for rider to keep our horses safe and healthy. *

YES

Email *

Cell Phone *

By providing my phone number, I agree to receive text messages from the business.

Rider’s Medical History/Conditions *

Parent/Guardian Name(s) if applicable

Student's Riding Level *

Beginner-I have never ridden, or I have ridden but need more work with the posting trot

Intermediate-I can walk, trot, and have cantered some, trot poles and cross-rails

Advanced- I can walk, trot, canter, and do full jump courses at canter

Equine Activity Liability Agreement and Risk Acknowledgement

I, the undersigned, have read and understand, and freely and voluntarily enter into this Release and Hold Harmless Agreement with Ingrid Levisay, Wide Stride Equestrian Center, Patricia Fanelli, Twin Willows, any employee, volunteer and/or helper and/or anyone directly or indirectly involved with Ingrid Levisay. Understanding that this Release and Hold Harmless Agreement is a waiver of any and all liability(ies).

I understand the potential dangers that I could incur in mounting, riding, walking, boarding, feeding and being around said equine(s); including, but not limited to, kicking, biting, bucking, rearing up and running off. Understanding those risks I hereby release and hold harmless Ingrid Levisay and anyone else directly or indirectly connected with my participation in equine activity at 194 Palmer Road Bangor, Pennsylvania from any liability whatsoever. I agree not to hold them accountable or file suit against them on account of or in connection with any claims, causes or action, injuries damages, costs or expenses arising out of my use of or presence upon the said property and facilities, including without limitation, those based on death, bodily injury, property damage, including consequential damages.

Warning: Under Pennsylvania Equine Activity Immunity Act (Act 38 of 2005) law an equine professional and equine activity sponsor is not liable for an injury to or death of a participant in equine activities resulting from the inherent risks of equine activities.

Any person who rides, drives or otherwise participates directly or indirectly in equine related activities is regarded as a participant.

This Release and Hold Harmless Agreement covers all horses that are on, brought onto, or rode on the property known as 194 Palmer Rd Bangor, PA 18013

This Release will remain in effect indefinitely. I have read and understand this Release of Liability and freely and voluntarily enter into this Release and Hold Harmless Agreement.

Date *

By their signature below, client hereby understand and agree to all terms and conditions of this Agreement.

Clear

Choose your Magical Moment: Sign Up!
Please Note: It takes about an hour to go through all of the stations. However, we stagger arrival times to help with the flow of traffic and parking. Please respect the arrival time you choose.

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Wide Stride Equestrian Center

Unicorn Party at Wide Stride Equestrian Center

Choose your Magical Moment: Sign Up!Please Note: It takes about an hour to go through all of the stations. However, we stagger arrival times to help with the flow of traffic and parking. Please respect the arrival time you choose.

Unicorn Party at
Wide Stride Equestrian Center

Choose your Magical Moment: Sign Up!
Please Note: It takes about an hour to go through all of the stations. However, we stagger arrival times to help with the flow of traffic and parking. Please respect the arrival time you choose.