TROT Release Agreements Form

TROT Release Agreements

Date*
Today's Date
Date Format: MM slash DD slash YYYY
TROT Participant/Guardian Information
Participant Name*
First Name Last Name
Parent/Legal Guardian/Conservator (if applicable)*
First Name Last Name
Email*
Liability Release Agreement
Liability Release: I acknowledge the risks and potential risks for horseback riding and activities in and around a facility where horses are kept, and farm machinery operated. However, I feel that the possible benefits to me/child/my ward are greater than the risk assumed. Intending legally to bind myself, my heirs, and assigns, executors or administrators, I hereby waive and release forever all claims for loss or damages of any kind against TROT, its Board of Directors, Instructors, Therapists, Aids, Volunteers and Employees for any and all injuries and losses that I/my child/my ward may sustain while participating in the TROT program. This release includes without limitation the risk of negligent instruction and supervision. I engage in activities at TROT voluntarily with knowledge of the risks and I assume all risks of injury, death, and property damage that may result. I agree to bear any loss myself. I acknowledge that TROT and the property owners are materially relying on this waiver and assumption of risk in allowing me/my child/my ward to participate in activities at TROT.
Liability Release Consent*
I agree to the Liability Release Agreement by (Participant,Parent, or Caregiver).
Confidentiality Agreement
I understand that all the personal information (written and verbal) about participants at TROT is confidential and not to be shared with anyone without expressed written consent of the participant and their parent/guardian in the case of a minor.
Confidentiality Agreement Consent*
I agree to the Confidentiality Agreement by (Participant,Parent, or Caregiver).
Photo and Video Release
Photo and Video Release Agreement*
- I Do Consent to the TROT Photo/Video Release Agreement
- I Do Not Consent to the TROT Photo/Video Release Agreement
Reasons for Discharge of Participant
Please be advised of the following reasons that may lead to discharge from the riding program and/or the center.
1. The client has reached all of their goals and is ready to graduate.
2. The client’s potential to maintain head and neck control while riding presents a safety concern.
3. The inability to follow directions is interfering with progress toward goals.
4. Uncontrolled and/or inappropriate behavior that constitutes a safety risk to a client, staff, and/or horse.
5. The client exceeds weight staff, volunteers, and/or horses can safely manage that.
6. Any change in the client’s medical, physical, cognitive, or emotional condition that makes therapeutic riding inappropriate.
7. Three scheduled appointments are missed without prior cancelation.
8. Disruptive behavior that is counterproductive to the benefit of anyone equine or human at TROT.
9. Any purposeful act of compromised safety related to any equine, human or self at TROT.
10. No longer suited, willing or able to perform activities at TROT safely or as directed.
11. Non-payment of fees, as originally agreed.
Procedure:
a) All participants/volunteers/guests who meet the criteria of dismissal will be asked to meet with the Volunteer Coordinator and Program Director to discuss the behavior/issue in question.
b) The Volunteer Coordinator and Program Director will work to educate and outline the appropriate expected behavior of the participant/volunteer/guest at TROT.
c) If the participant/volunteer/guest is willing to perform the expected behavior/task, then support and further education will be implemented by the TROT staff.
d) If the participant/volunteer/guest is not receptive to the expectation of behavior, the volunteer will be asked to leave the TROT program. Therefore, dismissed from the TROT property or returning in the future without permission.
e) The participant/volunteer/guest will be sent a signed, dated letter confirming the expected actions as a result of the meeting. f) An additional copy of the letter will be printed and placed in the participant's/volunteer’s file.
Reasons for Discharge Consent*
I understand and agree to TROT's Discharge policy.