LOUISIANA & MISSISSIPPI SADDLE FITTING CLINICS REGISTRATION Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Email * Phone * (###) ### #### Do you have more than one horse? * If you have more than one horse to be seen at the same location, you can use the same form. If the second or third horse is at a DIFFERENT location please fill out separate forms for each horse. Yes No If you have been seen before do you have a preferred organizer or location that you would like to work with or be seen at? * If no preferred organizer please list: none Horse name * Option to add second horse is further down Riding discipline * ie: hunter/jumper, dressage, western, endurance, trail, pleasure, eventing (please list all that apply) What are your current saddle/equipment issues? * If there are any specific issues that need to be addressed at this fitting please list them here Are you interested in looking at a different saddle for your horse? * If interested in looking at different equipment we will touch base with you before the fitting for more details. Yes No SECOND HORSE INFO: Second horse name Second horse riding discipline Second horse saddle/equipment issues Are you interested in looking at a different saddle for your second horse? If interested in looking at different equipment we will touch base with you before the fitting for more details. Yes No If you have a third horse to be seen please list pertinent info regarding that horse here ADDITIONAL HORSES: If you have additional horses to be seen please list pertinent info here: Any other details you feel we should know prior to your fitting? Liability Waver * I - RELEASE AND WAIVER OF LIABILITY, ASSUMPTION OF RISK, AND IMDEMNITY AGREEMENT READ THIS AGREEMENT CAREFULLY BEFORE SIGNING IT. YOUR SIGNATURE INDICATES YOU UNDERSTAND IT AND AGREE ON ITS TERMS. BY SIGNING THIS AGREEMENT, YOU ARE GIVING UP CERTAIN LEGAL RIGHTS, INCLUDING THE RIGHT TO SUE OR RECOVER DAMAGES IN CASE OF INJURY, DEATH OR PROPERTY DAMAGES. I HEREBY: Acknowledges that there are no warranties, express or implied, related to saddle fit, consultations for saddle fitting problems or saddle related problems. All advice, suggestions and recommendations regarding saddle fit or saddle related problems is provided with extensive background and experience, but does not guarantee specific results. All such advice is taken by consultee own their own risk. Acknowledges that Consultee has two weeks from the time the saddle is received after a fitting consultation OR from an On Site Saddle Fitting to assess the fit. Any problems or dissatisfaction related to the fit of a saddle after a consultation or On Site Fitting must be made within two weeks. Acknowledges that Consultee who does not provide measurements or participate in an On Site Fitting takes recommendations at Consultee’s own risk. Saddlery Solutions and Kristen Vlietstra cannot control whether such advice is followed correctly, and therefore, consultee releases and holds harmless Saddlery Solutions and Kristen Vlietstra for any property damage to saddle or physical problem with horse. Acknowledges that for ON SITE FITTINGS, a horse may, without warning or any apparent cause, buck, stumble, fall, rear, bite, kick, run, make unpredictable movements, spook, jump obstacles, step on a person’s feet, push or shove a person, saddles or bridles may loosen or break – all of which may cause the rider to fall or be jolted, resulting in serious injury or death. In other words, HORSEBACK RIDING IS AN INHERENTLY DANGEROUS ACTIVITY AND INVOLVES RISKS THAT MAY CAUSE SERIOUS INJURY AND IN SOME CASES DEATH, because of the unpredictable nature and irrational behavior of horses, regardless of their training and past performance. Consultee voluntarily assumes the risk and danger of injury or death or property damage inherent in the saddle fitting process. RELEASES, DISCHARGES AND PROMISES NOT TO SUE Saddlery Solutions or Kristen Vlietstra, doing business under its own name or any other name and/or any of its owners, officers, employees and agents, for any loss, liability, damages, or cost whatsoever arising out of or related to any loss, damage, or injury (including death) to my person or property which occurs for any Saddle/Saddle Fit Consultation. Acknowledges that Saddlery Solutions and Kristen Vlietstra cannot provide any guarantee regarding the fit of a saddle without accurate measurements or without an onsite fit with the horse present. The Undersigned expressly agrees that the foregoing release and waiver of liability, assumption of risk, and indemnity agreement is governed by the State of California and is intended to be as broad and inclusive as is permitted by California Law , and that in the event any portion of this Agreement is determined to be invalid, illegal, or unenforceable, the validity, legality and enforceability of the balance of the Agreement shall not be affected or impaired in any way and shall continue in full legal force and effect. Acknowledges that this document is a contract and agrees that if a lawsuit is filed against Saddlery Solutions or its owner, agents, employees for any injury or damage in breach of this contract, the Undersigned/Consultee will pay all attorney’s fees and costs incurred by Saddlery Solutions in defending such an action. IT IS RECOMMENDED BY SADDLERY SOLUTIONS THAT ALL RIDERS WEAR PROTECTIVE HELMET WHEN MOUNTED FOR SADDLE FITTINGS. If the person who is to enter into this Agreement is less than eighteen (18) years of age, his/her parent or guardian must read this Agreement and sign below on the behalf of the minor. I have read this entire Release of Liability Document. I understand it is a promise not to sue and to release Saddlery Solutions, its owners, employees and agents for all claims. I have made a free and deliberate choice to sign this Release and Waiver as a condition of participating in a consultation or On Site Saddle Fitting. I agree Thank you!
