Last Gasp of Summer JPR Last Gasp of Summer JPR Registration Adult Rider First Last Non-riding parent or guardian First Last Minor Rider First Last Email PhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Preferred Start Time Noon – 12:30 12:30 – 1:00 1:00 – 1:30 1:30 – 2:00 No Preference Preferred team members – yourself + 3 max Add RemoveRide Fee Quantity Price: $50.00 Quantity Haul-in fee Quantity Price: $15.00 Quantity Balance Due Preferred payment method is by Venmo after your registration is submitted. Username is @Barry-Dornon. Confirmation number is 1459. Alternately, Paypal is acceptable but please add $5 to Balance Due to cover fees. Cash or Check by mail or in person prior to the day of the ride is also acceptable.Consent for adults 18 years old or older I agree to the waiver of liability and indemnity.GENERAL RELEASE, VOLUNTARY WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT (Participants Age 18 or over) I have requested permission from Florence and Jean-Marc Germain, the owners (“Owners”) of AOPF Stables, LLC (“Stables”) and Indian Run Partners, LLC (“Farm”), to participate in various horse’s related activities on and around the Farm, including but not limited to boarding horses, caring for horses, riding, exercising, training, and taking horse riding lessons (from both employees of the Stable and third party instructors not employed by the Stable). (“Activities”). In consideration of Owners’ grant of permission to participate in the Activities, I, for myself, my personal representatives, heirs, next of kin, spouse, guardians, legal representatives and assigns, DO HEREBY: 1. Understand that my participation in the Activities contains DANGER AND RISK OF INJURY OR DEATH to horse, rider or spectator, and that there is INHERENT DANGER IN THESE ACTIVITIES WHICH I APPRECIATE AND VOLUNTARILY ASSUME. I have observed the Activities, and I know as well that other participants pose a danger to me. Nevertheless, I VOLUNTARILY ELECT TO ACCEPT ALL RISKS, including sickness and disease (including communicable diseases), trauma, pain & suffering, permanent disability, paralysis and death connected with my participation in the Activities; and 2. RELEASE AND DISCHARGE the Owners, their heirs, personal representatives and assigns, as well as any employees, agents, guests and other persons on or in any ways affiliated with the Farm (the“Releasees”), from any and all claims and liabilities arising out of my participation in the Activities on or about the Farm, including the actions or omissions of Releasees or any other participant in the Activities which cause the undersigned injury, death or property damage, regardless of the legal basis for any such claim or liability. I hereby covenant and agree to indemnify Releasees and hold them harmless from and against any and all claims, actions, judgments and expenses (including reasonable attorney’s fees) which Releasees may incur arising out of my participation in the Activities. This agreement shall be governed by the laws of Maryland. I agree that this agreement is intended to be as broad and inclusive as is permitted by law and that if any portion of this agreement is held invalid or unenforceable, the remainder of the agreement shall continue in full legal force and effect. I FURTHER CERTIFY AS FOLLOWS: (i) I HAVE READ THIS DOCUMENT; (ii) I UNDERSTAND IT IS A FULL RELEASE OF ALL CLAIMS; and (iii) I UNDERSTAND THAT I ASSUME ALL RISKS OF THE ACTIVITIES. I VOLUNTARILLY AGREE THAT CHECKING THE BOX ABOVE IS EVIDENCE i ACCEPT ALL PROVISIONS HEREIN. Consent for minors younger than 18 years old I agree to the waiver of liability and indemnity.GENERAL RELEASE, VOLUNTARY WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT (Participants Under Age 18) [To be signed by both Parents] We, the undersigned parents (“Parents”) of our minor child/children named below (“Child” and/or“Children”), have requested permission from Florence Germain and Jean-Marc Germain, the owners (“Owners”) of AOPF Stables, LLC (“Stable” ) and Indian Run Partners, LLC (“Farm”), to allow our Child to participate in various horse related activities on and around the Stable and Farm, including but not limited to, boarding horses, caring for horses, riding, exercising, training, taking horse riding lessons (from both employees of the Farm and third party instructors not employed by the Farm), (“Activities”). In consideration of Owners’ grant of permission for our Child to participate in the Activities, we, for ourselves, our Child and our personal representatives, heirs, guardians, legal representatives and assigns, DO HEREBY: 1. Understand that our Child’s participation in the Activities contains DANGER AND RISK OF INJURY OR DEATH to horse, rider and spectator, and that there is INHERENT DANGER IN THESE ACTIVITIES WHICH WE APPRECIATE AND VOLUNTARILY ASSUME. We have observed the Activities, and we know as well that other participants pose a danger to our Child. Nevertheless, WE VOLUNTARILY ELECT TO ACCEPT ALL RISKS, including sickness and disease (including communicable diseases), trauma, pain & suffering, permanent disability, paralysis and death, with our Child’s participation in the Activities, and 2. RELEASE AND DISCHARGE the Owners, their heirs, personal representatives and assigns, as well as any employees, agents, guests and other persons on or in any ways affiliated with the Farm (the “Releasees”), from any and all claims and liabilities arising out of our Child’s participation in the Activities on or about the Farm, including the actions or omissions of Releasees or any other participant in the Activities which cause my Child injury, death or property damage, regardless of the legal basis for any such claim or liability. We hereby covenant and agree to indemnify Releasees and hold them harmless from and against any and all claims, actions, judgments and expenses (including reasonable attorney’s fees) which Releasees may incur arising out of our Child’s participation in the Activities. This agreement shall be governed by the laws of Maryland. We agree that this agreement is intended to be as broad and inclusive as is permitted by law and that if any portion of this agreement is held invalid or unenforceable, the remainder of the agreement shall continue in full legal force and effect. WE FURTHER CERTIFY AS FOLLOWS: (i) WE HAVE READ THIS DOCUMENT; (ii) WE UNDERSTAND IT IS A FULL RELEASE OF ALL CLAIMS; (iii) WE UNDERSTAND THAT WE ASSUME ALL RISKS OF THE ACTIVITIES; and (iv) WE ARE THE PARENTS OF THE CHILD DESIGNATED BELOW AND ARE AUTHORIZED TO DELIVER THIS AGREEMENT ON BEHALF OF OUR CHILD. WE VOLUNTARILY AGREE CHECKING THE BOX ABOVE IS OUR ACCEPTANCE OF THE ABOVE PROVISIONS ON BEHALF OF OUR CHILD.
