Visitor Liability Release Form Name * First Name Last Name Email * Phone (###) ### #### Address Address 1 Address 2 City State/Province Zip/Postal Code Country Event or reason for attending * LIABILITY RELEASE * Check the box to agree to the statement below. It is understood that, being aware of the risks and exposures to personal injury involved through equestrian activities, I hereby release Center for Therapeutic Riding on the East End and Topping Riding Club and its employees assisting in any official capacity on their behalf, from all and every claim for damages which may occur to me or my property in any connection with any lesson, clinic, practice, schooling or any work with horses on the grounds or away from the grounds of Topping Riding Club, Sagaponack, NY. PHOTOGRAPHY RELEASE * I hereby irrevocably consent to allow Center for Therapeutic Riding of the East End to use the photograph(s) and/or video(s) of me for any purpose, and in any manner, including without limitation to print media, television, exhibition, publication and any trade or advertising purpose. I hereby irrevocably DO NOT consent to allow Center for Therapeutic Riding of the East End to use the photograph(s) and/or video(s) of me for any purpose, and in any manner, including without limitation to print media, television, exhibition, publication and any trade or advertising purpose. Your Signature or Signature of Parent/Legal Guardian if under 18: By entering my name below I understand and agree that all information on this form is true. * TODAY'S DATE * MM DD YYYY Thank you!
