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Medical Release Form
& Hold Harmless Forms
Release forms are required to be kept on file at the ranch
for a variety of reasons.
Each year all owners must complete a Adult Hold
Harmless form for horseback riding.
If you bring a minor guest to the ranch with out a parent or
legal guardian - a Medical Release Form, signed by the minor's parent or legal guardian is
required. That minor will also need a Minor Hold Harmless form signed by a parent or legal
guardian if he/she plans to horseback ride.
R-RANCH AT THE LAKE RANCH OWNERS’ ASSOCIATION STABLES “HOLD HARMLESS” AGREEMENT (ADULT)
I, the undersigned, hereby agree to assume all risk relative to the use of animals and/or tack
furnished me by R-Ranch at the Lake stables and warrant that said use is by the undersigned and no
other; further, I hereby RELEASE the above stable and R-Ranch at the Lake Ranch Owners’
Association, its owner, from all and every claim which may accrue to me at any time hereafter in
favor of myself, my heirs, representatives or dependents, by reason of any injury, loss or damage
which may be suffered by me because of any matter, thing or condition, negligence or default
whatsoever, or which may occur through or by any act or service rendered on the part of R-Ranch at
the Lake Stables, R-Ranch at the
Lake Ranch Owners’ Association, its members, agents, employees and representatives.
I have read the above and agree to abide therewith.
PLEASE PRINT:
Owner’s No.: ________________
Name of Rider: _________________________________________________________________
Address: ______________________________________________________________________
Home Ph. #: ____________________________Work Ph #: _____________________________
Guest of: _____________________________________________________________________
Effective Dates: From: _____________________To:_____________________
Signature of Rider: ______________________________________________________________
Date Signed:_________________________________
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