Horse Adoption Contract
COMING SOON
Trail riding Waiver
DuBar’s Corner Horse Rescue and Rehab Trail riding waiver
Rider’s Name:x_________________________________________
D.O.B:x_____________ Sex:__________________
Child’s Name:__________________________________________
D.O.B:______________ Sex:__________________
Mailing Adress:_________________________________________
______________________________________________________
Phone Number:_________________________________________
Email Address:_________________________________________
_____________________________________________________
How did you hear about us?:______________________________
_____________________________________________________
Would you like to get on our mailing list for up coming events, or our up coming coupons? If so please put down BOTH your E-mail address and your mailing address;X______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What experience,(If any) do you have with horses?:____________
_____________________________________________________
Today’s date;__________________________________________
Please list and describe any and all physical limitations/conditions which might limit or affect your participation in horse riding activities.
Please give full details including but not limited to;
Asthma, Back problems, Diabetes, Migraines, etc…:
______________________________________________________
______________________________________________________
______________________________________________________
Signature of Participant: X_________________________________
Signature of parent and/or guardian: (If there is a rider under eighteen (18).):
X_____________________________________________________
I recognize that there is a significant element of risk involved in horseback riding and the handling of horses. I state that I am fully capable of participating in such activities and I certify that I have no physical conditions, which might interfere with my capability to participate in horseback riding. Knowing the inherent risks, damages, and rigors involved in horseback riding, I assume responsibility for myself and/or my child for bodily injury, death, loss of personal property and all expenses thereof, which may occur as a result of my and/or my child’s participation in handling of horses and/or horseback riding and waive any and all claims which may result there from. I agree to indemnify DuBar’s Corner, It’s owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from costs from any accident, illness, injury or death which comes from mine and/or my child’s participation in said activities. Furthermore I do by waive any claim and release DuBar’s Corner it’s owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from and accident, illness, injury, or death which comes from mine and/or my child’s participation in said activities. This is binding upon my spouse, children and heirs.
I further understand that I can and will encounter various terrain changes, and that once on a horse DuBar’s Corner and its staff have little control over the horse. I understand that I must be able to control the horse and have no physical or medical conditions which would prevent me from doing so. I understand that horses have a will of their own, with unique personalities and at times can be unpredictable and I fully accept these conditions.
Pursuant to Florida Statute, 773.06, any child under the age of sixteen (16) is required to wear a helmet.
DuBar’s Corner strictly adheres to this law without exception.
X_____ DuBar’s Corner recommends that inexperienced riders wear a helmet.
I recognize that the risk of serious injury is increased by not a wearing certified helmet while horseback riding. I agree to wear a certified protective helmet at all times and understand that ALL students are required to wear certified helmets any time mounted on a horse.
DUBAR’S CORNER RIDING SERVICES STRONGLY RECOMMENDS THAT A HELMET IS TO BE WORN AT ALL TIMES, REGARDLESS OF AGE.
I understand it is strongly recommended that I wear a helmet for MY safety and that helmets are available at no charge to me.
I understand that regardless of my age, or the age of the minor I am signing for, DuBar’s Corner requires ALL persons, while mounted on horseback, to wear a riding helmet. (Initial) X_______________
As consideration for being permitted by DuBar’s Corner to engage in the activity of horseback riding, I do hereby waive claim and release DuBar’s Corner, and all of their owners, officers, staff members, volunteers, affiliated organizations and agents for injury and/or death caused by or resulting from my participation in such activity.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me and/or my child during the entire period of my participation in handling of horses and/or taking of horseback riding lessons or trail riding upon the premises of DuBar’s Corner on off-site locations.
WARNING! Under Florida law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 773 of Florida Statutes.
Signature of parent and/or guardian;X______________________________________________________________
Please enjoy your ride! We hope to see you soon!
All money goes to helping rescued animals!
Barn Manger;X__________________________________________________________
Asst. Barn Manager;X_____________________________________________________
Rider’s Name:x_________________________________________
D.O.B:x_____________ Sex:__________________
Child’s Name:__________________________________________
D.O.B:______________ Sex:__________________
Mailing Adress:_________________________________________
______________________________________________________
Phone Number:_________________________________________
Email Address:_________________________________________
_____________________________________________________
How did you hear about us?:______________________________
_____________________________________________________
Would you like to get on our mailing list for up coming events, or our up coming coupons? If so please put down BOTH your E-mail address and your mailing address;X______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
What experience,(If any) do you have with horses?:____________
_____________________________________________________
Today’s date;__________________________________________
Please list and describe any and all physical limitations/conditions which might limit or affect your participation in horse riding activities.
Please give full details including but not limited to;
Asthma, Back problems, Diabetes, Migraines, etc…:
______________________________________________________
______________________________________________________
______________________________________________________
Signature of Participant: X_________________________________
Signature of parent and/or guardian: (If there is a rider under eighteen (18).):
X_____________________________________________________
I recognize that there is a significant element of risk involved in horseback riding and the handling of horses. I state that I am fully capable of participating in such activities and I certify that I have no physical conditions, which might interfere with my capability to participate in horseback riding. Knowing the inherent risks, damages, and rigors involved in horseback riding, I assume responsibility for myself and/or my child for bodily injury, death, loss of personal property and all expenses thereof, which may occur as a result of my and/or my child’s participation in handling of horses and/or horseback riding and waive any and all claims which may result there from. I agree to indemnify DuBar’s Corner, It’s owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from costs from any accident, illness, injury or death which comes from mine and/or my child’s participation in said activities. Furthermore I do by waive any claim and release DuBar’s Corner it’s owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from and accident, illness, injury, or death which comes from mine and/or my child’s participation in said activities. This is binding upon my spouse, children and heirs.
I further understand that I can and will encounter various terrain changes, and that once on a horse DuBar’s Corner and its staff have little control over the horse. I understand that I must be able to control the horse and have no physical or medical conditions which would prevent me from doing so. I understand that horses have a will of their own, with unique personalities and at times can be unpredictable and I fully accept these conditions.
Pursuant to Florida Statute, 773.06, any child under the age of sixteen (16) is required to wear a helmet.
DuBar’s Corner strictly adheres to this law without exception.
X_____ DuBar’s Corner recommends that inexperienced riders wear a helmet.
I recognize that the risk of serious injury is increased by not a wearing certified helmet while horseback riding. I agree to wear a certified protective helmet at all times and understand that ALL students are required to wear certified helmets any time mounted on a horse.
DUBAR’S CORNER RIDING SERVICES STRONGLY RECOMMENDS THAT A HELMET IS TO BE WORN AT ALL TIMES, REGARDLESS OF AGE.
I understand it is strongly recommended that I wear a helmet for MY safety and that helmets are available at no charge to me.
I understand that regardless of my age, or the age of the minor I am signing for, DuBar’s Corner requires ALL persons, while mounted on horseback, to wear a riding helmet. (Initial) X_______________
As consideration for being permitted by DuBar’s Corner to engage in the activity of horseback riding, I do hereby waive claim and release DuBar’s Corner, and all of their owners, officers, staff members, volunteers, affiliated organizations and agents for injury and/or death caused by or resulting from my participation in such activity.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me and/or my child during the entire period of my participation in handling of horses and/or taking of horseback riding lessons or trail riding upon the premises of DuBar’s Corner on off-site locations.
WARNING! Under Florida law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 773 of Florida Statutes.
Signature of parent and/or guardian;X______________________________________________________________
Please enjoy your ride! We hope to see you soon!
All money goes to helping rescued animals!
Barn Manger;X__________________________________________________________
Asst. Barn Manager;X_____________________________________________________
Riding Waiver; Over 18 years of age
DUBAR’S CORNER HORSE RESCUE AND REHABILITATION
“RIDING WAIVER”
Rider’s name:_________________________________________________
DOB:_________________ Sex:_____________
Address:_____________________________________________________
Telephone #’s:____________________(home)______________________(cell)
Email:________________________________________
If you would like to get on our mailing list for up coming events and coupons, please put down the mailing address you would like our newsletter sent to.
________________________________________________________________________________________________________________________________________________
Please list & describe any physical limitations / conditions which might limit or affect your participation in horse riding activities. “Please give full details including but not limited to; asthma, back problems, diabetes, and migraines, etc.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
X Signature of participant:_________________________________________
ACKNOWLEDGEMENT OF RISKS, ACCEPTANCE OF RESPONSIBILITIES, AND WAIVER OF CLAIMS…
I recognize that there is a significant element of risk involved in horse back riding and the handling of
Horses. I state that I am fully capable of participating in such activities and certify that I have no physical
Conditions, which might interfere with my capability to participate in horseback riding. Knowing the
Inherent risks, damages, and rigors involved in horseback riding, I assume responsibility for myself / my
Child for bodily injury, death, loss of personal property and all expenses therein, which may occur as a
Result of my or my child’s participation in the handling of horses and/or horseback riding and waive any
And all claims which may result therein. I agree to indemnify Dubar’s Corner, it’s owners Daniel, Helena and Deborah Blair, there asst. manager Travis Redner, their staff, volunteers, associations and any and all government agencies, and all business from costs from any accident, illness, injury and/or death which comes from my or my child’s participation in said activities. furthermore I do here by waive any claim and release Dubar’s Corner, it’s owners Daniel, Helena and Deborah Blair, there asst. manager Travis Redner, their staff, volunteers, associations and any and all government agencies, and all business from costs from any accident, illness, injury and/or death which comes from my or my child’s participation in said activities. This is binding upon my spouse, children and heirs.
I further understand that I can and will encounter various terrain changes, and that once on a horse
Dubar’s corner and it’s staff have little control over the horse. I understand I must be able to control
The horse and have no physical or medical conditions which would prevent me from doing so. I
Understand that horses have a will of their own, with unique personalities and at times can be
Unpredictable and I fully accept these conditions.
Pursuant to Florida Statue, 773.06, any child under the age of 16 is required to wear a helmet.
Dubar’s corner strictly adheres to this law without exception.
Dubar’s corner recommends that inexperienced adult riders wear a helmet.
I RECOGNIZE THAT THE RISK OF SERIOUS INJURY IS INCREASED BY NOT WEARING A CIRTIFIED HELMET WHILE HORSEBACK RIDING. I agree to wear a certified protective helmet at all times and understand that all students are required to wear a certified helmet at all times while mounted on a horse.
As consideration for being permitted by Dubar’s Corner to engage in the activity of horseback riding, I do
Hereby waive any claim and release Dubar’s Corner, it’s owners Daniel, Helena and Deborah Blair, there asst. manager Travis Redner, their staff, volunteers, associations and any and all government agencies, and all business from costs from any accident, illness, injury and/or death which comes from my participation in said activities.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this
Agreement shall be effective and binding upon me / my child during the entire period of my participation
In the handling of horses and/ or taking of horseback riding lessons, or trail riding upon the premises of Dubar’s corner or on any of the horses of Dubar’s corner/ Daniel, Helena and Deborah Blair shall not be liable and under direction of Dubar’s corner on off-site locations.
WARNING! UNDER FLORIDA LAW, AN EQUINE ACTIVITY SPONSOR OR EQUINE PROFFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING EXCLUSIVELY FROM THE INHERENT RISKS OF EQUINE ACTIVITIES. ACCORDING TO CHAPTER 773 OF THE FLORIDA STATUES.
X______ I certify that I am over the age of 18/ or the legal guardian of the participant under the age of (18)
And that I have fully read and understand the foregoing waiver.
I understand that here at DuBar’s Corner no matter your age, DuBar’s Corner requires all persons, while mounted on horse back, to wear the proper protective head gear. (Initial) X___________________
This is the ________ day of ______________, 2011
Signature of rider:______________________________________________
SIGNATURE OF BARN MANAGER:______________________________________________________
SIGNATURE OF ASST. BARN MANAGER:________________________________________________
“RIDING WAIVER”
Rider’s name:_________________________________________________
DOB:_________________ Sex:_____________
Address:_____________________________________________________
Telephone #’s:____________________(home)______________________(cell)
Email:________________________________________
If you would like to get on our mailing list for up coming events and coupons, please put down the mailing address you would like our newsletter sent to.
________________________________________________________________________________________________________________________________________________
Please list & describe any physical limitations / conditions which might limit or affect your participation in horse riding activities. “Please give full details including but not limited to; asthma, back problems, diabetes, and migraines, etc.
_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
X Signature of participant:_________________________________________
ACKNOWLEDGEMENT OF RISKS, ACCEPTANCE OF RESPONSIBILITIES, AND WAIVER OF CLAIMS…
I recognize that there is a significant element of risk involved in horse back riding and the handling of
Horses. I state that I am fully capable of participating in such activities and certify that I have no physical
Conditions, which might interfere with my capability to participate in horseback riding. Knowing the
Inherent risks, damages, and rigors involved in horseback riding, I assume responsibility for myself / my
Child for bodily injury, death, loss of personal property and all expenses therein, which may occur as a
Result of my or my child’s participation in the handling of horses and/or horseback riding and waive any
And all claims which may result therein. I agree to indemnify Dubar’s Corner, it’s owners Daniel, Helena and Deborah Blair, there asst. manager Travis Redner, their staff, volunteers, associations and any and all government agencies, and all business from costs from any accident, illness, injury and/or death which comes from my or my child’s participation in said activities. furthermore I do here by waive any claim and release Dubar’s Corner, it’s owners Daniel, Helena and Deborah Blair, there asst. manager Travis Redner, their staff, volunteers, associations and any and all government agencies, and all business from costs from any accident, illness, injury and/or death which comes from my or my child’s participation in said activities. This is binding upon my spouse, children and heirs.
I further understand that I can and will encounter various terrain changes, and that once on a horse
Dubar’s corner and it’s staff have little control over the horse. I understand I must be able to control
The horse and have no physical or medical conditions which would prevent me from doing so. I
Understand that horses have a will of their own, with unique personalities and at times can be
Unpredictable and I fully accept these conditions.
Pursuant to Florida Statue, 773.06, any child under the age of 16 is required to wear a helmet.
Dubar’s corner strictly adheres to this law without exception.
Dubar’s corner recommends that inexperienced adult riders wear a helmet.
I RECOGNIZE THAT THE RISK OF SERIOUS INJURY IS INCREASED BY NOT WEARING A CIRTIFIED HELMET WHILE HORSEBACK RIDING. I agree to wear a certified protective helmet at all times and understand that all students are required to wear a certified helmet at all times while mounted on a horse.
As consideration for being permitted by Dubar’s Corner to engage in the activity of horseback riding, I do
Hereby waive any claim and release Dubar’s Corner, it’s owners Daniel, Helena and Deborah Blair, there asst. manager Travis Redner, their staff, volunteers, associations and any and all government agencies, and all business from costs from any accident, illness, injury and/or death which comes from my participation in said activities.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this
Agreement shall be effective and binding upon me / my child during the entire period of my participation
In the handling of horses and/ or taking of horseback riding lessons, or trail riding upon the premises of Dubar’s corner or on any of the horses of Dubar’s corner/ Daniel, Helena and Deborah Blair shall not be liable and under direction of Dubar’s corner on off-site locations.
WARNING! UNDER FLORIDA LAW, AN EQUINE ACTIVITY SPONSOR OR EQUINE PROFFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING EXCLUSIVELY FROM THE INHERENT RISKS OF EQUINE ACTIVITIES. ACCORDING TO CHAPTER 773 OF THE FLORIDA STATUES.
X______ I certify that I am over the age of 18/ or the legal guardian of the participant under the age of (18)
And that I have fully read and understand the foregoing waiver.
I understand that here at DuBar’s Corner no matter your age, DuBar’s Corner requires all persons, while mounted on horse back, to wear the proper protective head gear. (Initial) X___________________
This is the ________ day of ______________, 2011
Signature of rider:______________________________________________
SIGNATURE OF BARN MANAGER:______________________________________________________
SIGNATURE OF ASST. BARN MANAGER:________________________________________________
Riding Waiver; Under 18 years of age
DuBar’s Corner Horse Rescue and Rehab Riding lesson waiver
Dear parents of horseback rider:
We are excited that you have chosen our riding program to help teach your child about horses!
We not only teach them how to ride, but we also teach them how to understand their horse. We will teach them how to love them and respect them.
They will also learn how to properly tack their own horse.
Groom them (including hoof picking, mane and tail brushing, and on hot days bathes) be for and after each ride.
They will learn how to check their tack for any breaks or cracks before each ride. They also will learn how to clean their tack down after each ride.
We here at DuBar’s Corner take great pride in teaching others how to love and care for horses, in hopes that one day they too can share the same happiness and joy of owning one!
Parents; Before you fill in all the information needed there are a few guidelines for you and your child.
Please print:
Rider’s name:_________________________________________________
Parent and/or guardian’s name:____________________________________
Home address:_________________________________________________
____________________________________________________________
Phone number:_________________________________________________
Date:_________________________________________________________
Would you like to get on our mailing list for upcoming events and/or up coming coupons? If so please list the E-Mail or home address you would like the info sent to;_____________________________________________________________________________________________________________________________________________
Upon placing my signature on this paper, I hereby acknowledge my full understanding and willingness to accept any and all risks of injury for the above mentioned activities for myself or for the minor, for who I am responsible.
I waive DuBar’s Corner, and all DuBar’s Corner’s workers from any and all liability.
I understand and acknowledge that hazards and obstructions can exist when being involved with horses, and that injuries resulting from the unpredictable nature of horses can occur.
I understand that DuBar’s Corner requires any persons of any age, while mounted on horseback, to wear a helmet at all times. (Initial) X_____________
We do hope that you and your child will walk away with a new knowledge of horses, and will be back again to further that knowledge.
Parent and or guardian’s signature:______________________________________________
Date:_________________________________________________
Farm worker (instructor):_________________________________
Farm Manager/Owner:___________________________________
Signature of rider;_____________________________________________
Signature of parent and/or guardian (If rider is under the age of eighteen (18).)
Barn manger____________________________________
Asst. barn Manager_______________________________
Date___________________________________________
Time lesson began________________________________
Time lesson ended________________________________
Dear parents of horseback rider:
We are excited that you have chosen our riding program to help teach your child about horses!
We not only teach them how to ride, but we also teach them how to understand their horse. We will teach them how to love them and respect them.
They will also learn how to properly tack their own horse.
Groom them (including hoof picking, mane and tail brushing, and on hot days bathes) be for and after each ride.
They will learn how to check their tack for any breaks or cracks before each ride. They also will learn how to clean their tack down after each ride.
We here at DuBar’s Corner take great pride in teaching others how to love and care for horses, in hopes that one day they too can share the same happiness and joy of owning one!
Parents; Before you fill in all the information needed there are a few guidelines for you and your child.
- Please, no one other then the instructor and student are to be in or near the teaching area.
- Please, no talking to the student at any time while their lesson is in place. (Unless for emergencies.)
- When coming out for lessons please make sure your child has the proper attire. (Including but not limited to; Shoes with a heel. T-shirt and jeans. A helmet that fits- If you or your child does not own a helmet one will be provided for you.)
- At all times are the rules of the farm to be followed!
- No pictures of the student while in the lesson. (Pictures are aloud after their lesson is over, and their horse has been fully groomed down and all tack used has been cleaned.)
Please print:
Rider’s name:_________________________________________________
Parent and/or guardian’s name:____________________________________
Home address:_________________________________________________
____________________________________________________________
Phone number:_________________________________________________
Date:_________________________________________________________
Would you like to get on our mailing list for upcoming events and/or up coming coupons? If so please list the E-Mail or home address you would like the info sent to;_____________________________________________________________________________________________________________________________________________
Upon placing my signature on this paper, I hereby acknowledge my full understanding and willingness to accept any and all risks of injury for the above mentioned activities for myself or for the minor, for who I am responsible.
I waive DuBar’s Corner, and all DuBar’s Corner’s workers from any and all liability.
I understand and acknowledge that hazards and obstructions can exist when being involved with horses, and that injuries resulting from the unpredictable nature of horses can occur.
I understand that DuBar’s Corner requires any persons of any age, while mounted on horseback, to wear a helmet at all times. (Initial) X_____________
We do hope that you and your child will walk away with a new knowledge of horses, and will be back again to further that knowledge.
Parent and or guardian’s signature:______________________________________________
Date:_________________________________________________
Farm worker (instructor):_________________________________
Farm Manager/Owner:___________________________________
Signature of rider;_____________________________________________
Signature of parent and/or guardian (If rider is under the age of eighteen (18).)
Barn manger____________________________________
Asst. barn Manager_______________________________
Date___________________________________________
Time lesson began________________________________
Time lesson ended________________________________
Volunteer Waiver
DuBar’s Corner Horse
Rescue and Rehab
Volunteer and riding waiver.
Dear volunteer,
We would like to welcome you here to DuBar’s Corner, and would also like to thank you for taking time out of your life to help us and these animals in need.
There are a few things that we need to discuss with you before we can assign you to your duties.
These animals here are all rescues. Some of them are still overcoming their fears of people. We ask that you do not enter any pens unless otherwise told. Most of these animals have been starved and beaten. We here at DuBar’s Corner work very hard to get them trusting and able for adoption. We are happy to have you here to help share this with us, but the horses here must be treated differently than most horses. So please keep your voices down, NO yelling. Please no fast movements around the animals, such as, but not limited to; Running, waving your arms, jumping, swinging gates and/or anything in your hands etc… The staff members here at DuBar’s Corner will let you know which horses are in their later stages of recovery so you may interact with them.
Yelling at and/or hitting of the animals will not be tolerated, and you will be asked to leave the property!
Children under the age of sixteen (16) can NOT volunteer without the signed permission of a parent and/or guardian.
Your volunteering time may entail you to do the following (But not limited to); Cleaning out pens(Goat, chicken and/or horse), building fences, painting, cleaning tack, bathing horses, grooming horses, lunging horses, reorganizing equipment etc… You may not always get to ride, but if you are assigned to work out the horses for the day, NO MATTER WHAT AGE YOU ARE YOU WILL BE REQUIRED TO WEAR A HELEMT WHILE MOUNTED ON HORSEBACK. And you will be required to write out in full your experience and limits in horseback riding. Please let the manager on duty know if you have any bodily limits that will hinder you in doing any of the activities listed above.
Volunteer’s Name;X_________________________________________________________________
Name of Volunteer’s Parent and/or Guardian;X______________________________________________
Volunteer’s Home
Address;X______________________________________________________________________________________________________________________________________________________________________________________
Volunteer’s Phone Number;X_____________________________________________________________
Volunteer’s E-Mail Address;X_______________________________________________________________________________________
How did you hear about us?;X___________________________________________________________________________________________________________________________________________________________________________________________________________________
Please list any and all physical boundaries you may have.;X________________________________________________________________________________________________________________________________________________________________________________________
Please list any and all experience you may have working with horses and/or farm related animals.;X_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I understand that NO MATTER my age, while mounted on horseback I MUST wear a helmet at all times.;X_________________________________________________________________
I understand while volunteering I MUST wear the proper attire, such as, but not limited to; Boots and/or shoes with a heel (NO flip flops, steal toed boots, open toed shoes etc…), T-Shirt (NO midriff shirts, v-necks, or spaghetti strapped shirts etc… are aloud!);X________________________________________________________________
I understand that I am responsible for my own food and/or drinks.;X____________________________
I understand that there is to be no cursing at the animals and/or staff members at DuBar’s Corner.;X_______________________________________________________________
I understand that all farm rules are to be followed, breaking of any rules results in termination of any contracts verbal and/or written, and I will be asked to leave the property.;X______________________________________________________________
I understand that I am volunteering of my own free will, and I will not gain anything in return such as (but not limited to); Horseback riding lessons, trail rides and/or any products that come from the farm.;X_________________________________________________________________
ACKNOWLEDGEMENT
The activity of volunteering at Dubar’s corner includes but is not limited to heavy lifting, close physical
Contact with horses and goats, both of which can cause injury, cleaning of water troughs, manure
Collection, feeding and exercising. I know and understand the risks of volunteering at a farm and accept
Liability for any and all injurys, including death.
As consideration for being a volunteer at Dubar’s corner and engaging in a variety of activities, I do
Hereby waive any claim and release Dubar’s Corner, and all of their owners, officers, staff members,
Volunteers, affiliated organizations and agents for injury and/or death caused by or resulting from my
Participation in such activities.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me / my child during the "entire period of my participation in handling of the animals, equipment and supplies upon the premises ofDubar's Comer and while under direction of Dubar's Comer at off-site locations Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations, govemment entities and businesses with whom they associate with, shall not be held liable liable.
I agree to indemnify Dubar's Comer, it's owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, assoCiations and any and all government agencies, and business from costs from any accident, illness, injU1)' or death which comes from mine or my child's participation in said activities. Furthermore I do by waive any claim and release Dubar's Corner it's owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business fiom any accident, illness, injU1)" or death which comes fiom mine or my child's participation in said activities. This is binding upon my spouse, children and heirs:
I understand that working with horses and/or farm animals there is a risk. I understand that it is my full responsibility to care for myself and/or my child I am signing for’s health. I will not hold DuBar’s Corner, Daniel Blair, Helena Blair, Deborah Blair, DuBar’s Corner’s Staff members and/or DuBar’s Corner’s other volunteer’s liable for any bodily injury and/or death to myself and/or my child I am signing for.
(Initial) X__________
Signature of Volunteer;X______________________________________________________________
Signature of Volunteer’s Parent and/or Guardian;X_____________________________________________________________
Date;___________________________________________________________________
Asst. Barn Manager;X______________________________________________________________
Date;X__________________________________________________________________
Barn Manager/Owner;X_____________________________________________________
Date;X__________________________________________________________________
Rescue and Rehab
Volunteer and riding waiver.
Dear volunteer,
We would like to welcome you here to DuBar’s Corner, and would also like to thank you for taking time out of your life to help us and these animals in need.
There are a few things that we need to discuss with you before we can assign you to your duties.
These animals here are all rescues. Some of them are still overcoming their fears of people. We ask that you do not enter any pens unless otherwise told. Most of these animals have been starved and beaten. We here at DuBar’s Corner work very hard to get them trusting and able for adoption. We are happy to have you here to help share this with us, but the horses here must be treated differently than most horses. So please keep your voices down, NO yelling. Please no fast movements around the animals, such as, but not limited to; Running, waving your arms, jumping, swinging gates and/or anything in your hands etc… The staff members here at DuBar’s Corner will let you know which horses are in their later stages of recovery so you may interact with them.
Yelling at and/or hitting of the animals will not be tolerated, and you will be asked to leave the property!
Children under the age of sixteen (16) can NOT volunteer without the signed permission of a parent and/or guardian.
Your volunteering time may entail you to do the following (But not limited to); Cleaning out pens(Goat, chicken and/or horse), building fences, painting, cleaning tack, bathing horses, grooming horses, lunging horses, reorganizing equipment etc… You may not always get to ride, but if you are assigned to work out the horses for the day, NO MATTER WHAT AGE YOU ARE YOU WILL BE REQUIRED TO WEAR A HELEMT WHILE MOUNTED ON HORSEBACK. And you will be required to write out in full your experience and limits in horseback riding. Please let the manager on duty know if you have any bodily limits that will hinder you in doing any of the activities listed above.
Volunteer’s Name;X_________________________________________________________________
Name of Volunteer’s Parent and/or Guardian;X______________________________________________
Volunteer’s Home
Address;X______________________________________________________________________________________________________________________________________________________________________________________
Volunteer’s Phone Number;X_____________________________________________________________
Volunteer’s E-Mail Address;X_______________________________________________________________________________________
How did you hear about us?;X___________________________________________________________________________________________________________________________________________________________________________________________________________________
Please list any and all physical boundaries you may have.;X________________________________________________________________________________________________________________________________________________________________________________________
Please list any and all experience you may have working with horses and/or farm related animals.;X_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
I understand that NO MATTER my age, while mounted on horseback I MUST wear a helmet at all times.;X_________________________________________________________________
I understand while volunteering I MUST wear the proper attire, such as, but not limited to; Boots and/or shoes with a heel (NO flip flops, steal toed boots, open toed shoes etc…), T-Shirt (NO midriff shirts, v-necks, or spaghetti strapped shirts etc… are aloud!);X________________________________________________________________
I understand that I am responsible for my own food and/or drinks.;X____________________________
I understand that there is to be no cursing at the animals and/or staff members at DuBar’s Corner.;X_______________________________________________________________
I understand that all farm rules are to be followed, breaking of any rules results in termination of any contracts verbal and/or written, and I will be asked to leave the property.;X______________________________________________________________
I understand that I am volunteering of my own free will, and I will not gain anything in return such as (but not limited to); Horseback riding lessons, trail rides and/or any products that come from the farm.;X_________________________________________________________________
ACKNOWLEDGEMENT
The activity of volunteering at Dubar’s corner includes but is not limited to heavy lifting, close physical
Contact with horses and goats, both of which can cause injury, cleaning of water troughs, manure
Collection, feeding and exercising. I know and understand the risks of volunteering at a farm and accept
Liability for any and all injurys, including death.
As consideration for being a volunteer at Dubar’s corner and engaging in a variety of activities, I do
Hereby waive any claim and release Dubar’s Corner, and all of their owners, officers, staff members,
Volunteers, affiliated organizations and agents for injury and/or death caused by or resulting from my
Participation in such activities.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me / my child during the "entire period of my participation in handling of the animals, equipment and supplies upon the premises ofDubar's Comer and while under direction of Dubar's Comer at off-site locations Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations, govemment entities and businesses with whom they associate with, shall not be held liable liable.
I agree to indemnify Dubar's Comer, it's owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, assoCiations and any and all government agencies, and business from costs from any accident, illness, injU1)' or death which comes from mine or my child's participation in said activities. Furthermore I do by waive any claim and release Dubar's Corner it's owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business fiom any accident, illness, injU1)" or death which comes fiom mine or my child's participation in said activities. This is binding upon my spouse, children and heirs:
I understand that working with horses and/or farm animals there is a risk. I understand that it is my full responsibility to care for myself and/or my child I am signing for’s health. I will not hold DuBar’s Corner, Daniel Blair, Helena Blair, Deborah Blair, DuBar’s Corner’s Staff members and/or DuBar’s Corner’s other volunteer’s liable for any bodily injury and/or death to myself and/or my child I am signing for.
(Initial) X__________
Signature of Volunteer;X______________________________________________________________
Signature of Volunteer’s Parent and/or Guardian;X_____________________________________________________________
Date;___________________________________________________________________
Asst. Barn Manager;X______________________________________________________________
Date;X__________________________________________________________________
Barn Manager/Owner;X_____________________________________________________
Date;X__________________________________________________________________
Boarding Agreement
DuBar’s Corner Horse Rescue
Boarding Contract
This boarding contract for DuBar’s Corner Inc. is made and entered on this ________ day of _____________ the year of _____________, by and between Deborah Blair, hereinafter designated “Manager”, and ___________________________ hereinafter designated “Owner”. Manager agrees to accept Owner’s horse ____________________, for boarding: and, it is the plan and intention of the Owner to board this said horse. For and in consideration of the agreements hereinafter set fourth, Owner and Manager mutually agree as follows:
1. Owner agrees that DuBar’s Corner Inc., their agents, employees and/or volunteers are not liable for death, sickness and/or accident, including consequential damages, caused to said horse. In addition Owner agrees to hold Manager, DuBar’s Corner and its entire owner’s, employees, and volunteers, completely harmless and not liable for any injury whatsoever caused to Owner, and/or said horse, and loss or damage to personal property.
2. It is the Owners responsibility to carry full and complete insurance coverage on Owner, Owner’s horse and all personal property. Owner agrees to abide by all DuBar’s Corner’s rules and regulations and wear proper safety equipment.
3. Owner shall pay Manager/DuBar’s Corner for boarding services, as described below:
$________________________ Per month Or $________________________ Per day
Marked boxes indicate services included in board:
O Stall O Fans
O Grain O Worming
O Regular feedings O Bedding and Cleaning
O Turning out O Hay
O Exercise O Blanketing
O Grooming O Farrier Care and Handling
O Use of pastures O Training
O Lessons O Use of facilities (Such as Round pen)
O Clipping O Vaccinations
O Vet handling O Horse Trailer Use
4. Board is due on the ___________ day of each month, timely payments are strictly enforced. A late fee of $5.00 per day will be charged on payments received more then four (4) days late. If payment is overdue by thirty (30) days Manager is entitled to a lien against the said horse for amount due and shall enforce lien and sell horse for amount due, according to laws of the state.
5. Horse shall be free from infectious contagious or transmittable disease. Required: Current negative Coggins Test, a health, worming and immunization record. Manager reserves the right to refuse said horse if not in proper health upon arrival.
6. Manager reserves the right to notify Owner within seven (7) days of horse’s arrival if horse, in Manager’s opinion, is deemed dangerous, sick or undesirable for a boarding stable. In such case, Owner is responsible for removing horse within seven (7) days and for all fees incurred during the horse’s stay. After all fees have been paid, this contract is concluded.
7. Regular veterinarian and farrier attention will be arranged by Owner unless veterinarian and farrier services are the same persons used by Manager, and then visits will be arranged by Manager. Owner will than be invoiced by Manager directly to Owner. In the event of sickness and/or accident to the horse, after reasonable efforts have failed to contact Owner, Manager has permission to contact a veterinarian for treatment.
8. If horse dies, sold, or upon thirty (30) days written notice to Manager after this date ___________________________________ Owner may terminate this contract for any reason. In such case, Manager shall be paid for all fees incurred up to the termination date. After all fees have been paid in full, this contract is concluded.
9. If at any time the Manager feels that it is in the best interest for the stable to ask the Owner to remove the said horse from DuBar’s Corner, the Manager will give the Owner at least fourteen (14) days written notice and Manager will be held harmless. At that time the Owner has fourteen (14) days to pay all the fees incurred in full, and then this contract is concluded.
10. This contract is non-assignable and non-transferable. If stable shuts down, Manager will give Owner thirty (30) days written notice and Manager will be held harmless.
11. Should either party breach this contract, the breaching party shall pay for the others court and the attorney’s fees related to such breach.
12. This contract is made and entered in the state of _______________ and shall be enforced and interpreted under the laws of this state.
13. This Contract represents the entire agreement between the parties. No other agreements or promises, verbal or implied, are included unless specifically stated in this written agreement. Additional agreements should be separately written below, if none check box O.
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
When the Manager and Owner, and/or Owner’s parent and/or guardian, if Owner is a minor, sign this contract it will then be binding on both parties, subject to the above terms and conditions.
________________________________________ DATE_____________
Manager’s (Or authorized agent’s) signature
________________________________________ DATE____________
Owner’s signature
________________________________________ DATE_____________
Owner’s parent and/or guardian’s signature (If Owner is a minor.)
_________________________________________________________________________________________________________________________________________________________________________
Owner’s home address
________________________________
Owner’s phone number
_________________________________________________________
Said horse’s name
________________________________________________________
Said horse’s breed
_________________________________________________________________________________________________________________________________________________________________________
Said horse’s colors and markings
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please write down if there is anything said horse is allergic to, and/or can not touch and/or eat.
Owner hereby confirms that there is liability coverage in force with respect to the ownership of the said horse.
Yes_____________ No____________
Owner’s signature________________________________________
________________________________________________________
Parent and/or guardian’s signature of Owner (if owner is a minor)
DATE__________________
___________________________________________________________
Barn Manager’s signature
___________________________________________________________
Asst. Barn Manager’s signature
Boarding Contract
This boarding contract for DuBar’s Corner Inc. is made and entered on this ________ day of _____________ the year of _____________, by and between Deborah Blair, hereinafter designated “Manager”, and ___________________________ hereinafter designated “Owner”. Manager agrees to accept Owner’s horse ____________________, for boarding: and, it is the plan and intention of the Owner to board this said horse. For and in consideration of the agreements hereinafter set fourth, Owner and Manager mutually agree as follows:
1. Owner agrees that DuBar’s Corner Inc., their agents, employees and/or volunteers are not liable for death, sickness and/or accident, including consequential damages, caused to said horse. In addition Owner agrees to hold Manager, DuBar’s Corner and its entire owner’s, employees, and volunteers, completely harmless and not liable for any injury whatsoever caused to Owner, and/or said horse, and loss or damage to personal property.
2. It is the Owners responsibility to carry full and complete insurance coverage on Owner, Owner’s horse and all personal property. Owner agrees to abide by all DuBar’s Corner’s rules and regulations and wear proper safety equipment.
3. Owner shall pay Manager/DuBar’s Corner for boarding services, as described below:
$________________________ Per month Or $________________________ Per day
Marked boxes indicate services included in board:
O Stall O Fans
O Grain O Worming
O Regular feedings O Bedding and Cleaning
O Turning out O Hay
O Exercise O Blanketing
O Grooming O Farrier Care and Handling
O Use of pastures O Training
O Lessons O Use of facilities (Such as Round pen)
O Clipping O Vaccinations
O Vet handling O Horse Trailer Use
4. Board is due on the ___________ day of each month, timely payments are strictly enforced. A late fee of $5.00 per day will be charged on payments received more then four (4) days late. If payment is overdue by thirty (30) days Manager is entitled to a lien against the said horse for amount due and shall enforce lien and sell horse for amount due, according to laws of the state.
5. Horse shall be free from infectious contagious or transmittable disease. Required: Current negative Coggins Test, a health, worming and immunization record. Manager reserves the right to refuse said horse if not in proper health upon arrival.
6. Manager reserves the right to notify Owner within seven (7) days of horse’s arrival if horse, in Manager’s opinion, is deemed dangerous, sick or undesirable for a boarding stable. In such case, Owner is responsible for removing horse within seven (7) days and for all fees incurred during the horse’s stay. After all fees have been paid, this contract is concluded.
7. Regular veterinarian and farrier attention will be arranged by Owner unless veterinarian and farrier services are the same persons used by Manager, and then visits will be arranged by Manager. Owner will than be invoiced by Manager directly to Owner. In the event of sickness and/or accident to the horse, after reasonable efforts have failed to contact Owner, Manager has permission to contact a veterinarian for treatment.
8. If horse dies, sold, or upon thirty (30) days written notice to Manager after this date ___________________________________ Owner may terminate this contract for any reason. In such case, Manager shall be paid for all fees incurred up to the termination date. After all fees have been paid in full, this contract is concluded.
9. If at any time the Manager feels that it is in the best interest for the stable to ask the Owner to remove the said horse from DuBar’s Corner, the Manager will give the Owner at least fourteen (14) days written notice and Manager will be held harmless. At that time the Owner has fourteen (14) days to pay all the fees incurred in full, and then this contract is concluded.
10. This contract is non-assignable and non-transferable. If stable shuts down, Manager will give Owner thirty (30) days written notice and Manager will be held harmless.
11. Should either party breach this contract, the breaching party shall pay for the others court and the attorney’s fees related to such breach.
12. This contract is made and entered in the state of _______________ and shall be enforced and interpreted under the laws of this state.
13. This Contract represents the entire agreement between the parties. No other agreements or promises, verbal or implied, are included unless specifically stated in this written agreement. Additional agreements should be separately written below, if none check box O.
______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
When the Manager and Owner, and/or Owner’s parent and/or guardian, if Owner is a minor, sign this contract it will then be binding on both parties, subject to the above terms and conditions.
________________________________________ DATE_____________
Manager’s (Or authorized agent’s) signature
________________________________________ DATE____________
Owner’s signature
________________________________________ DATE_____________
Owner’s parent and/or guardian’s signature (If Owner is a minor.)
_________________________________________________________________________________________________________________________________________________________________________
Owner’s home address
________________________________
Owner’s phone number
_________________________________________________________
Said horse’s name
________________________________________________________
Said horse’s breed
_________________________________________________________________________________________________________________________________________________________________________
Said horse’s colors and markings
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Please write down if there is anything said horse is allergic to, and/or can not touch and/or eat.
Owner hereby confirms that there is liability coverage in force with respect to the ownership of the said horse.
Yes_____________ No____________
Owner’s signature________________________________________
________________________________________________________
Parent and/or guardian’s signature of Owner (if owner is a minor)
DATE__________________
___________________________________________________________
Barn Manager’s signature
___________________________________________________________
Asst. Barn Manager’s signature
Horse Trailer Rental Agreement
DuBar’s Corner Horse Rescue
Trailer Rental Agreement
Rental agreement date _____________
Trailer Description;
Two (2) horse slant load, bumper pull, white with red/black striping.
Doors;
One (1) right side tack door, two (2) back loading doors.
Number of axles;
Two (2)
Make;
Haylo
Model;
Trailer
VIN#;
__________________
Plate#;
_________________ (Florida Tags)
The basic rental rates are as follows;
Up to 3 hours = $50.00____________
Up to 5 hours = $100.00___________
Up to 12 hours = $150.00__________
Up to 24 hours = $175.00__________
Up to 48 hours = $225.00__________
Up to 72 hours = $250.00__________
Up to 80 hours = $300.00__________
Dates and Time of Rental:
(Pick- Up) ___________________________________
(Drop Off) ___________________________________
Anticipated Mileage __________________________
If the trailer is returned after hours (6:30pm) there will be an extra fee of $25.00 added to the renter’s final bill.
If the trailer is returned late there will be an extra $40.00 fee added to the renter’s final bill for every hour that he/she is late in returning the said trailer, starting five (5) minutes after the said drop off (return) time.
The trailer must be returned clean and free of debris and trash. If trailer cleaning is required, an additional $25.00 fee will be charged for labor of the owner/farm workers.
Renter’s signature (Stating that he/she has read the above and understands in full.) X_______________________________________________________________
Terms and Conditions
Renter responsibilities- The renter agrees that he/she is responsible for any and all bodily injury and/or property damage that may occur while the trailer is in his/her possession. Accordingly, the renter agrees not to hold the owner liable from any and all responsibility for any claim whatsoever during the time that said trailer is in his/her possession.
Trailer value- The trailer being rented is valued at $23,000. Accordingly, the renter agrees to pay the owner for any and all damages to said trailer that is not otherwise covered by insurance.
Insurance for trailer contents- The contents of the trailer are not insured by the owner. Any damage and/or theft in relation to these items are the sole responsibility of the renter.
Trailer cleaning- The trailer must be returned clean and free of debris and trash. If trailer cleaning is required, an additional $25.00 fee will be charged for labor of the owner.
Special uses for said trailer- This trailer is for hauling horses and travel related gear ONLY. It is not to be used to haul anything unrelated. Hauling anything other than what said trailer is designated for can result in damages that the renter will be responsible.
Mileage- There is no mileage restrictions or limitations on this trailer. However, for the purpose of performing scheduled maintenance, the owner does request that the renter provide mileage during the time of rental as well as the time of return.
Alterations- The said trailer is designed for the purpose of hauling a maximum of two (2) horses at a time. Any alterations, additions or modifications to said trailer are forbidden. Anything of the like is considered to be property damage and is the renter’s responsibility.
Trailer repairs- The trailer is well maintained and should not pose any problems or inconveniences during the rental period. In the event of failure or breakage of any safety related trailer component while underway, the renter is responsible for any necessary trailer repairs. Accordingly, all repairs should be performed by a qualified trailer or automotive repair shop. Any and all repairs must be accompanied by proper receipts and any replaced components in order to be considered for reimbursement.
Additional days- In the event that the said trailer is not going to be returned at the appointed time, the owner must be notified VIA telephone (24 hours: 386 383-0096 or 386 872-0587). An additional $40.00 per hour fee will be assessed beginning ten (10) minutes after the return time agreed upon.
Renter’s Initials; ________________
Please put down your mailing address if you would like to be signed up for our newsletters. You will receive coupons and will be notified on our up coming events.
Yes_______ No________
_______________________________________________________________________________________________
Renter Information:
Renter’s Name __________________________________________________
Renter’s FULL home or mailing address
_______________________________________________________________________________________________Renter’s phone number __________________________________________
Renter’s e-mail ___________________________________________________________
Renter’s drivers license#_____________________________________State________
Copy of renter’s drivers license attached_____
Copy of renter’s VALID credit card attached_____
If NOT attached, card # _________________________________________
Cards expiration date___________________________________________
Cards VIN #___________________________
_____Visa ______Master Card _____American Express
Tow vehicle tag # ____________________________________
Copy of tow vehicle insurance card attached ________
___________ The renter agrees that the trailer will ONLY be towed by the vehicle listed above.
___________ The renter agrees that he/she signing this waiver is the ONLY person(s) approved to tow the said trailer.
___________ The renter agrees that the drivers license, insurance card and credit card information that has all been provided above is valid and legal.
By signing, the renter stated that all information on this rental agreement is both true and accurate. Furthermore, that he/she has reviewed the trailer towing guide, and he/she is knowledgeable in towing a trailer.
Signature of Renter:
_____________________________________________________________
Signature of witness:
_____________________________________________________________
Signature of Asst. Manager/ Barn Manger:
_____________________________________________________________
__________(DO NOT WRITE BELOW THE LINE, MANAGEMENT ONLY!)_________
Date:
_________________________________
Total Charges:
Time of pick up ___________
Time of drop off___________
Rental Fee________________
Delivery/Pick-up fee_________________
Cleaning (If necessary) ______________
Late Fee __________________
Total Fee __________
NOTES:
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Trailer Rental Agreement
Rental agreement date _____________
Trailer Description;
Two (2) horse slant load, bumper pull, white with red/black striping.
Doors;
One (1) right side tack door, two (2) back loading doors.
Number of axles;
Two (2)
Make;
Haylo
Model;
Trailer
VIN#;
__________________
Plate#;
_________________ (Florida Tags)
The basic rental rates are as follows;
Up to 3 hours = $50.00____________
Up to 5 hours = $100.00___________
Up to 12 hours = $150.00__________
Up to 24 hours = $175.00__________
Up to 48 hours = $225.00__________
Up to 72 hours = $250.00__________
Up to 80 hours = $300.00__________
Dates and Time of Rental:
(Pick- Up) ___________________________________
(Drop Off) ___________________________________
Anticipated Mileage __________________________
If the trailer is returned after hours (6:30pm) there will be an extra fee of $25.00 added to the renter’s final bill.
If the trailer is returned late there will be an extra $40.00 fee added to the renter’s final bill for every hour that he/she is late in returning the said trailer, starting five (5) minutes after the said drop off (return) time.
The trailer must be returned clean and free of debris and trash. If trailer cleaning is required, an additional $25.00 fee will be charged for labor of the owner/farm workers.
Renter’s signature (Stating that he/she has read the above and understands in full.) X_______________________________________________________________
- Optional delivery and pick-up charge $1.75/mile. Mileage is calculated round trip.
- Miscellaneous Equipment- Certain items of loose or detachable trailer support equipment is provided with each rental to ensure proper, safe and enjoyable hauling and use of the said trailer. The renter is responsible for the return of this equipment. Missing and/or damaged equipment will be replaced at the renter’s expense.
- By signing this rental agreement, the renter certifies that the towing vehicle has liability insurance that extends to the trailer in tow.
- Renter must be twenty five (25) years of age or older and review the online trailer towing guide.
- The renter’s tow vehicle must be able to accommodate three tons (6,000 lbs) of towing capacity, be in good condition and must be equipped with a 7-pin trailer connection in addition to an electronic brake controller.
Terms and Conditions
Renter responsibilities- The renter agrees that he/she is responsible for any and all bodily injury and/or property damage that may occur while the trailer is in his/her possession. Accordingly, the renter agrees not to hold the owner liable from any and all responsibility for any claim whatsoever during the time that said trailer is in his/her possession.
Trailer value- The trailer being rented is valued at $23,000. Accordingly, the renter agrees to pay the owner for any and all damages to said trailer that is not otherwise covered by insurance.
Insurance for trailer contents- The contents of the trailer are not insured by the owner. Any damage and/or theft in relation to these items are the sole responsibility of the renter.
Trailer cleaning- The trailer must be returned clean and free of debris and trash. If trailer cleaning is required, an additional $25.00 fee will be charged for labor of the owner.
Special uses for said trailer- This trailer is for hauling horses and travel related gear ONLY. It is not to be used to haul anything unrelated. Hauling anything other than what said trailer is designated for can result in damages that the renter will be responsible.
Mileage- There is no mileage restrictions or limitations on this trailer. However, for the purpose of performing scheduled maintenance, the owner does request that the renter provide mileage during the time of rental as well as the time of return.
Alterations- The said trailer is designed for the purpose of hauling a maximum of two (2) horses at a time. Any alterations, additions or modifications to said trailer are forbidden. Anything of the like is considered to be property damage and is the renter’s responsibility.
Trailer repairs- The trailer is well maintained and should not pose any problems or inconveniences during the rental period. In the event of failure or breakage of any safety related trailer component while underway, the renter is responsible for any necessary trailer repairs. Accordingly, all repairs should be performed by a qualified trailer or automotive repair shop. Any and all repairs must be accompanied by proper receipts and any replaced components in order to be considered for reimbursement.
Additional days- In the event that the said trailer is not going to be returned at the appointed time, the owner must be notified VIA telephone (24 hours: 386 383-0096 or 386 872-0587). An additional $40.00 per hour fee will be assessed beginning ten (10) minutes after the return time agreed upon.
Renter’s Initials; ________________
Please put down your mailing address if you would like to be signed up for our newsletters. You will receive coupons and will be notified on our up coming events.
Yes_______ No________
_______________________________________________________________________________________________
Renter Information:
Renter’s Name __________________________________________________
Renter’s FULL home or mailing address
_______________________________________________________________________________________________Renter’s phone number __________________________________________
Renter’s e-mail ___________________________________________________________
Renter’s drivers license#_____________________________________State________
Copy of renter’s drivers license attached_____
Copy of renter’s VALID credit card attached_____
If NOT attached, card # _________________________________________
Cards expiration date___________________________________________
Cards VIN #___________________________
_____Visa ______Master Card _____American Express
Tow vehicle tag # ____________________________________
Copy of tow vehicle insurance card attached ________
___________ The renter agrees that the trailer will ONLY be towed by the vehicle listed above.
___________ The renter agrees that he/she signing this waiver is the ONLY person(s) approved to tow the said trailer.
___________ The renter agrees that the drivers license, insurance card and credit card information that has all been provided above is valid and legal.
By signing, the renter stated that all information on this rental agreement is both true and accurate. Furthermore, that he/she has reviewed the trailer towing guide, and he/she is knowledgeable in towing a trailer.
Signature of Renter:
_____________________________________________________________
Signature of witness:
_____________________________________________________________
Signature of Asst. Manager/ Barn Manger:
_____________________________________________________________
__________(DO NOT WRITE BELOW THE LINE, MANAGEMENT ONLY!)_________
Date:
_________________________________
Total Charges:
Time of pick up ___________
Time of drop off___________
Rental Fee________________
Delivery/Pick-up fee_________________
Cleaning (If necessary) ______________
Late Fee __________________
Total Fee __________
NOTES:
___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Summer Camp Waiver
DuBar’s Corner Horse Rescue and Rehab
Summer camp waiver
Dear Parents and/or guardians,
During our summer camp program your child will not only learn how to properly care for all the needs of the horses, but also how to properly care for the equipment that they will be using for the horses.
They will learn how to ride more then one style of horse while they are here at the summer camp.
Your child will also learn how to care for chickens, and goats. Along with caring for them they will learn how to milk the goats that they are caring for.
We will also have games set up (on horseback) through out the day, to help show our students that there is hard work involved but lots of fun as well!
Parent’s Name; X_________________________________________________________
Cell or home number; X__________________________________________________
Emergency number; X____________________________________________________
Home address; X______________________________________________________________________________________________Emergency contact information;
Name;X_________________________________________________________________
Home or work number;X_________________________________________________
Cell number;X___________________________________________________________
Home address;_________________________________________________________________________________________
Would you like to get on our mailing list for up coming events and coupons? If yes please put done the FULL mailing address you would like the news letter sent to if not the same as your home address; X______________________________________________________________________________________________
Please list and describe any and all physical limitations/conditions which might limit or affect your participation in horse riding activities.
Please give full details including but not limited to;
Asthma, Back problems, Diabetes, Migraines, Anything that your child may be allergic too, etc…:
______________________________________________________
______________________________________________________
______________________________________________________
I recognize that there is a significant element of risk involved in horseback riding and the handling of horses. I state that I am fully capable of participating in such activities and I certify that I have no physical conditions, which might interfere with my capability to participate in horseback riding. Knowing the inherent risks, damages, and rigors involved in horseback riding, I assume responsibility for myself and/or my child for bodily injury, death, loss of personal property and all expenses thereof, which may occur as a result of my and/or my child’s participation in handling of horses and/or horseback riding and waive any and all claims which may result there from. I agree to indemnify DuBar’s Corner, It’s owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from costs from any accident, illness, injury or death which comes from mine and/or my child’s participation in said activities. Furthermore I do by waive any claim and release DuBar’s Corner it’s owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from and accident, illness, injury, or death which comes from mine and/or my child’s participation in said activities. This is binding upon my spouse, children and heirs.
I further understand that I can and will encounter various terrain changes, and that once on a horse DuBar’s Corner and its staff have little control over the horse. I understand that I must be able to control the horse and have no physical or medical conditions which would prevent me from doing so. I understand that horses have a will of their own, with unique personalities and at times can be unpredictable and I fully accept these conditions.
Upon placing my signature on this paper, I hereby acknowledge my full understanding and willingness to accept any and all risks of injury for the above mentioned activities for myself or for the minor, for who I am responsible.
I waive DuBar’s Corner, and all DuBar’s Corner’s workers from any and all liability.
I understand and acknowledge that hazards and obstructions can exist when being involved with horses, and that injuries resulting from the unpredictable nature of horses can occur.
I understand that any child under the age of sixteen (16) MUST wear a helmet!
Any child sixteen (16) to eighteen (18), if the parent and/or guardian approve and signs, is NOT required to wear a helmet; X__________________________________________
As consideration for being permitted by DuBar’s Corner to engage in the activity of horseback riding, I do hereby waive claim and release DuBar’s Corner, and all of their owners, officers, staff members, volunteers, affiliated organizations and agents for injury and/or death caused by or resulting from my participation in such activity.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me and/or my child during the entire period of my participation in handling of horses and/or taking of horseback riding lessons or trail riding upon the premises of DuBar’s Corner on off-site locations.
WARNING! Under Florida law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 773 of Florida Statutes.
By signing this waiver for DuBar’s Corner Horse Rescue Summer Camp Program I, as the legal parent and/or guardian of the child I am signing for, understand that I am fully responsible for the said child’s lunches, snacks and drinks that he/she will be required to bring; X_____________________________________________
I also understand by signing this waiver that I will be responsible for getting the said child that I am signing for to DuBar’s Corner Horse Rescue at the proper drop off time and I will also be responsible for picking up the said child that I am signing for at the proper time; X_______________________________________________
Parent and/or Guardian’s Signature;X_______________________________________________________________
Name of child; X__________________________________________________________
Child’s D.O.B.; X__________________________________________________________
Date;_____________________________________________________________________
_________(DO NOT SIGN BELOW THIS LINE, MANAGEMENT ONLY!)_________
NOTES;____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Asst. Manager’s signature; X______________________________________
Date; X_______________
Manger and/or owner’s signature; X________________________________
Date; X_______________
Summer camp waiver
Dear Parents and/or guardians,
During our summer camp program your child will not only learn how to properly care for all the needs of the horses, but also how to properly care for the equipment that they will be using for the horses.
They will learn how to ride more then one style of horse while they are here at the summer camp.
Your child will also learn how to care for chickens, and goats. Along with caring for them they will learn how to milk the goats that they are caring for.
We will also have games set up (on horseback) through out the day, to help show our students that there is hard work involved but lots of fun as well!
Parent’s Name; X_________________________________________________________
Cell or home number; X__________________________________________________
Emergency number; X____________________________________________________
Home address; X______________________________________________________________________________________________Emergency contact information;
Name;X_________________________________________________________________
Home or work number;X_________________________________________________
Cell number;X___________________________________________________________
Home address;_________________________________________________________________________________________
Would you like to get on our mailing list for up coming events and coupons? If yes please put done the FULL mailing address you would like the news letter sent to if not the same as your home address; X______________________________________________________________________________________________
Please list and describe any and all physical limitations/conditions which might limit or affect your participation in horse riding activities.
Please give full details including but not limited to;
Asthma, Back problems, Diabetes, Migraines, Anything that your child may be allergic too, etc…:
______________________________________________________
______________________________________________________
______________________________________________________
I recognize that there is a significant element of risk involved in horseback riding and the handling of horses. I state that I am fully capable of participating in such activities and I certify that I have no physical conditions, which might interfere with my capability to participate in horseback riding. Knowing the inherent risks, damages, and rigors involved in horseback riding, I assume responsibility for myself and/or my child for bodily injury, death, loss of personal property and all expenses thereof, which may occur as a result of my and/or my child’s participation in handling of horses and/or horseback riding and waive any and all claims which may result there from. I agree to indemnify DuBar’s Corner, It’s owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from costs from any accident, illness, injury or death which comes from mine and/or my child’s participation in said activities. Furthermore I do by waive any claim and release DuBar’s Corner it’s owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from and accident, illness, injury, or death which comes from mine and/or my child’s participation in said activities. This is binding upon my spouse, children and heirs.
I further understand that I can and will encounter various terrain changes, and that once on a horse DuBar’s Corner and its staff have little control over the horse. I understand that I must be able to control the horse and have no physical or medical conditions which would prevent me from doing so. I understand that horses have a will of their own, with unique personalities and at times can be unpredictable and I fully accept these conditions.
Upon placing my signature on this paper, I hereby acknowledge my full understanding and willingness to accept any and all risks of injury for the above mentioned activities for myself or for the minor, for who I am responsible.
I waive DuBar’s Corner, and all DuBar’s Corner’s workers from any and all liability.
I understand and acknowledge that hazards and obstructions can exist when being involved with horses, and that injuries resulting from the unpredictable nature of horses can occur.
I understand that any child under the age of sixteen (16) MUST wear a helmet!
Any child sixteen (16) to eighteen (18), if the parent and/or guardian approve and signs, is NOT required to wear a helmet; X__________________________________________
As consideration for being permitted by DuBar’s Corner to engage in the activity of horseback riding, I do hereby waive claim and release DuBar’s Corner, and all of their owners, officers, staff members, volunteers, affiliated organizations and agents for injury and/or death caused by or resulting from my participation in such activity.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me and/or my child during the entire period of my participation in handling of horses and/or taking of horseback riding lessons or trail riding upon the premises of DuBar’s Corner on off-site locations.
WARNING! Under Florida law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 773 of Florida Statutes.
By signing this waiver for DuBar’s Corner Horse Rescue Summer Camp Program I, as the legal parent and/or guardian of the child I am signing for, understand that I am fully responsible for the said child’s lunches, snacks and drinks that he/she will be required to bring; X_____________________________________________
I also understand by signing this waiver that I will be responsible for getting the said child that I am signing for to DuBar’s Corner Horse Rescue at the proper drop off time and I will also be responsible for picking up the said child that I am signing for at the proper time; X_______________________________________________
Parent and/or Guardian’s Signature;X_______________________________________________________________
Name of child; X__________________________________________________________
Child’s D.O.B.; X__________________________________________________________
Date;_____________________________________________________________________
_________(DO NOT SIGN BELOW THIS LINE, MANAGEMENT ONLY!)_________
NOTES;____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
Asst. Manager’s signature; X______________________________________
Date; X_______________
Manger and/or owner’s signature; X________________________________
Date; X_______________
Visitor Waiver
DuBar’s Corner Horse Rescue and Rehab
Visitor waiver
Dear visitor,
We thank you for taking time out of your day to come and visit our rescue and meet our horses.
We request that you only touch and interact with the horses that management allows.
Please stay a good distance away from all pens, unless otherwise said by management, to keep the stress of the animals down.
Visitor’s Name, and/or other names of visitor’s party;X________________________________________________________________________________________________________________________________________________________________________________________
Reason for visit;X_____________________________________________________________________________________________________________________________________________________________________
Would you like to get on our mailing list for upcoming events and/or coupons? If so please you’re your mailing address that you would like our newsletters to be sent too;____________________________________________________________________________________________
Visitor’s Home Address;X_______________________________________________________________________________________Visitor’s Phone Number;X__(__________)__________________________________________________
ACKNOWLEDGEMENT
The activity of volunteering at Dubar’s corner includes but is not limited to heavy lifting, close physical
Contact with horses and goats, both of which can cause injury, cleaning of water troughs, manure
Collection, feeding and exercising. I know and understand the risks of volunteering at a farm and accept
Liability for any and all injurys, including death.
As consideration for being a volunteer at Dubar’s corner and engaging in a variety of activities, I do
Hereby waive any claim and release Dubar’s Corner, and all of their owners, officers, staff members,
Volunteers, affiliated organizations and agents for injury and/or death caused by or resulting from my
Participation in such activities.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me / my child during the "entire period of my participation in handling of the animals, equipment and supplies upon the premises ofDubar's Comer and while under direction of Dubar's Comer at off-site locations Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations, government entities and businesses with whom they associate with, shall not be held liable.
I agree to indemnify Dubar's Comer, it's owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from costs from any accident, illness, injury)' or death which comes from mine or my child's participation in said activities. Furthermore I do by waive any claim and release Dubar's Corner it's owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from any accident, illness, injury)" or death which comes from mine or my child's participation in said activities. This is binding upon my spouse, children and heirs:
I understand that working with horses/farm animals and/or interacting with horses/farm animals I am taking a risk of bodily injury and/or death. I understand that even if I am not interacting with the animals at DuBar’s Corner I am taking a risk of bodily injury and/or death;X_______________________________
I understand by signing this I am waiving DuBar’s Corner, its owner’s, their workers/volunteers and anyone associated with DuBar’s Corner, liable for any injury and/or death that may accrue to me and/or any children I am signing for. I understand that DuBar’s Corner, its owner’s, their workers/volunteers and anyone associated with DuBar’s Corner, cannot be held liable for any broken, lost and/or stolen items, of mine and/or of any children I am signing for;
X_______
Visitor’s signature;X______________________________________________________________
Date;X_____________________
Asst. Barn Manager’s Signature;X______________________________________________________________
Date;X____________________
Barn Manager/Owner’s Signature;X______________________________________________________________
Date;X___________________
Visitor waiver
Dear visitor,
We thank you for taking time out of your day to come and visit our rescue and meet our horses.
We request that you only touch and interact with the horses that management allows.
Please stay a good distance away from all pens, unless otherwise said by management, to keep the stress of the animals down.
Visitor’s Name, and/or other names of visitor’s party;X________________________________________________________________________________________________________________________________________________________________________________________
Reason for visit;X_____________________________________________________________________________________________________________________________________________________________________
Would you like to get on our mailing list for upcoming events and/or coupons? If so please you’re your mailing address that you would like our newsletters to be sent too;____________________________________________________________________________________________
Visitor’s Home Address;X_______________________________________________________________________________________Visitor’s Phone Number;X__(__________)__________________________________________________
ACKNOWLEDGEMENT
The activity of volunteering at Dubar’s corner includes but is not limited to heavy lifting, close physical
Contact with horses and goats, both of which can cause injury, cleaning of water troughs, manure
Collection, feeding and exercising. I know and understand the risks of volunteering at a farm and accept
Liability for any and all injurys, including death.
As consideration for being a volunteer at Dubar’s corner and engaging in a variety of activities, I do
Hereby waive any claim and release Dubar’s Corner, and all of their owners, officers, staff members,
Volunteers, affiliated organizations and agents for injury and/or death caused by or resulting from my
Participation in such activities.
I have read, understand, and agree to the terms and conditions stated herein. I acknowledge that this agreement shall be effective and binding upon me / my child during the "entire period of my participation in handling of the animals, equipment and supplies upon the premises ofDubar's Comer and while under direction of Dubar's Comer at off-site locations Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations, government entities and businesses with whom they associate with, shall not be held liable.
I agree to indemnify Dubar's Comer, it's owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from costs from any accident, illness, injury)' or death which comes from mine or my child's participation in said activities. Furthermore I do by waive any claim and release Dubar's Corner it's owners, Daniel, Helena and Deborah Blair, their staff, volunteers, organizations, associations and any and all government agencies, and business from any accident, illness, injury)" or death which comes from mine or my child's participation in said activities. This is binding upon my spouse, children and heirs:
I understand that working with horses/farm animals and/or interacting with horses/farm animals I am taking a risk of bodily injury and/or death. I understand that even if I am not interacting with the animals at DuBar’s Corner I am taking a risk of bodily injury and/or death;X_______________________________
I understand by signing this I am waiving DuBar’s Corner, its owner’s, their workers/volunteers and anyone associated with DuBar’s Corner, liable for any injury and/or death that may accrue to me and/or any children I am signing for. I understand that DuBar’s Corner, its owner’s, their workers/volunteers and anyone associated with DuBar’s Corner, cannot be held liable for any broken, lost and/or stolen items, of mine and/or of any children I am signing for;
X_______
Visitor’s signature;X______________________________________________________________
Date;X_____________________
Asst. Barn Manager’s Signature;X______________________________________________________________
Date;X____________________
Barn Manager/Owner’s Signature;X______________________________________________________________
Date;X___________________