Volunteer Release

MM/DD/YYYY

Emergency Information
Emergency Medical Treatment

 for emergency medical treatment/aid in the case of illness or injury during the process of receiving services or while being on the property of Saddle Up!. Consent for emergency medical treatment authorizes Saddle Up! to secure and retain medical treatment and transportation if needed and release client records upon request to the authorized individual or agency involved in the medical emergency treatment. This authorization includes x-ray, surgery, hospitalization, medication and any treatment procedure deemed “life saving” by the physician. If you choose DO NOT consent you will be required to meet with a full-time staff member.

Publicity Agreement

to and authorize the use and reproduction by Saddle Up! of any and all photographs and any other audio-visual materials taken of me for promotional material, educational activities, exhibitions or for any other use for the benefit of the program.

Release and Indemnity Agreement for Volunteers 

In recognition of the fact that I will be working in a volunteer capacity with the Saddle Up! program to be conducted either at the Saddle Up! facilities in Franklin, Tennessee, or at another location for a Saddle Up! related event, recognizing that working with and around horses is an inherently risky behavior, I hereby, intending to be legally bound, for myself, my heirs and assigns, executors or administrators, do hereby release, absolve, indemnify and hold harmless Saddle Up!, its representatives, supervisors, directors, officers, employees, suppliers, corporate sponsors or any other volunteers from any damages, injuries, claims, suits or costs arising in any way out of the conduct of the activities of the Saddle Up! program, including any injury which may occur at the Saddle Up! facilities or in transit to or from the Saddle Up! facilities or related events, except such liability or claim of liability as may result from gross negligence on the part of Saddle Up!. I am executing this Release with a full understanding that the Saddle Up! program will involve my working directly with horses and individuals with disabilities.

Warning

Under Tennessee law, an equine professional is not liable for an injury to or death of a participant in equine activities resulting from the inherent risks of equine activities, pursuant to Tennessee Code Annotated, Title 44, Chapter 20, Section 1.

Confidentiality Statement:

I understand that all medical, social, referral, personal and financial information regarding the student(s) and his/her family, other staff members and volunteers as well as Saddle Up! mailing lists is strictly confidential. (See the volunteer manual for the full Confidentiality Policy.)