Loudoun Therapeutic Riding 2021 Participant Application

Welcome to LTR!


LTR is a Professional Association of Therapeutic Horsemanship, Intl. Premier Accredited Center and abides by the standards, guidelines, policies and Code of Ethics set forth in PATH, Intl. Standards for Certification & Accreditation Manual.


Our Mission: LTR was formed in 1974 to empower and improve the lives of people with cognitive, psychological and physical disabilities through the benefits of equine assisted activities and therapies, while serving our industry through training and education.  


Our Vision: LTR strives to provide our community news ways to build strong relationships and experience personal growth through the healing power of horses in a culture of CARE...Courage, Acceptance, Respect, Encouragement.


Our Programs: Built around our Core Values of Love, Trust & Respect. Partnering with our horses, programs are developed to foster a community environment that promotes learning, inclusion, respect & independence.


This application is required (and must be updated annually) by our accreditation standards and is intended for returning, new and prospective participants in order for our staff to provide a safe and positive experience. Thank you for carefully completing the required information below, and we look forward to your participation. 


General Information





















Parent/Legal Guardian/Caregiver Information**REQUIRED if participant is under 18 years of age or not  own guardian**
















Health History  










Releases








Liability Release and Waiver of Right to Sue

 

            I, __________________________________________________  give this release and waiver of right to sue (the "Release") in consideration for the opportunity to: (i) volunteer; (ii) take lessons; (iii) receive therapy; (iv) visit, handle, ride or be in proximity to horses; and/or (v) engage in any other Equine Activity at the property (“Property”) owned by Loudoun Therapeutic Riding Foundation, Inc., a Virginia not for profit corporation (“LTR”).  Capitalized terms not defined in this Release shall have the meaning defined in Virginia’s Equine Activity Liability Act (Code of Virginia Sec. 3.2-6200 et seq.) (the "Act") which is incorporated by this reference. In this Release use of the term "Released Parties" shall be defined to include LTR, as well as its directors, officers, employees, volunteers, agents, successors, assigns and insurers.

 

            The Act defines Equine Activities and I understand and hereby acknowledge and agree that when I am on the Property I am a Participant in an Equine Activity. The Act also describes certain Intrinsic Dangers of Equine Activities (the “Intrinsic Dangers”).  Those Intrinsic Dangers include: (i) the propensity of equines to behave in ways that may result in injury, harm or death to persons on or around them; (ii) the unpredictability of an equine's reaction to such things as sounds, sudden movement, and unfamiliar objects, persons, or other animals; (iii) certain hazards such as surface and subsurface conditions; (iv) collisions with other animals or objects; and (v) the potential of a Participant acting in a negligent manner that may contribute to injury to the Participant or others, such as failing to maintain control over the equine or not acting within the Participant’s ability.    

 

  I understand and hereby acknowledge and agree that LTR, its directors, officers, employees, volunteers and agents are Equine Activity Sponsors and/or Equine Professionals as defined by the Act and that the Act provides that such Sponsors and Professionals are not liable for injury or death resulting from the Intrinsic Dangers. I understand that, as a Participant, the Act allows me to waive my right to sue for any potential injury or death resulting from the Intrinsic Dangers. The Act allows this Release to be binding in certain circumstances even if the Equine Activity Sponsor or Professional has committed an act or omission that constitutes negligence for my safety.

 

            Because I desire to participate in Equine Activities I hereby agree that I understand the Intrinsic Dangers and I agree to assume all of the risks posed by the Intrinsic Dangers and I release and waive all claims and rights to sue, including without limitation claims for negligence, which I or my family members, estate, heirs, personal representatives, successors and assigns may now or hereafter have against the Released Parties for my death or personal injury as a result of participating in Equine Activities.

 

If the Participant is a minor or otherwise under a legal disability, this Release shall be executed by the Participant’s parents, legal guardian or their duly authorized representative. By signing, the parents or guardian agrees to waive the parents’ or guardian’s and Participant’s rights to sue the Released Parties and also assumes on behalf of the parents, guardian and Participant the Intrinsic Dangers and all other risks of Equine Activities; and agrees to hold harmless and indemnify the Released Parties against any and all payments, claims, damages, liabilities, suits, losses and expenses, including attorneys fees and costs, for any accident, damage, loss, injury, illness or death caused to Participant or to Participant’s property.  The person or persons signing on behalf of a Participant hereby warrant and represent that they are duly authorized to grant this Release and will indemnify and hold harmless the Released Parties against any claims against the Released Parties by another parent or other non-signing party.

 

 I intend for this Release to be interpreted so as to afford the Released Parties the maximum protection against liability possible under the Act and other provisions of Virginia law. If any provision in this Release, or any portion thereof, is held to be invalid, that fact shall not affect the validity of the remaining provisions and portions thereof.

 

I have read and understand this Release and the rights I am giving up and I agree to be bound by this Release on an ongoing basis.  I agree that I may not revoke this Release for conduct that occurred prior to my revocation, and that I can only revoke this Release on a prospective basis by delivering a written revocation to LTR’s Executive Director.

Caution: Read before signing:  






Next Steps:


Thank you for completing the required Participant Application. 


Please check spam/junk folders for LTR replies to email or application submissions.


You will be redirected back to the forms page once you click "Submit" below. 


To complete the application process, please print the required Physician’s Statement, then have your/your child's doctor complete, sign, date and then return to LTR, Inc. via email or postal mail prior to the first day of participation. 


The LTR Program Director will contact you regarding the session schedule once available space is determined. Once space in a session is confirmed you will receive an invoice via email for program service fees.


If you are a prospective participant you will be contacted for a required initial visit & assessment.


Questions? Please contact us at info@ltrf.org