General Release Form

We are excited to share the magic of Misty Meadows Equine Learning Center with you. Please complete the following application so that we can get to know you better.

Contact Details

Participant Name

Birthdate

Preferred Gender Pronouns

Guardian 1 Information/Adult participant information

First Name

Last Name

Mobile Phone

Work Phone

Home Phone

Preferred Phone

Email Address

Address

City

State

Postal Code

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Guardian 2 Information/Not applicable if adult participant

This information is not applicable to me

First Name

Last Name

Mobile Phone

Work Phone

Home Phone

Preferred Phone

Personal Email

Work Email

Alternate Email

Preferred Email

Address

City

State

Postal Code

If you do NOT wish to receive our newsletter or updates please check here

Okay to Text

Person (s) to contact in the case of an emergency.

Full Name of Emergency Contact 1

Phone # of Contact 1

Full Name of Emergency Contact 2

Phone # of Contact 2

Participant's Name

This Release and Indemnification is granted by the undersigned individual, the “Participant”) or the Participants parent, or legal guardian if the Participant is under the age of eighteen (the “Participant’s Parent”), to Misty Meadows Foundation, Inc. (the “Foundation”), owner of 55 Misty Meadows Lane, West Tisbury, MA (Assessor Map 26, Parcel 20) (the “Property”), and Misty Meadows Equine Learning Center, Inc., the entity that is running and overseeing the Activities as defined below.

In consideration for allowing the Participant to use the Property for various equine activities, including but not limited to riding, training, caring for or taking lessons with horses, engaging in therapeutic activities, or viewing any such activities, whether the horses are owned by the Participant, by the Foundation, by Misty Meadows, or by others (together, the “Activities”), the Participant and the Participant’s Parent hereby acknowledge and agree, for themselves and their heirs, executors, administrators, and spouses, descendants and parents if applicable, that they will not sue or otherwise hold liable, and that they will indemnify, defend and hold harmless, the Foundation, Misty Meadows, and any of the Foundation’s or Misty Meadow’s members, officers, directors, shareholders, agents, employees, contractors, representatives, volunteers, or related entities, for and from any death or injury to themselves or to others, or for any damage to property, however caused, arising out of or in any way related to the Activities or the use of the Property by the Participant or the Participant’s Parent or their guests, agents or representatives, to the fullest extent allowed by law.

The Foundation and Misty Meadows will not permit the Participant and the Participant’s Parent to utilize the Property for the Activities without the execution of this Release and Indemnification, which is of material significance to the Foundation. As used herein, the word “horse” shall include horses and ponies of every kind.

The Participant/ the Participant’s Parent hereby acknowledges that the Activities are “equine activities”, that the Foundation is an “equine activity sponsor”, that Misty Meadows and its representatives are “equine activity sponsors” and/or “equine professionals”, and that the Participant / the Participant’s Parent is a “Participant”, all as defined by Massachusetts General Laws Chapter 128, Section 2D.

The Participant / the Participant’s Parent acknowledge and understand that horses and activities related to horses are inherently dangerous and that there are dangers and risks which are an integral part of equine activities, including but not limited to the propensity of horses to behave in ways that may result in injury, harm or death to persons on or around them; the unpredictability of a horse’s reaction to such things as sounds, sudden movement and unfamiliar objects, persons or other animals; certain hazards such as surface conditions and subsurface conditions; collisions with other horses, animals and objects; and the potential of the Participant or the Participant’s Parent or others to act in a negligent manner that may contribute to injury to themselves or others. The Participant / the Participant’s Parent acknowledge and agree that these are just some of the risks associated with the Activities, that the Participant / the Participant’s Parent is not relying on the Foundation or Misty Meadows to list all of the possible risks associated with the Activities, and that, despite these inherent risks, the Participant / the Participant’s Parent has chosen to engage in the Activities at the Property.

The Participant / the Participant’s Parent represent that they have voluntarily chosen and desire to use the Property and engage in the Activities, that they will not engage in any activities if they are unable to safely do so, and that they will comply with all directions, requirements and rules imposed by the Foundation and Misty Meadows. In case of injury to the Participant or the Participant’s Parent while at the Property, the Participant / the Participant’s Parent authorizes Misty Meadows to seek medical care for them. The Participant and the Participant’s Parent acknowledge that they shall be solely responsible for the payment of medical costs associated with such care.

This Release and Indemnification shall be interpreted in accordance with the laws of Massachusetts. No waiver by any party of any breach by any other party of, or failure of any party to comply with, any condition or provision of this Release and Indemnification shall be deemed a waiver of any other breach or failure. The invalidity of any provision of this Release and Indemnification shall in no way affect the validity of any other provision.

I have read this document in complete detail and have had an opportunity to consult with an attorney if I have chosen to do so. I understand that it is a promise not to sue and a release and indemnity for all claims, and I understand all consequences of signing this release and indemnity.

This Release and Indemnification shall be binding upon me each and every time I engage in any of the Activities, without the need for re-execution. I hereby execute this Release and Indemnification as an instrument under seal, for myself and my spouse, descendants, parents, heirs, executors and administrators.

Release & Indemnification

Electronic Signature

Date

PHOTO RELEASE

Please Check One

I hereby consent to authorize the use and reproduction by Misty Meadows Equine Learning Center/Misty Meadows Foundation of any and all photographs and any other audio visual materials taken of me/my child for the sole benefit of the program from a professional, promotional or educational standpoint.

I hereby DO NOT consent to authorize the use and reproduction by Misty Meadows Equine Learning Center/

Misty Meadows Foundation of any and all photographs and any other audio visual materials taken of me/my child for the sole benefit of the program from a professional, promotional or educational standpoint.

Electronic Signature (Photo Release)

Date

Confidentiality Policy

At Misty Meadows, we place great importance on protecting the confidential information of our students, staff, and volunteers.

Confidential information includes, but is not limited to, personally identifiable information (i.e. surnames, telephone numbers, addresses, e-mails, etc.), the non-public business records of Misty Meadows, medical information about students.

Confidential Information shall never be disclosed to anyone other than Misty Meadows Staff. Volunteers must seek staff permission before taking any pictures or videos.

I have read and understand the Misty Meadows Confidentiality Policy and agree to abide by same.

Electronic Signature (Confidentiality)

Date

Conduct Expectations

The following Conduct Expectations shall apply to the Misty Meadows Equine Learning Center (MMELC) community which includes: employees, board members, students and their families, volunteers, and visitors.

We are committed to honesty and integrity in all realms of our work, treating every individual with courtesy, dignity, and respect, providing conditions that safe guard our participants’ well-being, and acting for the benefit of the communities that we serve.

There is zero-tolerance for use or possession of alcoholic beverages, tobacco products, or illegal drugs on the Misty Meadows property. Staff or Volunteers may not report to work under the influence of alcohol, illegal drugs, or controlled substances.

There are some actions that we unequivocally condemn and will not be tolerated in the name of our Center.

Using angry or vulgar language including swearing, name-calling, or shouting
Making physical contact with a person in any angry or threatening manner
Engaging in sexual activity, harassment, or contact with another person
Harassing, threatening or intimidating by words, gestures, body language, or other menacing behavior
Stealing or destruction of property
Carrying or concealing any weapons, devices or objects which may be used as a weapon (unless carrying tools for the purpose of a property-related task)

There are equine-specific expectations that everybody should follow

Any form of negative language directed to the horses is prohibited
Any form of harassment or physical violence, or talk of, towards horses is prohibited.

I understand and agree that failure to abide by these Conduct Expectations may result in immediate dismissal from Misty Meadows Equine Learning Center.

Electronic Signature (Attendance Policy)

Date