Registration Forms


You may download the following forms by right-clicking on the icon or
red arrow at the end of each form or you may copy and paste each form into a Word document. Then print the forms.

Please complete and sign the forms, then bring them with you to your riding session. You may not participate in riding until your registration forms are submitted.


There are several medical release forms and liability forms, you must complete ALL of them because they are used for different purposes and events.

Complete all forms and bring them with you to the first riding session.





Rider Registration/Emergency Tmt

     YOU’VE GOT TO HAVE HEART
A Texas Corporation
dba S.H.A.R.E.

RIDER REGISTRATION AND EMERGENCY TREATMENT

DATE__________________

Although every effort will be made to avoid any accident, no liability can be accepted by any of the individuals or organizations concerned.

Please provide the following information in case of an emergency:

Rider Name____________________________________

Date of birth:___________________________________

Address:_______________________________________

City, State, Zip:_________________________________

Phone(s):______________________________________

Medical Problems (if any):___________________________________________


Parent/Guardian (if applicable):______________________________________________

Emergency Phone Number(s):_______________________________________________

Physican’s Name:___________________________________Phone:______________________

Alternate contact in case of an emergency:__________________________________

_____________________________________________________________________
Download Rider Registration Form-new.doc

Release of Liability

     RELEASE OF LIABILITY AND WAIVER OF PAYMENT FOR INJURIES, DAMAGES OR DEATH

WARNING:

UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE) AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES.

It is expressly understood that You’ve Got To Have Heart (d/b/a S.H.A.R.E. (Special Horses And Riders Excelling)) is a not-for-profit (501(c)(3)) corporation, incorporated in the State of Texas to provide recreational activities for individuals with disabilities and their families. You’ve Got To Have Heart (d/b/a S.H.A.R.E.) does not carry liability or medical insurance as all work is done by volunteers who give of their time and allow the use of their personal horses.

You’ve Got To Have Heart tries at all times to provide a safe environment in which to ride and gentle horses for the riders to learn, practice, and compete on. As noted above, equine activities are inherently dangerous.

The undersigned agree that they, their heirs, successors, and assigns will take no legal action nor seek restitution for damages and/or medical bills from You’ve Got To Have Heart (d/b/a S.H.A.R.E.) nor from any of the volunteers or owners of horses used in the program in the event of any injury, damage, or death resulting from participation in the activities of You’ve Got To Have Heart.



___________________________
Signature of Rider/Volunteer


________________________
Printed Name



___________________________
Signature of Parent or Guardian


________________________
Printed Name



___________________________
Date
Download liability release re insurance new2.doc

Authorization for Medical Treatment

     Authorization for Purposes of Providing Medical Treatment

You are being asked to complete this form to give appropriate medical facility permission

to treat__________________________________________for minor injury or medical
problems. In the event of serious injury or illness, you will be contacted; treatment will
proceed before contacting you only if the situation is urgent and does not permit delay.

Preferred medical facility_______________________________________________

Medical conditions or health problems_____________________________________

Medications currently being taken________________________________________


In case of medical emergency, the undersigned authorizes You’ve Got to Have Heart
d/b/a/S.H.A.R.E. volunteers/employees to seek any medical and/or surgical treatment

necessary for the care of __________________________________who is participating in
the SHARE riding program with parent/guardian permission and with the permission of

his/her physician______________________________. I understand that no liability can
be accepted by an individual or organization concerned with this program in the event of
any accident which may occur.

Health Insurance Policy holder_____________________________________________

Health Insurance Company______________________________________________________________

Policy Number and employer______________________________________________

The above designated person(s) is (are) hereby authorized to incur medical costs necessary to provide medical treatment for said participant for which we shall be fully responsible. We also authorize the medical facility to release any and all information required to complete insurance claims and also authorize insurance payment directly to the medical facility.

Signature of rider/parent/guardian__________________________________________

Date______________________________

Witness__________________________________________
Download Authorization for  Medical Treatment-new.doc

Riding Waiver

     RIDING WAIVER

I understand that riding is a dangerous sport, and I assume risk and liability for myself or my child. I understand that You’ve Got to Have Heart d/b/a/ SHARE, the property owners, and its employees/volunteers cannot be held liable for injuries while on stable premises or otherwise under the supervision of its volunteers/employees. Knowing the You’ve Got to Have Heart organization will do its best for the safety of its members, I assume all responsibility and waive any claim for compensation for accidental injury while on the stable premises and hereby agree to indemnify and hold harmless You’ve Got to Have Heart, its property owners, its director, and its volunteers/employees against any claims which may arise from an injury.

WARNING

UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE), AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES.

Name of rider/volunteer_____________________________________________________

Signature of rider/volunteer or parent/guardian___________________________________

Printed name_____________________________________________________

Date__________________________________Phone_____________________

Address__________________________________________________________




Download Riding Waiver-new.doc

Special Olympics Liablity Waiver

     EQUINE LIABILITY RELEASE

This release contains important limitations of legal liability.
All coaches, chaperones, and athletes shall present a copy of this form, signed appropriately, with area and chapter entry forms.

The undersigned states as follows:

I have read and understand the following:

WARNING

UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE), AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES.

Signature (athlete)_____________________________________________________

(parent/guardian)___________________________________

(coach)_____________________________________________________

Date__________________________________
Download Special Olympics RIDING WAIVER-new.doc

Riding Cancellation Info

     S.H.A.R.E.

CANCELLATION/WEATHER INFORMATION
(If you cannot attend your scheduled riding session or to see if riding has been cancelled due to bad weather)


Dear S.H.A.R.E. riders:

You’ll have been wonderful about calling or emailing -  lombard650@gmail.com   -to let me know if you are canceling or to get a weather check prior to driving out.

It is best to use the email only for “early” cancellations (up to 2 hours before your assigned riding time) as I do not check the email accounts once we start getting the horses ready to go.

You may call the barn (979) 690-2364 to find out if riding is cancelled due to inclement weather or other problems. This phone has voice mail.

You may call my house if you are doing a weather check early in the morning or shortly before an evening ride (979) 690-9341.

My cell phone (which I usually have with me only if I am away from home) is (979) 229-6637. The cell phone is an excellent number to use when traveling to a competition or if you need to speak to me and do not find me at either of the above numbers.

Thanks!

Patricia




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