I (Participant or Parent/Legal Guardian if above named Participant is under the age of 18), hereby acknowledge that I am voluntarily seeking access to and/or requesting to participate in equestrian activities on or away from the premises of The National Center for Equine Facilitated Therapy (NCEFT).

I agree to abide by all rules, written and implied, at NCEFT. I am aware that equine-related activities can be hazardous. I am voluntarily participating in these activities with the knowledge of the danger involved and hereby agree to accept any and all risks of injury or death.

In consideration for being permitted access or to use the facilities at NCEFT and/or participate in any NCEFT programs, I hereby agree that I, my heirs, my distributes, guardians, legal representatives and assignees will not make a claim against, sue, attach the property of or prosecute NCEFT, its directors, officers, members, employees, volunteers or assignees, for any claim I now have or may hereafter have for death, injury or property damage resulting from my use of the facilities at NCEFT or my participation in any NCEFT endorsed activities, whether caused by my acts of omission or negligence or anyone else’s acts of omission or negligence. In addition, it is understood that any and all insurance that I have shall be primary.

To the fullest extent permitted by law, I shall defend, indemnify and hold harmless, NCEFT, its directors, officers, agents, volunteers, or employees for and against any and all claims, damages, losses, expenses and liabilities of any and every kind, including but not limited to attorney’s fees, in any way arising out of or in connection with my activities under this agreement. This indemnity shall apply regardless of any active or passive negligent act or omission of NCEFT, its directors, officers, agents, volunteers and employees.

I have carefully read this agreement and release and fully understand its contents. I am aware that this is a release of liability, a waiver of legal rights and contract between me and NCEFT and sign it of my own free will. I further acknowledge that there are no warranties, either express or implied, concerning the facilities, events or activities at NCEFT.

All information gathered by and located in patient charts at NCEFT is considered confidential. Discussions of patient care, personal issues, or medical conditions may only be engaged in on a need-to-know basis and with appropriate persons.

Only with the patient or guardian’s written permission will information be disclosed or released to anyone. Information will be released in the following situations, as required by law and with respect for HIPAA regulations:

Referring physicians and others on a need to know basis will be allowed to view, or given copies of a patient’s medical record when there is:

1. A request for Evaluation and/or progress notes.
2. Any changes which may result in contraindication as related to Equine Facilitated Therapy.
3. Hospitalization following an emergency.