Release, Waiver & Indemnity Agreement
I, the undersigned or parent or legal guardian of the undersigned (either as a “Participant,
Volunteer or Staff”), desiring to utilize the premises known as the Cori Sikich
Therapeutic Riding Center and the adjoining properties known as 10128 Fire Tower Road
and 10102 Fire Tower Road, and any adjoining property owned by Daniel Potter, Karen
K. Potter, Neal E. Knemeyer, or NDK Investments, LLC (collectively known as “the
Premises”), and the facilities either owned or controlled by Dream Catchers at the Cori
Sikich Therapeutic Riding Center (“DCTR”), and to participate in programs offered by
DCTR (the “Programs”), do hereby affirm that as a Participant, Volunteer or Staff is
voluntarily entering upon the Premises to participate in the Programs, and I, as the
undersigned or parent or legal guardian of the undersigned, do hereby willingly enter into
this Release, Waiver & Indemnity Agreement.
I recognize that, under Virginia law, an equine activity sponsor or equine professional is
not liable for an injury to or the death of a Participant, Volunteer or Staff in equine
activities resulting exclusively from the inherent risks of equine activities. I fully
understand that the activity of mounting, riding, boarding, feeding, or even being near a
horse, involves numerous dangers and risks of injury to the Participant, Volunteer or
Staff and I completely release the owner of the Premises, and DCTR and its officers,
directors, volunteers, employees, or its agents from any and all liability for any and all
injuries resulting from the Participant’s, Volunteer’s, or Staff’s engagement in the
Programs offered by DCTR.
I expressly agree that this Release, Waiver and Indemnity Agreement shall be governed
and construed as being sufficient to satisfy the assumption of risk and waiver
requirements necessary to relieve equine activity sponsors and equine professionals from
liability under the Virginia Equine Activity Liability Act, Section 3.1-796.130, et.seq. of
the Code of Virginia (the “Act”), and that the owners of the Premises, DCTR and its
officers, directors, volunteers, employees, and agents are covered as equine activity
sponsors and/or equine professionals by the provisions of this Act. This Release, Waiver,
and Indemnity Agreement shall be governed and construed by the laws of the
Commonwealth of Virginia, regardless of where any injury or loss shall occur. In the
event that any portion of this Release, Waiver, and Indemnity Agreement shall be
declared unenforceable, such declaration shall not affect the remaining terms of this
document, which shall survive intact.
I am also aware and consent to Participant’s, Volunteer’s, or Staff’s inclusion in a study
performed by DCTR that, in the interest of improving the quality and effectiveness of the
programs offered, will gather data on the program participants. Such data will include,
but not be limited to, the age, gender, dates of participation, and level of satisfactions of
the program participants. Program participants may be selected for the study at random,
and DCTR affirms that all program participants selected for the study will be treated in a
manner substantially identical to those program participants not selected for the study and
that the identities of all program participants will be held strictly confidential and not
published in any way or as the part of any publication.
I hereby give my permission to participate in the Programs offered by DCTR as a
Participant, Volunteer, or Staff and, in consideration, agree individually and as
applicable, on behalf of my child or ward, to the terms of the above agreement and
release of liability.
Date:___________________________________
_______________________________________
Signature of Participant, Volunteer or Staff
_______________________________________
Signature of Parent or Guardian of Participant, Volunteer or Staff
if under the age of 18