Day Camp Intake Sheet & Release of Liability

Day Camp Intake Sheet & Release of Liability

Huntsville, Walker County, Texas

PART I – CAMPER INFORMATION (INTAKE FORM)

PART II – EMERGENCY CONTACTS

Emergency Contact #1 (other than parent/guardian):

Emergency Contact #2:

PART III – MEDICAL INFORMATION

Allergies (check all that apply and explain):

PART IV – AUTHORIZATION FOR EMERGENCY MEDICAL CARE

I, the undersigned parent or legal guardian, authorize Stone Cottage Ranch LLC and its staff to obtain emergency medical treatment for my child if I cannot be reached. I understand that reasonable efforts will be made to contact me prior to treatment when possible.

PART V – CAMP PARTICIPATION INFORMATION

PART VI – RELEASE OF LIABILITY & ASSUMPTION OF RISK

TEXAS EQUINE ACT NOTICE (REQUIRED BY LAW)

WARNING

UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE), AN EQUINE ACTIVITY SPONSOR OR 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.

ASSUMPTION OF RISK

I understand that participation in a farm- and ranch-based day camp includes inherent risks, including but not limited to horseback riding, animal interaction, uneven terrain, weather conditions, bee and insect exposure, outdoor equipment, and water activities. I voluntarily assume all such risks on behalf of my child.

RELEASE AND WAIVER OF LIABILITY

In consideration for my child’s participation in the Stone Cottage Ranch Day Camp, I hereby release, waive, discharge, and covenant not to sue Stone Cottage Ranch LLC, its owners, managers, employees, volunteers, instructors, and agents from any and all liability, claims, demands, actions, or causes of action arising out of or related to any loss, damage, or injury (including death) that may be sustained by my child while participating in camp activities, whether caused by negligence or otherwise, to the fullest extent permitted by Texas law.

INDEMNIFICATION

I agree to indemnify and hold harmless Stone Cottage Ranch LLC from any loss, liability, damage, or cost incurred due to my child’s participation in camp activities.

PHOTO & MEDIA RELEASE

TRANSPORTATION ACKNOWLEDGMENT

I understand that all activities occur on ranch property unless otherwise communicated in writing, and I release Stone Cottage Ranch LLC from liability related to on-site movement of campers.

ACKNOWLEDGMENT & SIGNATURE

I certify that I am the parent or legal guardian of the above-named minor. I have read and understand this document in its entirety and agree to all terms.

Stone Cottage Ranch LLC | 24 Louis Voan Rd., Huntsville, TX 77320