RIDING INSTRUCTION AND LIABILITY RELEASE FORM FOR INDIVIDUALSTHIS FORMMUSTBE COMPLETEDBYANDFOREACHPARTICIPANT.

PLEASEREADCAREFULLYBEFORESIGNING.SERIOUSINJURYMAYRESULTFROMYOURPARTICIPATIONINTHIS ACTIVITY.THIS STABLEDOESNOTGUARANTEEYOURSAFETY.

Circle Lake Ranch. Inc., Paula Layne Spltzenberger, Garry Pierre Oubre, Lacey Lea Spltzenberger, Pony Productions, Inc.,and all employees, oftlcers or contract laborers are hereinafter known as "THIS STABLE".

RIDERNAME: AGE(IF UNDER21): _Weight over 180 lbs? YES NO(Our horses are capable of only carrying a rider up to 180 lbs)Horse Riding Experience: Under 10hours Over 10 hoursDoes this rider have any physical and/or mental health conditions, problems, disorders, and/or dlsabillties with special needswhich may affect his/her safety and abillty to ride a horse? __ If "Yes", please here and advise this stable prior to ridingof how we may assist you with any specialneeds:

ACCIDENTIMEDICALINSURANCE- I AGREETHAT:Should emergency medical treatment be requIred, I and/or my ownaccldentJmedicallnsurance company shall pay for all such Incurred expenses.Health Insurance Company: _Group Number: Plan or Identification Number: _

Both Parents Must InItial Below for Each Paragraph:_I __ REGISTRATIONOFRIDERSANDAGREEMENTPURPOSE- In consideration of payment of a fee and the signing of this agreement, I, the following

Ilsted individual, and the parent or legal guardlan(s) thereof If a minor, do hereby voluntarily request and agree to participate In riding Instruction as astudent at THISSTABLE,and that this student will either ride hlslber own horse, or school horses provided by THIS STABLEfor Instructional purpose, todayand on all future dates.

_I __ AGREEMENTSCOPEANDTERRITORYANDDEFINITIONS- This agreement sball be legally binding upon me, the registered student, and theparents or legal guardian thereof. If a minor, my heirs, estate, assigns, including all minor cblldren. and personal representatives; and It shall beInterpreted according to the laws of the state and county of THIS STABLE'Sphysical location. If any clause, phrase, or word Is In confllct with state law then

that single part Is null and void. The term "HORSE"herein sball refer to all equine species. The term "HORSEBACKRIDING"herein sball refer to riding orotherwise handl1ng of horses, ponies, mules or donkeys, whether from the ground or mounted. The terms "STUDENT"and/or "RIDER" sball herein refer to aperson who rides a horse mounted or otherwise handles or comes near a horse from the ground. The terms "I", "ME", "MY"shall herein refer to the aboveregistered student rider and the parents or legal guardians thereof If a minor.

_I __ ACTIVITYRISKCLASSIFICATION-I UNDERSTANDTHAT:Horseback riding Is classified as a RUGGEDADVENTURERECREATIONALSPORTACTIVITYand that there are numerous obvious and non· obvious Inherent risks always present In such activity despite all safety precautions. According to

NEISS(National Electronic Injury Surveillance systems of United States Consumer Products) horse activities rank approximately 64'" among the activities ofpeople relative to injuries that result In a stay at U.s. Hospitals. Related injuries can be severe requiring more hospital days and resulting In more lastingresidual effects than injuries In other activities.

_I __ NATUREOFTHIS STABLE'SSCHOOLHORSES-I UNDERSTANDTHAT:THISSTABLEchooses Its school horses for their calm dispositions andsound basic training as Is required for use for STUDENTRIDERS,and THIS STABLEfollows a rigid safety program. Yet, no riding horse Is a completely safehorse. Horses are 5 to 15 times larger, 20 to 40 times more powertul, and 3 to 4 times faster than a human. If a rider falls from horse to ground It willgenerally be at a distance of from 3 ~ feet to 5 ~ feet, and the Impact ay result In Injury to the rider. Horseback riding Is the only sport where one much

smaller, weaker predator animal (human) tried to Impose Its will on, and become one unit with. another much larger, stronger prey animal with a mind of Itsown (horse) and each has a limited understanding of the other. If a horse Is frightened or provoked It may divert from Its training and act according to Itsnatural survival Instincts which may Include, but are not limited to: Stopping short, changing directions or speed at will; shlftJng Its weight; bucking;rearing; kicking; biting; or running from danger.

_I __ RIDERRESPONSIBILITY-I UNDERSTANDTHAT: Upon mounting a horse and taking up the reins the rider Is In primary control of the horse.The rider's safety largely depends upon bIsIher ablllty to carry out simple Instructions, and hlslber ablllty to remain balanced aboard the moving animal Iagree that the rider sball be responsible for hlslber own safety,lncludlng that of an unborn cblld, If the rider Is pregnant Pregnant women should ridehorses only under the advice of their physician. THISSTABLEadvises pregnant women not to ride horses.

_I __ CONDITIONSOFNATUREANDINSPECTIONOFPREMISES-I UNDERSTANDTHAT: THIS STABLEIs not responsible for total or partial acts,occurrences, or elements of nature that can scare a horse, cause It to faJJ, or react In some other unsafe way. SOMEEXAMPLESARE: Thunder, Ilghtnlng,rain, wind, wild and domestic animals, Insects, reptiles, which may walk, run or fly near or bite and sting a horse or person; and Irregular footing on out-of·door groomed or wild land which Is subJect to constant change In condition according to weather, temperature, and natural and man-made changes Inlandscape. The rider and parent or legal guardian have Inspected THISSTABLE'Sfaclllties and are satisfied that all premise conditions are reasonably safefor rider's Intended purpose, usage and presence upon THIS STABLE'SPREMISES.

_I __ SADDLEGIRTH'SNATURALLOOSENING-I UNDERSTANDTHAT:Saddle girths (saddle fasteners around horse's belly) may loosen during a ride.If a rider notices this he/she must alert the riding Instructor as quickly as possible so action can be taken to avoid sUppage of saddle and a potential fallfrom the animaL

_I __ PROTECTIVEHEADGEARWARNING-I AGREETHAT:I have been fully warned and advised by this stable that I should purchase and wearprotective headgear of a quallty not less than SEI CERTIFIEDASTMSTANDARDFl163 Equestrian RIding Helmet wblle riding, being and working aroundhorses. I do understand that the wearing of such headgear while mounting, riding, dismounting and otherwise being around horses, may prevent or reduceseverity of some of the headgear wearer's head injuries and may even prevent the wearer's death from happening as the result of a fall from a horse orother occurrence. Riders under 18 years of age are required to use proper equestrian helmets while mounted at THIS STABLE.

_I __ LIABILITYRELEASE- I AGREETHAT:In consideration of THIS STABLEallowing my participation In this activity, under the terms set forthherein. I, the rider, and the parent or guardian thereof If a mInor, do agree to hold harmless and release THIS STABLE,lts owners, agents, employees,

contract laborers, officers, members, premises owners, affiliated organizations, an Insurers from legal llablllty due to THIS STABLE'Sordinary negllgence,and I do further agree that except In the event of THISSTABLE'Sgross and willful negllgence, I shall bring no cIalms, demands, actions and causes of action

and/or lltigation against THISSTABLEand ITS ASSOCIATEDas stated above In this clause, for any economic and non· economic losses due to bodily Injury,death, property damage, sustaIned by me and/or my mInor cblld or legal ward In relation to the premises and operations of THIS STABLE,to Include whileriding, bandilng, or otherwise being near horses owned by or In the care, custody and control of THISSTABLE.

_I __ PHOTOGRAPHS,VIDEOPRODUCTIONS,AUDIOPRODUCTIONS,WEBSITEPRODUCTIONSANDTELECASTS·I AGREETHAT:Photographs, videoproductions, audio prOductions and telecasts may be made of the Rider either alone or together with others, during horseback riding events at such times orplaces as THIS STABLEsbaII designate. The Rider agrees that all rights In such photographs, video productions, audio productions, website productions andtelecasts Including, but not Umlted to, rights of sale, reproduction, use and distribution, shall belong to THIS STABLEand or an affiliate of THIS STABLEItssuccessors or assigns, which may make whatever use of such photographs, video productions, audio productions, website productions and telecasts as It or

they may desire. The undersigned hereby grant to THIS STABLEand or an affillate of THISSTABLE,Its successors and assigns the non·excluslve right to usethe Rider's ftrst name or Ukeness for any and all commercial beneftt and purpose, without Umltation, In perpetuity, throughout the universe, In all mediawhether known or unknown.

_I __ RIDINGLESSONAPPOINTMENTSANDPAYMENTS:I UNDERSTANDANDAGREETHAT:THISSTABLEoffers lessons on a monthly and weekly basisand that lessons should be paid for at the time services are rendered AUhorseback riding Instruction held during summer camps Is considered a"horseback riding lesson". THISSTABLEalso offers a monthly discounted lesson plan; payment should be made on the ftrst week of each month, In fullMakeup lessons must be taken withIn 30 days or the lesson missed Is forfeited THIS STABLEdoes not provide cash refunds or credits for lessons not takenduring the appropriate time periOd Rider hereby agrees to pay for all riding lessons taken at THISSTABLE,and Is responsible for returned Item fees, andlegal collection costs If requIred by THIS STABLE.In cases of Inclement weather, rider or Instructor UIness, or other unforeseen occurrences, THIS STABLEreserves the right to reschedule lessons at the rider and Instructor's convenience. STUDENTSnot appearing for two consecutive lessons, who do not contact

THISSTABLE,will lose their appointed lesson time and need to reschedule their regular lesson. STUDENTSwho do not cancel lessons 24 hours In advancewill forfeit said lesson.

_I __ RIDERSAREEXPECTEDTO: Ride In appropriate clothIng Including but not Umlted to: Jeans, jodhpurs. Western boots, EngUsh riding boots.paddock boots. Bare feet and tennis shoes are not allowed wblle mounted and are discouraged on premises. Riders are also expected to exhibit properconduct wblle on premises at THISSTABLEIncluding abiding by the barn rules, which are posted on the door of the tack room of THIS STABLE.and to followInstructions given by employees or contract labor personnel of THIS STABLE. THIS STABLEwill not accept dangerous, disrespectful or Inappropriatebehavior from parents or students on stable premises. If you have problems that need to be addressed, you are expected to do so with the Instructor and/orBarn Manager In private. Failure to exhibit proper conduct and behavior will result In a forfeiture of lesson monies paid and a cancellation of servicesprovided by THIS STABLE.

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.

All RJders and Parents or Legal GuardIans must sign below after reading this entire two·page document.

SIGNER STATEMENT OF AWARENESS

I1WE, THE UNDERSIGNED, HAVE READ AND DO UNDERSTAND THE FOREGOING AGREEMENT, WARNINGS, RELEASE AND

ASSUMPTION OF RISK. I/WE FURTHER A'rI'EST THAT ALL FACTS RELATING TO THE APPLICANT'S PHYSICAL CONDITION,

EXPERIENCE, RELATIONSHIP TO GUARDIANIPARENT AND AGE, ARE TRUE AND ACCURATE.

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SIGNATURE OF PARENT (FATHER) for

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PRINTED NAME OF RIDER

PRINTED NAME OF RIDER

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