AMBOY TRAIL RANCH HORSE CAMP RESERVATION FORM

Child's Name _______________________________

Date of Birth _______________

Parent's Name ________________________________________________

Address_______________________________________________________

Phone _________________________

Email _____________________________________________________________________

Emergency contact while at camp_______________________________________________________

Medical conditions/allergies ___________________________________________________________

_____Mustang (9-11 yr old, first time)

_____Maverick (5-8 yr olds)

_____Trailblazer (10 & 11 yr old, must have previously attended Mustang Camp)

_____ Horses, Horses, Horses (12 and over)

All campers will receive a t-shirt. Please indicate size below:

Child's: Small _____ Medium______ Large______ X-Large ______

Adult's: Small _____ Medium______ Large______ X-Large ______

RELEASE FROM LIABILITY

I, the undersigned parent or legal guardian of a minor child, have read and understand the following: WARNING UNDER IOWA LAW, A DOMESTICATED ANIMAL PROFESSIONAL IS NOT LIABLE FOR DAMAGES SUFFERED BY, AN INJURY TO , OR THE DEATH OF A PARTICIPANT RESULTING FROM THE INHERENT RISKS OF DOMESTICATED ANIMAL ACTIVITIES, PURSUANT TO IOWA CODE CHAPTER 673. YOU ARE ASSUMING INHERENT RISKS OF PARTICIPATING IN THE DOMESTICATED ANIMAL ACTIVITY. A number of inherent risks are associated with a domesticated animal activity. A domesticated animal may behave in a manner that results in damages to property or an injury or death to a person. Risks associated with the activity may include injuries caused by bucking, biting, stumbling, rearing, trampling, scratching, pecking, falling, or butting. The domesticated animal may act unpredictably to conditions, including, but not limited to , a sudden movement; loud noise; an unfamiliar environment; or the introduction of unfamiliar persons, animals, or objects. The domesticated animal may also react in a dangerous manner when a condition or treatment is considered hazardous to the welfare of the animal; a collision occurs with an object or animal; or a participant fails to exercise reasonable care, take adequate precautions, or use adequate control when engaging in a domesticated animal activity, including failing to maintain reasonable control of the animal or failing to act in a manner consistent with the person's abilities.

Signed__________________________________ Date_____________

Return completed form with check to:

Amboy Trail Ranch , 4423 Iowa Street, Newton, Iowa, 50208.