Eponamind Clinic Agreement & Liability Release 2017

EponaMind Registration Agreement Thank you for participating in this EponaMind clinic.

. Clinic starts at 9am. Please arrive by 8:45 am -- especially for the first day. . Participants will be responsible for their own lodging, breakfast and dinner. Lunch will be provided at the clinic . We have some shoeing tools to share but we would prefer if you bring your own tools.

More information about the event is posted at www.EponaMind.com. The format and content of the clinic may vary. AAPF credits will be granted to AAPF members who attend this clinic. The attendees will receive a certificate of completion.

Liability: It is understood that due to the nature of the horse, working with their hooves and handling in general, accidents can occur. You are advised to wear protective boots and clothing. The last page of this document is a liability release form we ask you to sign.

Your signature below certifies: “I have read and understand this Registration Agreement in full and agree to all terms herein. I understand this is a group clinic and I can safely work around horses.�

Please give us your contact information below:

Name____________________________________________________________________

Address__________________________________________________________________

City_____________________________________State_____________Zip_____________

Phone Number__________________________________

Email Address__________________________________

Signature______________________________________ Date_________________

Questions? E-mail info@eponashoe.com or call us at (805) 239-3505

Liability Release I certify that I am physically fit and that there are no health-related reasons or problems which preclude my participation in this position or event. I certify that I carry health insurance and automobile insurance equal to the minimum standard insurance required by the State of California. In the event I elect not to carry minimum health insurance, or automobile insurance I certify that I accept full liability for the cost of any injury sustained while a Guest, Visitor, Employee, or Independent Contractor at EponaShoe, Inc., or any other entity listed hereinafter called “The Companies” as shown in the Header of this document.

I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows: (A) I WAIVE, RELEASE, AND DISCHARGE from any and all liability, including but not limited to, liability arising from the negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me as I enter the property at 6720 Linne Rd. Paso Robles , California, 93446, THE FOLLOWING ENTITIES OR PERSONS: EponaMind, EponaTech LLC, EponaShoe Inc., Epona Podiatry Center,LLC and/or their Directors, Owners, Officers, Employees, Mentors, Instructors, Volunteers, Representatives, and Agents: (B) I INDEMNIFY, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph (EponaMind, EponaTech LLC, EponaShoe Inc., Epona Podiatry Center LLC, and John and Monique Craig) from all liabilities or claims made because of participation in this work, activity, or event. I am fully aware of the potential dangers and hazards in working with horses and working around farm machinery and have been warned by the owners of “The Companies” of the diligence and caution I must have while working as an Employee, Visitor, or Independent Contractor for EponaMind, EponaTech LLC, EponaShoe Inc., and Epona Podiatry Center LLC.

I acknowledge that EponaMind, EponaTech LLC, EponaShoe Inc., and Epona Podiatry Center LLC, and their Directors, Officers, Volunteers, Representatives, and Agents are NOT responsible for the errors, omissions, acts, or failures or the act of any party or entity conducting a specific event or activity on behalf of the Companies. The risks may include, but are not limited to, those caused by terrain, facilities, X-ray equipment and X-ray Generator, temperature, weather, condition of participants, equipment, horses, vehicular traffic, actions of other people including, but not limited to, participants, volunteers, spectators, and lack of hydration. These risks are not only inherent to participants, but are also present for volunteers and Visitors. I hereby consent to receive medical treatment which may be deemed advisable in the event of injury, accident, and/or illness during this work, activity or event. This accident waiver and release of liability shall be construed broadly to provide a release and waiver to the maximum extent permissible under California applicable law.

I CERTIFY THAT I HAVE READ THIS DOCUMENT, AND I FULLY UNDERSTAND ITS CONTENT. I AM AWARE THAT THIS IS A RELEASE OF LIABILITY. I SIGN IT OF MY OWN FREE WILL.

________________________________ _______________ _________________________ _____________________ Print Guest, Visitor, Contractor or Employee’s Name

Signature

Date