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190 Line Road, Malvern, PA 19355
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610-644-1963
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Volunteer Release
Mike Hermansen
2022-03-11T16:59:50-05:00
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Participant Release
My relationship to Thorncroft is as a
*
Rider
Volunteer
Staff
Community Service
Visitor
Volunteers 18 years and or older must have proof of a current/clear Pennsylvania Child Abuse History Clearance (this is a State Law) before they can attend Volunteer Training. Those doing service/school or community service hours, are responsible for keeping a copy of their hours when they leave, Thorncroft will not keep track of your hours.
Participant Name
*
Participant Date of Birth
Riders only, please note the height:
cm.
and weight
lbs.
Thorncroft strives for inclusion of all body sizes, and while our herd is currently conformationally able to accommodate a rider weight of 200 lbs. or less, everyone is invited to become a part of the Farm family. Unmounted, ground lessons are available to all.
If participant is under 18, name of
Parent(s)
Guardian
Caregiver
Choose one
If you are married, the name of your spouse
Address
*
City
*
State
*
Zip
*
Cell Phone
*
Email
*
If this is a rider release, please note below the name and address of the person(s)/organization responsible for payment of lessons
Name
Cell Phone
Address
Email
IN CASE OF EMERGENCY, PLEASE CONTACT
*
Parent(s)
Spouse/Partner
Guardian/Caregiver
Name
*
Phone
*
LIABILITY RELEASE In consideration of accepting
Participant’s name
*
in the riding program, or any other activity at Thorncroft, I understand that horses are unpredictable by nature and I voluntarily assume the risks and dangers involved. I hereby, intending to be legally bound, for myself, my heirs, executors or administrators, waive and release all claims for damages I may have against Thorncroft Equestrian Center/Thorncroft Therapeutic Horseback Riding, Inc., its Owners, Instructors, Volunteers, Aids and or Employees for any and all injuries and or loses. A non-employee is not covered by Thorncroft's worker's compensation policy. Respecting the ability of the horses, Thorncroft is unable to provide services to riders with a weight of over 200 pounds. Thorncroft is not responsible for any personal items ie: helmets, cell phones, etc.
Initials
*
MEDICAL RELEASE The above participant hereby (check one)
*
Consents
Does not consent
to any medical, dental, or surgical treatment or procedure of an emergency nature that is reasonably necessary to save the life of the person named above or to restore the person to health. I understand that should medical emergency treatment be required, the current insurance information listed here will be provided to the attending clinic or hospital to cover future payment of incurred bills.
Initials
*
HELMET REQUIREMENT & SUGGESTED RIDING ATTIRE: An ASTM-SEI approved helmet is required while mounted. I have been advised to wear hard soled shoes and pants in and around the stables and while working with or riding horses, so as to help prevent horse-related injuries. (Open toe shoes are not allowed in the stable area).
Initials
*
INSURANCE: The above named participant carries accident/medical insurance:
*
Yes
No
Name of Insurance Co.
*
Policy #
*
Initials
*
PHOTO/SOCIAL MEDIA RELEASE:The above named participant hereby
*
Authorizes
Does not authorize
the use and reproduction by Thorncroft Therapeutic Horseback Riding, Inc. of any and all photographs taken for promotional and or printed materials.
Initials
*
POLICY OF CONFIDENTIALITY:
All information including but not limited to, personal, medical, and financial documents are confidential among all participants, volunteers, and staff. Confidentiality is considered one of our most basic responsibilities.
Initials
*
COST OF LESSONS - WE OFFER THE FOLLOWING PAYMENT POLICIES, YOU MAY CHOOSE ONE
(1) Pre pay for the month: $175.00 by the 7th of the current month
(2) Be billed $200.00 at the end of the month
(3) New arrivals, first month you may pay by the lesson $50.00 each ½ hour private or a one-hour group lesson (4) If you are going to be absent for a month you may "hold" your lesson time for $90.00 per month. Lesson times not held are not guaranteed to be available upon your return.
Initials
Bills are due upon receipt. Lessons will be discontinued for any amount past due 90 days or over. Payment and a signed release for new riders must be received before the first lesson.
There are no make ups for missed or canceled lessons,
you may not pay "by the lesson".
Initials
PAYMENT METHODS:
Thorncroft accepts online payments for lessons at thorncroft.org via credit card, via check payable to Thorncroft, or over-the-phone payments at 610-644-1963 via credit card.If you to elect to pay by cash, you may obtain a cash receipt from the office. If you pay by mail, please remit payment to the above address payable to Thorncroft. Please include on your check the rider's name, instructor's name and the month being paid.
Initials
MISSED LESSONS:
If you are unable to attend a lesson, please call 610-644-1963 and leave a message for your instructor. This courtesy will offer time out in the fields for a horse that may otherwise be kept in the stall. Four absences with no notice will result in lessons being discontinued.
Initials
TEC CLOSINGS:
December 31 at 5pm, January 1, Memorial Day Weekend Fri - Mon, July 4, 5K Trail Run at 3 pm, Labor Day, Thanksgiving, December 24 at 5pm, and December 25. Make-up lessons or rescheduling of lessons on these days is not available
Initials
INCLEMENT WEATHER:
If the barn is closed our answering machine will have a message stating "The barn is closed.”
Initials
TERMINATING LESSONS:
We would appreciate notification two weeks before you plan to discontinue lessons. In the interest of better serving our riders, we would like to have additional information as to why you are terminating lessons
Initials
HORSE CARE:
If physically able, each student is responsible for preparing his or her horse for the lesson (grooming, tacking up, sweeping up after the horse, etc.). Please plan on an additional ½ hour before and after each lesson to tack up and untack your horse/pony. There is barn help available to help you prepare.
Initials
BEHAVIOR AND ZERO TOLERANCE REGARDING DISCRIMINATION/ HARASSMENT:
TEC will not engage in or tolerate unlawful discrimination (including any form of unlawful harassment or retaliation) on account of a person’s sex, pregnancy, age, race, color, religion, creed, national origin, ancestry, citizenship, immigrant status, military status, veterans status, disability, handicap, genetic information, sexual orientation, gender identity, marital status, family status, domestic partner, civil union, or ridership in any other protected group. TEC will not tolerate threatening behavior of any kind, threats towards any TEC staff member, volunteer, or student will result in immediate expulsion from TEC.
Initials
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NON-HARASSMENT:
TEC will not engage in or tolerate any other forms of unlawful harassment. The term “discrimination” or “harassment” includes, but is not limited to, derogatory comments, slurs, offensive remarks or jokes, or other verbal, graphic, or physical conduct. Harassment also includes unwelcome sexual advances, requests for sexual favors, unwelcome or offensive touching and other conduct of a sexual nature.
Initials
*
ACCEPTANCE OF POLICIES:
I have read, understand and will respect Thorncroft's policies.
Signed
*
(Signature of participant, parent, caregiver, or guardian.)
Date
*
Submit
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