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The release form is required for all persons entering property.
Palmetto Stables
Owner: Hugh Eggersman
Barn Manager: Leighton Jones
Under South Carolina law an equine activity sponsor or equine professional is no liable for injury to or of
a participant in an equine activity resulting from an inherent risk of equine activity, pursuant to article 7, chapter 9,
of title 47, code of law of South Carolina 1976.
I realize that riding or watching a horse may result injury, death, or property damage and I will not hold
responsible the owner, employees, or volunteers of Palmetto Stables. Furthermore, I agree to carry and to implement my own
insurance for fees incurred as the result of injury, death, or damage. I am authorized to sign this release on behalf of myself
and/or as a parent or guardian of minor. I have read and understand all of the above.
___________________________ _____________
Signature date
PHONE AND ADDRESS REQUIRED:
___________________________________________________
List all persons under this agreement including self:
___________________________________________________
Consent to Emergency Medical Form
Consent to emergency medical, dental, or surgical treatment for minor child
My name is ___________________. I am the mother/father/guardian of ______________________, a minor child and a riding student
at ___________________________.
I hereby consent to any medical, dental, or surgical treatment or procedures of an emergency nature that is reasonably
necessary to save the life of the minor child named above or to restore the child to health.
Name of insurance company ________________________
Policy number _________________________
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.
Emergency phone numbers:
Numbers persons to contact
________________________________________
___________________________ _____________
Signature date
Student record form
NAME:_______________________ DOB:________________
ADDRESS: __________________________________________
PARENT’S NAMES: __________________________________
CONTACT IN CASE OF EMERGENCY: _______________________ PHONE: _____________________
DOCTOR: _______________________PHONE:______________
HOSPITAL:_______________________
ALLERGIES:______________________
LEVEL OF RIDING EXPERIENCE:
BEGINNER INTERMEDIATE ADVANCED
NUMBER OF YEARS RIDNG: _______________
DATE OF SESSION DESIRED: ____________________
SPECIAL INSTRUCTIONS:_________________________________
Palmetto Stables
Owner: Hugh Eggersman
Barn Manager: Leighton Jones
Under South Carolina law an equine activity sponsor or equine professional is no liable for injury to or of a participant
in an equine activity resulting from an inherent risk of equine activity, pursuant to article 7, chapter 9, of title 47, code
of law of South Carolina 1976.
I realize that riding in a vehicle may result injury, death, or property damage and I will not hold responsible
the owner, employees, or volunteers of Palmetto Stables. Furthermore, I agree to carry and to implement my own insurance for
fees incurred as the result of injury, death, or damage. I am authorized to sign this release on behalf of myself and/or as
a parent or guardian of minor. I have read and understand all of the above.
___________________________ _____________
Signature date
PHONE AND ADDRESS REQUIRED:
_______________________________________________
List all persons under this agreement including self:
_______________________________________________
Required for Boarders
PALMETTO STABLE’S
BOARDER AGREEMENT AND CONTRACT
UNDER SOUTH CAROLINA LAW AN EQUINE ACTIVITY SPONSOR OR EQUINE PROFESSIONAL IS NOT LIABLE FOR INJURY TO OR THE DEATH OF
A PARTICIPANT IN AN EQUINE ACTIVITY, PURSUANT TO ARTICLE 7, CHAPTER 9 OF THE TITLE 47, CODE OF LAW OF SOUTH CAROLINA 1976.
Conditions of boarding
Owners accept all conditions of the property, land, buildings, and equipment by signing this agreement. Therefore horse
owners are responsible for all and any medical expenses for their horse no matter the cause of injury.
The stables, the owner, manager, employees, or volunteers are not responsible for the injuries or death of a horse or participant.
Only owners and designated persons are to ride owner’s horse and must have a release form signed upon entering the
property.
You are to use only your horse and equipment, including grooming tools.
Boarders are required to fill out a boarder record form and any guests must sign a release form for personal injury due
to equine activity or injuries occurring while on the property. ALL GUESTS ARE TO SIGN A RELEASE FORM BEFORE ENTERING PROPERTY.
No persons under the age of 15 allowed on property without adult supervision.
Parent or guardian must sign a release form for all minors under the age of 21.
No smoking or drinking of alcoholic beverages are allowed on the property.
No firearms including air pistols are allowed on the property.
Riders are to remain in designated areas.
Boarders must pay their board fees at the beginning of each month by the 10th and may not fall more than two
months behind without being penalized by seizing the horse as property of Palmetto Stables until all dues are paid. The owner
will only be given a month to pay fees before the horse will be sold for compensation of dues.
Horse may not leave the property without owners written and signed permission.
Boarder ( person signing the agreement) has shown ownership and a shot record that includes: current coggins, west nile,
east/west, tetnus, rhino, and rabies prior to arriving at the stables. West nile, east/west and rhino must be vaccinated twice
a year and tetnus and rabies once a year.
If horse is brought into contract late in the month or leaves early there will be no reduction in cost or refunds.
Owner is responsible for damages and loss to personal property. (Tack rooms are provided as a courtesy, please do not leave
extremely valuable items in tack room.) Boarders are responsible for all of their tack and equipment. The stables is not responsible
for items that are damaged or stolen.
If the horse is not properly being cared for ( farrier services, worming, feeding, or vet care for injuries, or required
vaccinations, etc.) the stables will step in to provide proper care for the horse and the owner will be responsible to reimburse
all charges, including the handling fee.
If the horse becomes an aggressive problem in the pasture the manager reserves the right to stall the horse or put the
horse in a private paddock in which the owner is responsible for paying.
Please circle type of boarding
Full pasture half pasture full stall half stall private paddock I have read and understand all of the above. I agree to
carry out these conditions. I am authorized to sign this release on behalf of myself and/or as a parent or guardian of a minor.
I understand the boarding fee I am responsible to pay each month of ________________ (corresponding to the one circled above).
I understand and agree to the penalties if I fail to pay the boarding fee.
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