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THE UNITED STATES PONY CLUBS, INC.

RELEASE, ASSUMPTION OF RISK, WAIVER OF LIABILITY, AND INDEMNITY AGREEMENT

FOR USPC NON-MEMBERS

This document waives important legal rights. Read it carefully before signing.

Revised 07/2016

I AGREE for myself, and/or my child, my/our administrators and assigns, in consideration for my, and/or my child’s, participation in this United

States Pony Clubs, Inc. (USPC) activity to the following:

I AGREE that I choose to participate voluntarily in an USPC activity, as a rider, driver, handler, lessee, owner, agent, spectator, volunteer,

and/or trainer. I am fully aware and acknowledge that horse sports and USPC activities involve inherent dangerous risks of accident, loss, and

serious bodily injury including, but not limited to, broken bones, head injuries, trauma, pain, suffering or death (“Harm”). I fully understand

that this release covers, but is not limited to, inherent risks of an equine activity which mean a danger or condition that is an integral part of an equine

activity, including but not limited to, any of the following:

 The propensity of an equine to behave in ways that may result in injury, death, or loss to persons on or around the equine;

 The unpredictability of an equine’s reaction to sounds, sudden movement, unfamiliar objects, persons, or other animals;

 Hazards, including, but not limited to, surface or subsurface conditions;

 A collision with another equine, another animal, a person, or an object;

 The potential of an individual during an equine activity to act in a negligent manner that may contribute to injury, death, or loss to the

person of the participant or to other persons, including but not limited to, failing to maintain control over an equine or failing to act

within the ability of the participant.

I Acknowledge that it is my/parent/legal guardian responsibility to ensure that I am/my child is wearing a completed wristband or armband card

at this USPC activity. I authorize USPC, it successors or assigns, officials, officers, directors, employees, agents and/or volunteers to obtain and

release to any USPC activity personnel (including, but not limited to, organizers, instructors, test examiners, chaperones), and to any first aid and

safety personnel, medical professional, and treating medical facility, any information regarding my/my child’s medical history, symptoms, treatment,

exam results and/or diagnosis contained in the wristband or armband card. Furthermore, I agree and understand that it is my/parental/legal guardian

responsibility to ensure that I/my child will not participate in any USPC mounted activities if I/my child have/has had a head injury or other medical

condition and have/has been restricted from activity, until such time as the injury or condition is resolved and any activity restriction is lifted.

I AGREE to release the USPC, its successors or assigns, officials, officers, directors, employees, agents, personnel, volunteers and affiliated

organizations from all claims including, but not limited to, claims for money or property, disability, covenants, actions, suits, causes or action,

obligations, debts, costs, expenses, attorneys’ fees, judgments, orders and liabilities of whatsoever kind or nature in law, equity or otherwise,

whether now known or unknown, suspected or unsuspected, and whether concealed or hidden, including but not limited to any state or federal

statutory or common law claim or remedy of any kind whatsoever arising out of or in any way connected with any Harm to me or my horse

and for any Harm caused by me or my horse to others, even if the Harm resulted,

directly or

indirectly, from the negligence of the USPC or the USPC

activity.

I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of the USPC or the USPC

activity, and specifically agree to the applicable state statute/law regarding equine/farm animal activity liability and signed posting (if any),

in any state in which I or my child participates in a USPC activity. While a list of state statues and select portions of those statues believed

to be in effect at the time of the execution of this agreement is attached hereto, I AGREE to locate, review and understand the full applicable

state statutes in place in my jurisdiction.

I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the USPC and the USPC activity and to hold them

harmless with respect to claims for Harm to me or my horse, and for claims made by others for any Harm caused by me or my horse in the USPC

activity.

I AGREE that neither I, nor any one claiming through me, will hereafter bring, commence, prosecute or maintain, or cause or permit to

be brought, commenced, prosecuted or maintained, any suit or action, either at law or in equity, in any court in the United States or in any state

thereof, or elsewhere, against the USPC, its successors or assigns, for, on account of, arising out of, or in any way connected with any Harm to me

or my horse, and that neither I, nor any one claiming though me, will enforce, prosecute, or recover upon, or attempt to enforce, prosecute, or

recover upon, any claim or right of action whatsoever, which I, or any one claiming though me, may now have or hereafter assert, in any way

connected with claims for Harm to me or my horse, and for claims made by others for any Harms caused by me or my horse at the USPC activity.

I AGREE this Agreement is the entire agreement of the parties, and supersedes all prior oral and written understandings and agreements.

This Agreement may be modified only by a written amendment signed by both parties.

I AGREE that if any provision of the Agreement is found to be invalid or illegal by a court of competent jurisdiction, the remaining provisions

shall be construed as if the affected provision had not been included in order to effectuate the intent of the parties.

In the event this form is signed by the parent/guardian of a minor, then all representations and acknowledgements herein are expressly

made by, for, and on behalf of the parent/guardian and minor.

By signing below, I AGREE to be bound by all applicable USPC rules and all terms and provisions of the USPC activity. I acknowledge

that I enter into this release after having read the same, and place my signature hereto of my own free voluntary act and deed. By signing below,

I represent to the USPC that I fully understand its contents that I do not need any further explanation, and I waive any further explanation.

I have read and AGREE to abide be the above. REQUIRED — all signatures must be originals, not photocopies.

OR __________________________________________________________________

Original Signature of Participant Date Original Signature of Applicant’s Parent(s) or Legal Guardian(s) Date

Required if applicant is of the age of majority in their state of residence. Required if applicant is under the age of majority in their state of residence.

S T A T E E Q U I N E A C T I V I T Y L I A B I L I T Y S T A T U T E S

P L E A S E R E T A I N F O R Y O U R P E R S O N A L R E C O R D S .

REVISED 07/2016

PAGE 3 OF 4

ALABAMA

AL ST §6-5-337 WARNING: Under Alabama

law, an equine activity sponsor or 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, pursuant to the Equine Activities

Liability Protection Act.

ALASKA

AK ST § 09.65.145; AK ST § 09.65.290

ARIZONA

AZ ST § 12-553

ARKANSAS

AR ST § 16-120-201, 202 WARNING: Under

Arkansas law, an equine activity sponsor,

livestock activity sponsor, livestock owner,

livestock facility, and livestock auction market

are not liable for an injury to or the death of

a participant in equine activities or

livestock activities resulting from the

inherent risk of equine activities or livestock

activities.

CALIFORNIA

NO KNOWN EQUINE ACTIVITY LIABILITY

STATUTE

COLORADO

CO ST § 13-21-119 WARNING: Under

Colorado Law, 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, pursuant

to section 13-21-119, Colorado Revised

Statutes.

CONNECTICUT

CT ST § 52-557p

DELAWARE

DE ST TI 10 § 8140 WARNING: Under

Delaware Law, 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, pursuant

to 10 Delaware Code § 8140.

FLORIDA

FL ST § 773.01 - 773.06 WARNING: Under

Florida law, an equine activity sponsor or

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.

GEORGIA

GA ST §§ 4-12-1 - 5 WARNING: Under

Georgia law, an equine activity sponsor or

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, pursuant to Chapter 12 of

Title 4 of the Official Code of Georgia

Annotated.

HAWAII

HI ST § 663B-1, B-2

IDAHO

ID ST § 6-1801 - 1802

ILLINOIS

IL ST CH 745 § 47/1 - 47/999 WARNING:

Under the Equine Activity Liability Act, each

participant who engages in an equine activity

expressly assumes the risks of engaging in and

legal responsibility for injury, loss, or damage to

person or property resulting from the risk of

equine activities.

INDIANA

IN ST 34-31-5-1 - 5 WARNING: Under Indiana

law, 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.

IOWA

IA ST § 673.1 - 673.5 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 THIS

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 react

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.

KANSAS

KS ST § 60-4001 - 4004 WARNING:

Under Kansas law, there is no liability for an

injury to or the death of a participant in

domestic animal activities resulting from the

inherent risks of domestic animal activities,

pursuant to K.S.A. 60-4001 through 60-4004.

You are assuming the risk of participating in

this domestic animal activity.

Inherent risks of domestic animal activities

include, but shall not be limited to:

(1) The propensity of a domestic animal to

behave in ways i.e., running, bucking, biting,

kicking, shying, stumbling, rearing, falling or

stepping on, that may result in an injury, harm

or death to persons on or around them; (2) the

unpredictability of a domestic animal's reaction

to such things as sounds, sudden movement

and unfamiliar objects, persons or other

animals; (3) certain hazards such as surface and

subsurface conditions; (4) collisions with other

domestic animals or objects; and (5) the

potential of a participant to act in a negligent

manner that may contribute to injury to the

participant or others, such as failing to

maintain control over the domestic animal or

not acting within such participant's ability.

KENTUCKY

KY ST § 247.401 – 4029 WARNING:

Under Kentucky law, a farm animal activity

sponsor, farm animal professional, or other

person does not have the duty to eliminate all

risks of injury of participation in farm animal

activities. There are inherent risks of injury that

you voluntarily accept if you participate in farm

animal activities.

LOUISIANA

LA R.S. 9:2795.1 - 9:2795.3

WARNING: Under Louisiana law, an equine

activity sponsor or 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, pursuant

to R.S. 9:2795.3.

MAINE

ME ST T. 7 § 4101 - 4103-A

WARNING: Under Maine law, an equine

professional has limited liability for an injury or

death resulting from the inherent risks of

equine activities.

MARYLAND

NO KNOWN EQUINE ACTIVITY LIABILITY

STATUTE

MASSACHUSETTS

MA ST 128 § 2D WARNING:

Under Massachusetts law, 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, pursuant to section 2D of chapter

128 of the General Laws.

S T A T E E Q U I N E A C T I V I T Y L I A B I L I T Y S T A T U T E S

P L E A S E R E T A I N F O R Y O U R P E R S O N A L R E C O R D S .

REVISED 07/2016

PAGE 4 OF 4

MICHIGAN

MCLA 691.1661 - 1667 WARNING: Under

the Michigan equine activity liability act, an

equine professional is not liable for an injury to

or the death of a participant in an equine

activity resulting from an inherent risk of the

equine activity.

MINNESOTA

MN ST § 604A.12

MISSISSIPPI

MS ST § 95-11-1 - 7 WARNING: Under

Mississippi law, an equine or livestock activity

sponsor or an equine or livestock professional is

not liable for an injury to or the death of a

participant in equine activities or livestock

shows resulting from the inherent risks of

equine activities or livestock shows, pursuant to

this chapter.

MISSOURI

MO ST 537.325 WARNING: Under

Missouri law, an equine activity sponsor, an

equine professional, a livestock activity sponsor,

a livestock owner, a livestock facility, a livestock

auction market, or any employee thereof is not

liable for an injury to or the death of a participant

in equine or livestock activities resulting from the

inherent risks of equine or livestock activities

pursuant to the Revised Statutes of Missouri.

MONTANA

MT ST 27-1-725 - 728

NEBRASKA

NE ST § 25-21,249 - 253 WARNING:

Under Nebraska law, 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, pursuant to sections

25-21,249 to 25-21,253.

NEVADA

NO KNOWN EQUINE ACTIVITY LIABILITY

STATUTE

NEW HAMPSHIRE

NH Rev. Stat. § 508:19

NEW MEXICO

NMSA 1978, § 42-13-1 – 5

NEW JERSEY

NJ ST 5:15-1 to 5:15-1 12 WARNING: UNDER

NEW JERSEY LAW, AN EQUESTRIAN AREA

OPERATOR IS NOT LIABLE FOR AN INJURY TO

OR THE DEATH OF A PARTICIPANT IN EQUINE

ANIMAL ACTIVITIES RESULTING FROM THE

INHERENT RISKS OF EQUINE ANIMAL

ACTIVITIES, PURSUANT TO P.L.1997, c.287

(C.5:15-1 et seq).

NEW YORK

NO KNOWN EQUINE ACTIVITY LIABILITY

STATUTE

NORTH CAROLINA

NC ST § 99E-1 - 99E-9 WARNING: Under

North Carolina law, an equine activity

sponsor or equine professional is not liable for an

injury to or the death of a participant in equine

activities resulting exclusively from the inherent

risks of equine activities. Chapter 99E of the

North Carolina General Statutes.

NORTH DAKOTA

ND ST 53-10-01; ND ST 53-10-02

OHIO

OH ST § 2305.321

OKLAHOMA

76 OK St. Ann. § 50.1 - 50.4

OREGON

ORS § 30.687 – 697

PENNSYLVANIA

PA ST 4 P.S. § 601 – 606

RHODE ISLAND

RI ST § 4-21-1 – 4 WARNING: Under Rhode

Island Law, an equine professional, unless he or

she can be shown to have failed to be in the

exercise of due care, is not liable for an injury to,

or the death of, a participant in equine activities

resulting from the inherent risks of equine

activities, pursuant to this chapter.

SOUTH CAROLINA

SC Code 1976 § 47-9-710 - 730 WARNING:

Under South Carolina law, an equine activity

sponsor or equine professional is not liable for an

injury to or the death 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 Laws of South Carolina, 1976.

SOUTH DAKOTA

SDCL § 42-11-1 - 5 WARNING: Under South

Dakota law, 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, pursuant to § 42-11- 2.

TENNESSEE

TCA § 44-20-101 - 105 WARNING: Under

Tennessee Law, 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, pursuant to Tennessee Code

Annotated, title 44 chapter 20.

TEXAS

VTCA CIV PRAC & REM CODE § 87.001 -

005 WARNING: UNDER TEXAS LAW (CHAPTER

87, CIVIL PRACTICE AND REMEDIES CODE), A

FARM ANIMAL PROFESSIONAL IS NOT LIABLE

FOR AN INJURY TO OR THE DEATH OF A

PARTICIPANT IN FARM ANIMAL ACTIVITIES

RESULTING FROM THE INHERENT RISKS OF

FARM ANIMAL ACTIVITIES. WARNING: UNDER

TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND

REMEDIES CODE), A LIVESTOCK SHOW SPONSOR

IS NOT LIABLE FOR AN INJURY TO OR THE DEATH

OF A PARTICIPANT IN A LIVESTOCK SHOW

RESULTING FROM THE INHERENT RISKS OF

LIVESTOCK SHOW ACTIVITIES.

UTAH

UT ST § 78B-4-201 – 203 An equine or

livestock activity sponsor is not liable for

inherent risks with regard to equine or livestock

activities. “Inherent risk” with regard to equine

or livestock activities means those dangers or

conditions which are an integral part of equine

or livestock activities, which may include: (a) the

propensity of the animal to behave in ways that

may result in injury, harm, or death to persons

on or around them; (b) the unpredictability of

the animal's reaction to outside stimulation such

as sounds, sudden movement, and unfamiliar

objects, persons, or other animals; (c) collisions

with other animals or objects; or (d) the

potential of a participant to act in a negligent

manner that may contribute to injury to the

participant or others, such as failing to maintain

control over the animal or not acting within his

or her ability.

VERMONT

12 VSA § 1039 WARNING: Under Vermont

Law, an equine activity sponsor is not liable for

an injury to, or the death of, a participant in

equine activities resulting from the inherent

risks of equine activities that are obvious and

necessary, pursuant to 12 V.S.A § 1039.

VIRGINIA

VA ST § 3.2-6200 – 6302

WASHINGTON

RC WA 4.24.530 - 540

WEST VIRGINIA

W.Va. CODE § 20-4-1 – 7

WISCONSIN

WSA 895.481 NOTICE: A person who is

engaged for compensation in the rental of

equines or equine equipment or tack or in

the instruction of a person in the riding or

driving of an equine or in being a passenger

upon an equine is not liable for the injury or

death of a person involved in equine activities

resulting from the inherent risks of equine

activities, as defined in section 895.481(1)(e)

of the Wisconsin Statutes.

WYOMING

WY ST § 1-1-122 – 123