MURPHY MEADOWS WAIVER & RELEASE FORM Name* First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*Email* IN CASE OF EMERGENCY:Name* First Last Phone*ACKNOWLEDGMENT OF RISKS & ACCEPTANCE OF RESPONSIBILITY/EMERGENCY AUTHORIZATION: I recognize that there is a significant element of risk in horseback riding and any outdoor activity including serious bodily injury. I acknowledge and assume all risks associated with any and all equine and other activities engaged in, and in connection therewith (“Equine Activities”), promise, agree and warrant to release, hold harmless, protect, indemnify, and forever discharge Murphy Meadows, LLC, Bridget Murphy, and her respective officers, members, managers, agents and representatives (jointly and severally, “Indemnified Parties”), from any and all causes of action, claims and demands of any nature for any and all loss, damage, or injuries sustained by participant, participant's family members, including children, or any other of participant's guests and invitees, including children, or their equipment or animals, incurred at any time during activities on the property. Participant(s) further promises and agrees never to institute any claim, suit or action at law against Indemnified Parties which may arise as a result of the use of the property and activities engaged in on the property. Participant(s) shall indemnify and hold harmless Indemnified Parties from any and all claims for bodily injury, death, or property damage or other losses, claims, causes of action, attorney fees, or other costs which may result or arise, in any manner, from the use of the property and the activities engaged in on the property, including but not limited to Equine Activities. In the event a minor, whether it be participant, participant's children or other individuals using the property with participant(s) hereinafter referred to as "minor"), is injured and/killed and /or suffers loss of property while engaging in activities, participant(s) specifically agrees to indemnify and hold harmless injury, death, or property damages or other losses, claims, causes of action, or other costs resulting or arising in any manner or way from said minor's participation in or attendance at any such activities on the property and any property owned or used by the Indemnified Parties for the Equine Activities (“Property”). To the extent necessary to indemnify and hold harmless Murphy Meadows and Bridget Murphy in the event of injury or death as a result of a minor, participant specifically agrees to waive any applicable statute of limitation. Visitor's obligation to indemnify Indemnified Parties includes, but is not limited to, paying for counsel of Indemnified Parties choosing to defend against any claim arising out of participants or said minor's use of the property. In the event it is necessary to refer this Agreement to an attorney, the prevailing party in such action shall be entitled to its costs and reasonable attorney fees. Venue of any action involving this Agreement shall be in Polk County, Wisconsin. Knowing the inherent risks, dangers and rigors involved in Equine Activities. I certify that I and any minor children of mine are fully capable of participation in all activities. I assume full responsibility for myself and my minor children for bodily injury, death, loss of personal property and expenses thereof, as a result of my negligence or the negligence of my children. I further understand the Identified Parties reserve the right to refuse any person it judges to be incapable if meeting the rigors and requirements of participation in Equine Activities. I have read, understand and accept the terms and conditions stated herein and acknowledge that this agreement shall be effective and binding upon us during the entire period of participation in the activities. I agree to RELEASE, HOLD HARMLESS and INDEMNIFY the Indemnified Parties and its/their employees, agents, contractors, officers or owners from all claims including negligence, which arise out of participation in or travel to and from 2085 Beddor Court, Luck WI 54853. This release is binding as to any other persons, including family members, heirs and executors. This release does not apply to gross negligence or intentional acts. If I am signing on behalf of a minor, I recognize that I may not release any claims the minor may have. However, I accept full responsibility for medical expenses incurred as a result of the minor's participation in or travel to and from the Property. I also agree to HOLD HARMLESS AND INDEMNIFY the Indemnified Parties for any claims brought by the minor. I hereby give permission to the medical personnel selected by the Murphy Meadows LLC personnel to order Xrays, routine tests and treatment for my minor children and myself and in the event, I cannot be reached in an emergency, I hereby give permission to the physician selected by Murphy Meadows, LLC personnel to hospitalize, secure proper treatment for and to order injection and /or anesthesia and /or surgery for my minor children or myself as named above. This waiver, release and authorization shall continue indefinitely, unless I otherwise revoke this authorization in writing. Wis. Stat. s 895.525 (1994) 895.525 states that an equine activity sponsor or professional is not liable for any injury to, or the death of a participant in an equine activity resulting from the inherent risks of the equine activities. I have read and understand this document.Signature of Participant*Date MM slash DD slash YYYY Handwritten Name:* WARNING NO PERSON MAY RIDE UNLESS THEY: 1. Have permission of the management, abide by the management's rules and have signed the Release and Waiver. 2. Are wearing adequate protective headgear or have signed a headgear waiver and are wearing long pants and boots or shoes with a heel. 3. Maintain control of their horse and ride within their ability. 4. Have had all their tack and equipment properly inspected and in safe operational condition. 5. Have fairly and accurately made known their riding ability and experience to the activity sponsor or professional. RECOMMENDATION AND WAIVER FOR USE OF ASTM/SEI APPROVED PROTECTIVE HEADGEAR Indemnified Parties highly recommend the use of a properly fitting ASTM/SEI approved equestrian helmet for all individuals participating in horseback riding activities. Protective helmets are REQUIRED for all minors. If you choose to ride without helmet you must sign this release form below. NO minor children may ride without a helmet. I understand the additional safety an ASTM/SEI approved equestrian riding helmet provides. I understand that riding without an appropriate helmet increases the risk of injury in the event of an accident. I choose for myself to ride without and ASTM/SEI approved riding helmet and I assume full responsibility for this decision. I have read, understand and agree to be bound by the stipulations stated in the warning. Δ