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Thank you for retaining Pinnacle Rehab Center as your provider of horse rehabilitation and conditioning services. In furtherance of Pinnacle Rehab Center providing your horse with your requested services, Pinnacle Rehab Center requires the owner, authorized lessee, or authorized agent of any horse receiving services from Pinnacle Rehab Center to agree to the terms of this Medication Administration Release Agreement (“Release”). This Release applies to any and all of your horses (“the Horse”) placed in Pinnacle Rehab Center’s care for services. By signing below, you agree to the following terms and conditions:
- I understand and agree that the Horse will be visually inspected for any obvious signs of illness or injury and that such visual inspection and other care, unless otherwise stated by Pinnacle Rehab Center will not be performed by veterinary professionals or other medical personnel and should not replace my medical care for the Horse. In the event I request or authorize Pinnacle Rehab Center and/or the other Released Parties toadminister medications, supplements, sedatives, or any injections (“Meds”) for the Horse, Pinnacle Rehab Center and the other Released Parties will use reasonable procedures for the safety and/or well-being of the Horse in providing such service.
- I understand and agree that, despite any reasonable procedures, and without any fault or wrongdoing when administering Meds, there is no guarantee that the Meds or administration itself in any form (i.e. intramuscular, intravenous, oral, topical, etc.) will not harm or result in an adverse reaction for the Horse as there is always risk involved with Meds, even when properly administered.
- I therefore agree to fully release, defend, indemnify and hold Pinnacle Rehab Center, Unbridled Equine LLC, Lauri Mason, and Katie Hawkins and any of these listed parties’ respective spouse, relatives, heirs, agents, assigns, trusts, trustees, beneficiaries, trainers, employees, working students, volunteers, independent contractors, guests, visitors, members, managers, officers, directors, owners, lessors, lessees, licensors, licensees, or others acting on their behalf (collectively “Released Parties”) harmless for any illness, injury, death, or other loss (collectively “Loss”) to the Horse or myself, directly or indirectly arising out of or relating to Meds. No express or implied warranties are made regarding Pinnacle Rehab Center’s care of the Horse unless otherwise provided in this Release and Pinnacle Rehab Center does not expressly or impliedly accept responsibility for identifying, diagnosing, or treating any injury or illness.
- I acknowledge having inspected Pinnacle Rehab Center’s facility and agree that I am satisfied with the conditions and the level of care provided to the horses. I accept this same level of care as satisfactory for the Horse.
- I understand and agree Pinnacle Rehab Center is authorized, but not obligated, to secure veterinary care (including such care as may be necessary, in Pinnacle Rehab Center’s sole discretion, to protect the life or health of the Horse or other horses in Pinnacle Rehab Center’s care), farrier care, transportation, and any other services required for the health, well-being, and/or other benefit of the Horse. Pinnacle Rehab Center does not expressly or impliedly accept responsibility for identifying, diagnosing, or treating any injury or illness, whether routine or emergency in nature. I shall remain solely responsible for the costs of all such services.
- I agree that this Release shall be construed and enforced in accordance with the laws of the State of Arkansas. All disputes relating to the interpretation and enforcement of this Release shall be resolved by the state court in Washington County, Arkansas and I submit to the jurisdiction and venue of the Court for such purpose. I agree that this Release does not expire, that any and all claims and/or causes of actions surviving the release provisions of this Release must be brought within one (1) year of the date accrued, and any surviving claim for personal property Loss is limited to $500.00. The prevailing party shall be entitled to recover its attorneys' fees and costs incurred in enforcing the terms of this Release and/or in defending or prosecuting any such claims or causes of action. I agree to waive trial by jury in any action with Released Parties.
- I agree that if any provision of this Release is deemed invalid or unenforceable, the remaining provisions shall be valid and enforceable to the fullest extent of the law. This Release can only be modified in writing signed by myself and Lauri Mason and/or Katie Hawkins. I represent and confirm that I have the requisite authority to execute this Release and bind myself and the owner of the Horse (if other than myself) to the terms of this Release. I certify that I have read this entire Release and understand that the signing of this Release is a condition for the Horse receiving services from Pinnacle Rehab Center. I know that I have other therapeutic service providers to choose from, and voluntarily intend on my own behalf and on behalf of the owner of the Horse (if other than myself), my spouse, relatives, heirs, agents, trustees, beneficiaries, representatives, successors, and assigns, to be bound by the terms and conditions contained herein.
In the event the Horse requires surgery and I cannot be reached, I authorize / do not authorize surgery for the Horse.
I authorize surgery for the horse
I do not authorize surgery for the horse
THIS DOCUMENT AFFECTS YOUR LEGAL RIGHTS – READ CAREFULLY BEFORE SIGNING
