Hamilton County Riding Club, Inc.

HELMET LAW

Acknowledgement of Warning and Assumption of Risk and Complete Release

PROTECTIVE HEADGEAR/HELMET WARNING AND OFFERING

I/WE ACKNOWLEDGE THAT:

for myself and on behalf of my child and or/legal guardian have been fully warned by THE HAMILTON COUNTY RIDING CLUB, INC. that protective headgear/helmet which meets or exceeds the quality standards of the SEI CERTIFIED ASTM STANDARD F1163 Equestrian Helmet, should be worn while riding, handling and / or being near horses and I understand that wearing of such headgear/helmet at these times may reduce the severity of some of the wearer's head injuries and possibly prevent the wearer's death from happening as results of a fall or other occurrences.

I/WE ACKNOWLEDGE THAT:

HAMILTON COUNTY RIDING CLUB, INC has informed me of this Florida Law.

I/WE will be responsible for properly securing the headgear/helmet on the participant's head at all times. I am not relying on the Hamilton County Riding Club, Inc. or its associates to check any headgear/helmet strap that my minor child is wearing.

I understand that the Hamilton County Riding Club, Inc. requires riders under 16 years old to wear SEI CERTIFIED ASTM STANDARD F1163 protective headgear/helmet according to the following requirements. Senate Bill (S 68) Nicole Hornstein Act/Equine Activities (EPSC) Requires a child younger than a specific age to wear a helmet when riding an equine in certain locations. Provides requirements for helmets. Requires a person renting or leasing an equine for riding by a child younger than a specified age to provide a helmet if the child does not have a helmet. Prohibits a parent or guardian of a child younger that a specified age from authorizing or permitting the child to engage in certain conduct, etc. Effective 10/01/2009

*** 9-15 years of age: Must wear headgear/helmet!

+16 years of age: Must wear protective headgear/helmet unless their parents of legal guardians sign the refusal statement in the box that follows.

 PROTECTIVE HEADGEAR/HELMET ACCEPTANCE: I/WE request for this participant to wear protective headgear/helmet which the PARENT/ GUARDIAN will provide and will be solely responsible for securing the headgear/helmet on the participant's head.

 PROTECTIVE HEADGEAR/HELMET REFUSAL: I/WE REFUSE for this participant to wear any type of protective headgear/helmet. I/WE ACCEPT FULL RESPONSIBILTY FOR MY/OUR SAFETY IN THIS DECISION.