Participant Waiver — Rysdon Ranch Camp

⚠ Important: This is a legally binding document. By submitting this form, the parent or legal guardian acknowledges the inherent risks of equine and livestock activities and agrees to the Release of Liability, Medical Authorization, and Photo Release terms below. Please read each section carefully before signing.

Questions about the waiver? We're happy to help.

info@rysdonranchcamp.com

1. Camper & Session Information

Camper Full Name ★

Date of Birth ★

Age at Time of Camp ★

Session ★

T-Shirt Size

2. Emergency Contacts & Medical Information

Please provide two emergency contacts. The primary contact should be the parent or legal guardian signing this form.

Primary Emergency Contact

Full Name ★

Relationship to Camper ★

Primary Phone ★

Alternate Phone

Secondary Emergency Contact

Full Name ★

Relationship to Camper ★

Primary Phone ★

Alternate Phone

Medical Information

Physician / Pediatrician

Physician Phone

Health Insurance Carrier

Policy / Group Number

Allergies (food, medication, environmental, insect — list all) ★

Current Medications (name & dosage)

Physical Limitations or Health Conditions Staff Should Know About

3. Assumption of Risk — Equine & Livestock Activities

Equine and livestock activities carry inherent risks. Please read each statement and check the box to acknowledge your understanding before proceeding.

I understand that horses, donkeys, and other livestock are unpredictable live animals that may react suddenly and cause injury, even when well-trained and closely supervised.

I understand that activities including riding, leading, grooming, and proximity to animals carry inherent risks of falling, being kicked, stepped on, or bitten.

I understand that outdoor ranch environments present additional hazards including uneven terrain, weather conditions, and farm equipment.

I understand that South Dakota law (SDCL Ch. 42-11) recognizes the inherent risks of equine activities and limits the liability of equine activity sponsors. I voluntarily assume all known and unknown risks associated with my child's participation.

4. Release of Liability, Waiver & Medical Authorization

Release & Waiver. In consideration of my child's participation in Rysdon Ranch Camp, I, on behalf of myself, my child, and our heirs and assigns, hereby release, waive, and discharge HiRoad Ranch, Triple R Enterprise, Addie Reiman, and their officers, employees, volunteers, and agents ("Released Parties") from any and all claims, losses, or damages arising from participation in camp activities, including claims arising from the negligence of the Released Parties. I agree to indemnify and hold the Released Parties harmless from any related claims or costs. This release is intended to be as broad as permitted under South Dakota law. I sign freely and voluntarily.

Medical Authorization. If I cannot be reached in a timely manner, I authorize camp staff to seek emergency medical treatment including hospitalization or surgery as deemed necessary; administer first aid; transport my child to a medical facility; and share relevant medical information with treating personnel. My health insurance is primary and I accept financial responsibility for any expenses incurred.

I have read and understand the Release of Liability, Waiver, and Medical Authorization above. I agree to all terms.

5. Photo & Video Release

Photos and videos are taken at camp for session documentation and family sharing. Please indicate your preference:

YES — I authorize HiRoad Ranch and Triple R Enterprise to photograph and/or video my child during camp activities and to use these images for sharing with camp families, program documentation, and promotional materials including social media and the camp website. My child will not be identified by full name in public-facing materials.

NO — I do not authorize the use of photos or video of my child for any purpose other than direct sharing with our family.

6. Signatures

By completing the fields below and submitting this form, you confirm that you are the parent or legal guardian of the named camper, that you have read this entire document, understand and agree to all of its terms, and are submitting voluntarily and of your own free will.

Parent/Guardian Full Name (typed signature) ★

Today's Date ★

Parent/Guardian Email (we'll send a confirmation) ★

Camper Acknowledgment

I understand I will be working with horses and other live animals at Rysdon Ranch Camp. I agree to follow all safety rules and listen to my counselors.

Camper Full Name ★

I confirm that all information provided in this form is accurate and complete. I understand that submitting this form constitutes a legal electronic signature and agreement to all terms outlined above.

You will receive a confirmation email once your waiver has been submitted. This form must be completed before your camper's first day of camp.

✅

Waiver Submitted Successfully!

Thank you! We have received your completed waiver for . A confirmation has been sent to your email.

If you have any questions, contact us at info@rysdonranchcamp.com or 605-366-2519.

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Participant Waiver & Consent