Larry's Riding Stables
Student Information and Waiver Form
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Larry's Stables Inc. Student Information & Waiver Form I, the parent or guardian of
 _________________________________fully 
understand th
e inherent risk of horseback riding activities. Having read th

following Ohio House Bill 564, I give my permiss
ion for my child to 
p
articipate in equine activities at Larry's Stables Inc. in Kent, Ohio wit

Larry Hannum, Debbie Alsop, or Tammie Menke a
s
instructor. I fully 
underst
and that Larry Hannum or any employee or volunteer of La
rry's 
St
ables Inc. is liable in NO way for any injury or death to a particip
ant 
pur
suant to Ohio HB 564.
Ohio House Bill 564 "Under Ohio law,
equine owner operator is not liable for an injury to or 
d
eath of a participant in equine activities resulting from the inhere
nt 
risk of equine activiti
es pursuant to HB564"


Parent or Guardian Signature __________________________
Date_____________________________
Student's Name_____________________
Address__________________________________________
Emergency contact _____________________
Parent's Name_______________Home Phone____________
Work Phone________________ Emerg. Phone___________


Please note: All students should wear long pants during lessons. Safet
helmets are provided, however, stud
ents are welcome to bring the
ir own 
helmet.