INDEMNITY FORM 

Heart

Activities: HORSE RIDING, CAMPING, ARCHERY, CRAFTS, HIKING, SURFING, CANOEING, SURFING .

Organizer: TNT Horse and Heart
Contact Person: Thomas Muller
Contact Number: 0027 741009968.

DATE OF ACTIVITY:  START DATE:         END DATE:

o IN THE CASE OF LESSONS OR ACTIVITIES THAT HAPPEN ON A WEEKLY BASIS OR REPEATEDLY IN THE FUTURE PLEASE MARK

Important Notice:

By completing and signing this indemnity form, you (the undersigned) acknowledge and agree to the following terms and conditions. This form is a legal agreement that limits your right to claim against TNT Horse and Heart, its owners, employees, and agents. Please read it carefully and ensure all sections are completed accurately.

1. Participant Details

• Full Name of Participant/s __________________________________________

• _________________________________________________________________

• _________________________________________________________________

• Age of Participant (if under 18): _____________
  (If under 18, a parent or legal guardian must sign on their behalf)

• Address: _________________________________________________________

• Email Address: _________________________________________________

• Phone Number: _________________________________________________

• Emergency Contact Name: ________________________________________

• Emergency Contact Number: ______________________________________

• Relationship to Participant: _____________________________________

2. Medical Information

Please provide details of any relevant medical conditions, allergies, or special needs. This information is essential to ensure the safety and well-being of the participant.

• Does the participant have any allergies? Yes / No (Please specify):

• Does the participant have any existing medical conditions? Yes / No (Please specify):

• Is the participant currently on any medication? Yes / No (Please specify):

• Does the participant have any special dietary needs or restrictions? Yes / No (Please specify):

3. Medical Aid Information

Please provide the participant’s medical aid details.

• Medical Aid Scheme: ____________________________________________

• Membership Number: ___________________________________________

• Policy Holder’s Name (if different from participant): ____________________

• Medical Aid Contact Number: ___________________________________

• Doctor’s Name: _______________________________________________

• Doctor’s Contact Number: ______________________________________

4. Experience Level

Please indicate the participant’s level of experience with horse riding:

• Complete Beginner

• Beginner (Has ridden a horse a few times)

• Intermediate (Has experience riding but may need assistance)

• Advanced (Confident rider with significant experience)

• Other (Please specify): ____________________________________________

5. Indemnity Agreement

I, the undersigned, acknowledge that:

1.       Horse riding and our other activities are physically demanding activities that involve inherent risks, including but not limited to fall or accidents  that may result in injury or even death.  

2.       I confirm that I (or the participant, if under 18) am physically fit to engage in horse riding and/ or otheractivities and I accept full responsibility for the participant’s actions and decisions during the activity.

3.       I acknowledge that TNT Horse and Heart, its owners, employees, agents, and contractors are not responsible for any injuries, loss, or damage to the participant or their property that may occur during the horse riding activity OR ANY OTHER ACTIVITY that TNT Horse and Heart may offer unless caused by gross negligence.

4.       I agree to indemnify and hold harmless TNT Horse and Heart, its owners, employees, agents, and contractors from any and all claims, damages, losses, and expenses arising from participation in the horse riding activity or any other activity whether caused by accident, or any other reason, except for Gross Negligence.

5.       I give my consent for emergency medical treatment to be administered to the participant if necessary and agree to cover all medical expenses incurred during the activity.

6.       I understand that safety instructions must be followed at all times and that failure to comply with these instructions may result in removal from the activity without a refund.

7.       I confirm that the information provided in this form is accurate to the best of my knowledge, and I will notify TNT Horse and Heart of any changes to the participant's medical or contact details.

6. Consent

By signing below, I confirm that I have read and fully understand the contents of this indemnity form. I consent to the participant’s involvement in horse riding activities at TNT Horse and Heart under the conditions outlined above.

• Signature of Participant/s (or Parent/Guardian if under 18): _________________________________________

• Full Name of Parent/Guardian (if applicable): ___________________________________

• Date: _______________________

8.   Additional Notes (if any):______________________________________________________________________                 

9.   HOW DID YOUR HEAR ABOUT TNT HORSE AND HEART ? Word of Mouth?____ Face Book?____ TikTok_____ InstaGram___

This form must be signed and submitted before the horse riding activity can take place. Thank you for your cooperation!

 We look forward to your visit to TNT Horse and Heart