Client Waiver

Your Name: *

Your Email: *

Phone: *

Address: *

Horse Registered Name: *

Horse Barn Name: *

Age & Breed: *

Has your horse been with us before? *

Yes

Any Medical Conditions/Lameness/Allergies/Quirks: *

I give consent to Dr. Gavaga to perform sedation and other procedures I may request on my horse (Gelding stallion 2yrs+). *

Agreed

I understand there is risk to sedation, anesthesia and any procedure, that even with a health exam, there may be unforeseen circumstances or underlying health issues that can cause serious illness or death. I therefore release all liability and surrender my right to sue Dr. Gavaga, Charles Ranch Equine, and any of his/its employees, agents or family, (collectively known as Charles Ranch Equine), even in the event of neglect. *

Agreed

Charles Ranch Equine Strongly advises on horse insurance. *

The horse is insured and The Owner agrees to provide a copy of the contract upon arrival of the mare

The horse is not insured and Owner agrees to accept all responsibility for costs should The Mare (and or her foal) become sick, injured or die at Charles Ranch Equine.

Upload a Copy Of The horses Insurance Policy

This is only required if the mare is insured and you have a copy of the insurance policy.

Choose File

In the event of an injury or emergency I consent to treatments and consent for Charles Ranch Equine to charge my credit card before proceeding with treatment to the amount of: *

In the event of a dispute, I agree to pay all costs associated with a dispute, including, but not limited to, legal fees, court costs, travel costs, professional time for Charles Ranch Equine. *

Agreed

Disagree

I agree to a Non-Disclosure Agreement of any information, negative or other, in or to, but not limited to, any public or private forum, society, college, association, company or person. In the event I break the Non-Disclosure Agreement, I agree compensate Charles Ranch Equine for any associated costs for defence, enforcement, or loss of business. *

Agreed

By typing your name and clicking SUBMIT, you agree to all terms set out in this contract. *

Understood

Signed *

Date *

Thank you for submitting your Mare Admission & Waiver. Within 48hrs you will receive an invoice for your deposit. Mares are accepted in the order that they book. Drop off day must be pre-arranged with Charles Ranch Equine. Mare drop-off and pick-up is Monday to Friday, 8am - 4:30pm.

There was an error submitting your form. Please try again or contact us at equine@charlesranch.com so we can send you a copy via email.

HOURS:
8am - 4:30pm Mon-Fri

3700 Highway 97c
Ashcroft, BC, Canada

equine@charlesranch.com
1 (250) 457-7426

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Client Waiver

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