Waiver Of Liability/ Consent Form - West Wind Veterinary Hospital (Page 2 of 2) in pdf

A. the propensity of livestock to behave in ways that may result in personal injury or death to a person around it;

B. the unpredictability of livestock’s reaction to sound, sudden movement, or an unfamiliar object, person or other

animal;

C. certain land conditions and hazards, including surfaces and sub-surfaces;

D. a collision of livestock with another animal or object;

E. the potential that another animal may expose the horse to sickness or disease;

F. the propensity of livestock to behave in ways that may result in self-inflicted injury or death of such livestock;

and

G. the potential for a person to act in negligent manner that may contribute to injury to the horse, including, but not

limited to failing to maintain control over livestock or not acting within the person’s ability.

Horse owner / Agent hereby specifically acknowledges all of the inherent risks potentially associated with the

breeding and care of horses and fully waives West Wind Veterinary Hospital and Equistar Veterinary Services,

their subsidiaries, affiliated companies, shareholders, employees, family and contract personnel from and against

any and all claims, demands and liabilities which the horse owner may have, including negligence, gross

negligence, and strict liability now or in the future, known or unknown.

7. Biosecurity is an important aspect of preventative health care. We strive to keep your horse safe and healthy but

acknowledge that any comingle site carries an increased risk of contagious disease especially when young animals

are involved. Please vaccinate and deworm prior to arrival, delay your visit if your horses are not feeling well and

isolate once you horse returns home to help reduce this risk.

8. Horse owner may elect to provide equine insurance. This coverage is provided by:

Name of Insurance Company: ____________________________________________________

Insurance Agent: ______________________________________________________________

Policy Number: ________________________________________________________________

Phone Number: ________________________________________________________________

________________________________________

_______________________

Signature of Horse Owner or

Date:

Authorized Representative

________________________________________

_______________________

Signature of WWVH representative

Date

West Wind Veterinary Hospital

51136 Range Road 212

Sherwood Park, Alberta T8G 1E7

Clinic: 780-662-0112 Fax: 780-662-0110

Waiver Of Liability/ Consent Form - West Wind Veterinary Hospital Page 2