Code of Conduct

Our Code of Conduct provides for a safety and enjoyment for everyone at the Farm.
Thank you for your cooperation!

1. We ask that you WASH YOUR HANDS before and after touching the animals.
2. Make sure to clean up after yourself and your animal.
3. Make sure to ask permission before entering pastures or stalls.
4. If you open a gate to enter a pasture area make sure to lock it behind yourself.
5. Make sure to ask permission before feeding the animals, remember out animals
have teeth.
6. We know it can be difficult when you are excited, but running / sudden
movements inside the barn or arenas can scare the animals. Make sure to be in
control while at the farm.
7. We ask that all visitors / volunteers not use profanity or disrespectful language
while at the farm.
8. Cell phones need to either stay in your pocket on vibrate or in the office while at
the farm.
9. Due to all the dry hay and wood we ask that NO SMOKING, TOBACCO or
ALCOHOL products are permitted on farm property
10. When in doubt make sure to ask.
11. Your siblings are welcome to visit the farm they just need to be supervised.
12. Due to the unpredictability of how outside animals will react we ask that you do
not bring your pets to the farm.

Burgess Family Farm

4440 Solano Road, Fairfield CA 94533
(707) 290-6753
 WAIVER/RELEASE OF LIABILITY, ASSUMPTION OF RISK, AND
INDEMNITY AGREEMENT

PARTICIPANT __________________________ (Adult, Parent, Guardian) of _____________________

(Minor) (hereafter known as “PARTICIPANT)” hereby acknowledge that PARTICIPANT / or my minor
child is voluntarily applying to participate in the following activities: care of farm animals (not
domesticated pets), ranch work (building and repairing fencing / barns / stables, working with power tools
and / or equipment), driving motorized vehicles (trucks, tractors) (the “activities” or “participated
activities”), on the PROPERTY of 4440 SOLANO ROAD, FAIRFIELD, CA 94533 (the “PROPERTY”)
and other public roads/land, and conducted by BURGESS FAMILY FARM, INC (the “BUSINESS”). In
consideration of the above and my participation in the aforementioned activities, PARTICIPANT, and
any representative on my behalf, including but not limited to minor children, personal representatives,
heirs, and next of kin, do affirm the following:
_____ 1. RISK OF SERIOUS INJURY AND/OR DEATH
PARTICIPANT understands that the participated activities involve numerous inherent risks of
injury that are my sole responsibility, and PARTICIPANT assumes these risks as a result.
PARTICIPANT fully understands and acknowledges that these activities pose seen and unseen
dangers. PARTICIPANT fully understand that the activities involve the risk of injuries inflicted by
animals can include bites, kicks, crushing, ramming, trampling, and transmission of certain
infectious diseases such as giardia, salmonella, ringworm and leptospirosis or property damage
and/or injury(ies), including a potential risk for serious injury, permanent disability and/or death.
While measures such as protective equipment, safety procedures and/or personal discipline, may
be undertaken to minimize this risk, the risk of personal / property damage and/or injury still
exists. These risks and dangers may be caused foreseeable or unforeseeable causes, including, but
not limited to other participants, accidents, forces of nature, selection of farm animal, uneven
terrain, weather conditions, and other risks, hazards, and dangers that are integral to activities the
take place involving horses, cows, pigs, alpacas, goats, rabbits, chickens, and farm equipment such
as motorized vehicles and equipment.

_____ 2. RISKS DUE TO ANIMAL BEHAVOIR

PARTICIPANT acknowledge and assume any risk which may arise out of unpredictable farm
animal behavior. Specifically, PARTICIPANT understand that an animal, regardless of its training

Burgess Family Farm

4440 Solano Road, Fairfield CA 94533
(707) 290-6753
 and habitual past behavior and characteristics, may act or react unpredictably at times based upon
instinct or fright, which in effect, is a risk to be assumed by each participant in any riding activity.
PARTICIPANT further understand the inherent risks, dangers or conditions that are integral to any
farm animal activity, including, but not limited, to the following:
a) A natural inclination of an animal to behave in ways that may result in harm, injury, or death
to persons on or around them
b) The unpredictability of an animal’s reaction to such things as sounds, sudden movement, and
unfamiliar objects, persons, or animals.
c) Certain hazards such as surface and/or subsurface conditions.
d) Collisions with other animals or objects.
e) The potential of a participant to act in a negligent manner that may contribute to bodily injury
or other harm to the participant or others, such as failing to maintain control over the animal
or not acting within the participant’s ability

_____ 3. ACKNOWLEDGMENT AND UNDERSTANDING OF RULES AND PROCEDURES

PARTICIPANT acknowledge and understand that it is at my discretion and option whether to
wear a helmet, or safety apparel, while engaging in the participated activities. PARTICIPANT
also understand that, if PARTICIPANT elect to wear a helmet, or safety apparel, is to be provided
by myself, the participant. Further, PARTICIPANT understand the importance of knowing and
abiding by the established rules, regulations, and procedures for the safety of those engaging in
the participated activities.

_____ 4. CLAIMS OF LIABILITY AND INDEMNIFICATION

PARTICIPANT agree to indemnify, pay, protect, defend, and hold harmless the BUSINESS, the
PROPERTY, their owners, officers, agents, employees, trainers, volunteers, and any other
representatives of PROPERTY and / or the BUSINESS from any and all claims, damages, losses,
liabilities, injuries, and/or expenses that may occur or arise out of, or resulting, from my
participation in care of farm animals, ranch work (building and repairing fencing / barns / stables,
working with power tools and / or equipment), driving motorized vehicles (trucks, tractors),
whether causes by the negligence of the PROPERTY and / or the BUSINESS, its owners,
officers, agents, volunteers, employees, or otherwise.
To participate in any, or all of the activities, PARTICIPANT hereby agree to release the
PROPERTY and / or the BUSINESS, any of its owners, officers, agents, volunteers, employees,

Burgess Family Farm

4440 Solano Road, Fairfield CA 94533
(707) 290-6753
 or trainers; and their agents or employees from liability due to any negligence whatsoever.
PARTICIPANT shall bring no claims, demands, actions, and causes of action, and/or litigation
against the PROPERTY and / or the BUSINESS, any of their owners, agents, volunteers,
employees, or trainers and their agents or employees for any pecuniary and non-pecuniary losses
due to bodily injury, death, property damage, sustained by me and/or my minor child or legal
ward in relation to the premises and operations of these stables, including while handling, or
otherwise being near the farm animals owned by or in the care, custody and control of
BUSINESS. The parties agree that the PROPERTY and / or the BUSINESS, any of its owners,
officers, agents, volunteers, employees, or trainers; shall be entitled to all costs and expenses
associated with enforcement of the provisions of this Agreement including, but not limited to,
reasonable attorney’s fees. This contract can only be modified in a written agreement that has
been signed by all parties. This Agreement shall extend to and be binding upon the parties, and
the estate, heirs, personal representatives and any other representative, successors and assigns of
the parties. Further, this agreement shall be considered continuing in nature beyond the date
ascribed herein so long as the participant engages in the participated activities.

_____ 5. PARTICIPANT GUARANTEE OF HEALTH COVERAGE AND HEALTHINESS

PARTICIPANT represent, assert, and covenant to PROPERTY and / or the BUSINESS that
PARTICIPANT have sufficient personal health, accident, and liability insurance to cover injuries
or property damage that PARTICIPANT may sustain or cause while engaging in participated
activities, or any other activities on or around the PROPERTY. PARTICIPANT affirm and assert
that my minor child, being a minor under 18 years of age, or any other children in my custodian
and/or guardianship have eligible health insurance that will cover any farm animal related
accidents or injuries. PARTICIPANT also warrant and affirm that PARTICIPANT am physically
able to engage in the participated activities, and PARTICIPANT hereby assume the responsibility
of physical fitness and capacity to take part, in any manner whatsoever, in the participated
activities. PARTICIPANT further certify that PARTICIPANT am taking no medication, or under
the influence of any medication, drug, alcohol, or other substance, which may adversely affect or
inhibit the ability of my participation of care of farm animals (not pets), ranch work (building and
repairing fencing / barns / stables, working with power tools and / or equipment), driving
motorized vehicles (trucks, tractors).

Burgess Family Farm

4440 Solano Road, Fairfield CA 94533
(707) 290-6753
_____ 6. EMERGENCY MEDICAL TREATMENT AND OTHER PROVISIONS
In the event that emergency medical treatment is required due to illness or injury during my
participation care of farm animals, ranch work (building and repairing fencing / barns / stables,
working with power tools and / or equipment), driving motorized vehicles (trucks, tractors),
PARTICIPANT authorize the PROPERTY and / or the BUSINESS to secure and retain medical
treatment, and transportation, if necessary. The authorization alluded to herein includes x-rays,
surgery, hospitalization, medication, and any other treatment procedure to be deemed, by the
attending physician, for the purpose of saving one’s life. However, the expenses or costs incurred
in such an event will be the responsibility of the participant, and not the PROPERTY and / or the
BUSINESS. Note that this provision shall only be invoked if the participant is unable to consent
for treatment.

PARTICIPANT also agree and consent that if PARTICIPANT am asked by owners, agents, volunteers,
employees, trainers, or any other representative of the PROPERTY and / or the BUSINESS to halt or stop
my participation in the activities and leave the premises, PARTICIPANT will do so immediately and at
time of request, and PARTICIPANT will not hold them liable for any expenses incurred whatsoever.
PARTICIPANT expressly agrees that this Agreement is binding on my estate, heirs, next of kin,
assignees, coassignees, and personal representatives, such as parents or legal guardians. PARTICIPANT
agree to the terms and conditions of this Agreement, which are set forth herein and constitute a legal
agreement between me and PROPERTY and / or the BUSINESS, and any modifications or changes to
this Agreement must be in writing and approved and signed by both myself and a representative of the
PROPERTY and / or the BUSINESS. PARTICIPANT also acknowledges that this agreement is intended
to be as broad and inclusive as permitted by the laws of the State of California. PARTICIPANT agree that
if any portion of this Agreement is determined to be invalid or unenforceable, that part will be amended to
achieve, as nearly as possible, the same effect as the original and the balance of the agreement shall
remain in full force and effect.

Under California law, the PROPERTY and / or the BUSINESS, their owners, officers, agents,
employees, trainers, volunteers, and any other representatives of BUSINESS are not liable for an
injury to, or the death of, a participant in care of farm animals, ranch work (building and repairing
fencing / barns / stables, working with power tools and / or equipment), driving motorized vehicles
(trucks, tractors) activities resulting from the inherent risks of the participated activities.

Burgess Family Farm

4440 Solano Road, Fairfield CA 94533
(707) 290-6753
PARTICIPANT has carefully read this Waiver/Release of Liability, Assumption of Risk, and
Indemnity Agreement, and fully understands, agree, and consent to its terms and conditions.
PARTICIPANT understands that PARTICIPANT has given up a substantial right by signing this
agreement. PARTICIPANT also assert and certify that PARTICIPANT am not under the influence
of any medication, drug, alcohol, or other substance that may affect my ability to read, understand,
and agree to this Agreement. Furthermore, PARTICIPANT is aware of its legal consequences and
has signed it freely and voluntarily without any inducement, assurance, or guaranty being made to
me. Do not sign if you do not understand or agree in full with the terms and conditions set forth
herein. PARTICIPANT intends my signature to be a complete and unconditional release of liability
to the greatest extent allowed by law.
Participant’s Name: _____________________________ Date: / /
Participant’s Signature: _____________________________
Participant’s DOB: _____________________________
Phone Number: _____________________________
Street Address: _____________________________
City, State, and Zip: _____________________________
If Applicable,
Parent/Legal Guardian Name: _____________________________ Date: / /
Parent/Legal Guardian Signature: _____________________________

Witness Signature: _____________________________ Date: / /

Burgess Family Farm

4440 Solano Road, Fairfield CA 94533
(707) 290-6753
 CONSENT FOR MEDICAL TREATMENT OF A MINOR
 
I, the undersigned parent, hereby grant Burgess Family Farm, of 4440 Solano Road, Fairfield, California
94533, the authority to obtain medical treatment for the following child:
 
Name of Child: ______________________________________
Birthdate: _________________
The above care provider(s) are authorized to:
 obtain medical treatment and procedures for the child as may be appropriate in emergency circumstances,
including treatment by physicians, hospital and clinic personnel, and other appropriate health care
providers.
 obtain routine medical treatment from appropriate health care providers if symptoms of illness occur (e.g.,
fever, coughing, irregular breathing, unusual rashes, swallowing problems, etc.).
 administer medications as follows:
 
Name of Child: ________________________________________
Name of Medication: ___________________________________________________________
Amount to be Given: _________________
Time to be Given: _________________
Other Information: _____________________________________________________________
 
This grant of temporary authority shall begin on _________________, and shall remain effective until
terminated by the undersigned.
 
In case of an emergency, the care provider(s) should first try to contact the parent(s). If the parent(s) cannot be
reached, the care provider should then contact the following person(s) in the order listed below:
 
Name: _____________________________________________________
Relationship to Child: _________________
Address: ____________________________________, _________________, CA ____________
 
Place of Employment: ___________________________________________
Preferred Phone Number: _________________
Alternate Phone Number: _________________

Burgess Family Farm

4440 Solano Road, Fairfield CA 94533
(707) 290-6753
If the child become ill, the care provider(s) will first try to contact the parent(s). If the parent(s) cannot be
reached, the care provider should contact the following physician:
 
Name of Physician: ________________________________________
Address: __________________________________,_________________, CA _____________
Phone Number: _________________
 
If the child need hospitalization, the preferred choice is:
 
Hospital preference: ________________________________________
Address: ____________________________________________________________________
 
The care provider(s) may provide the physician and other health care providers with the following health
insurance information:
 
Insurance Company: _______________________________________
Policy Number: _________________
Name of Policy Holder: _________________
 
This Consent for Medical Treatment of a Minor is executed and agreed to by:

Print Parent #1: _________________________________________________________

Signature Parent #1: _____________________________________________________
Address: _______________________________,_________________, CA _________________
Preferred Phone Number: _________________
Alternate Phone Number: _________________
 
Print Parent #2: _________________________________________________________
Signature Parent #2: _____________________________________________________
Address: _______________________________,_________________, CA _________________
Preferred Phone Number: _________________
Alternate Phone Number: _________________

Burgess Family Farm

4440 Solano Road, Fairfield CA 94533
(707) 290-6753