Equine Protection Fund: Gelding Assistance Application

Equine Information

Veterinarian info. If you are seeking reimbursement for a gelding which has already taken place, please also attach the receipt, cancelled check, or bank statement showing the charge.

Equine 2 Information

Veterinarian info. If you are seeking reimbursement for a gelding which has already taken place, please also attach the receipt, cancelled check, or bank statement showing the charge.

Equine 3 Information

Veterinarian info. If you are seeking reimbursement for a gelding which has already taken place, please also attach the receipt, cancelled check, or bank statement showing the charge.

Equine 4 Information

Veterinarian info. If you are seeking reimbursement for a gelding which has already taken place, please be sure to include the receipt, cancelled check, or bank statement showing the charge.

WAIVER OF LIABILITY AND RELEASE
Animal Protection New Mexico’s (APNM) Equine Protection Fund is offering Gelding Assistance (Assistance). If your application is approved, Assistance will pay your veterinarian, or will reimburse you, for a portion, or the entire cost, of gelding(s).

It is your responsibility to coordinate the time and location of the procedure and to ensure that your equine’s needs are met.

We ask that you read and sign this Waiver of Liability and Release. By signing it, you will be indicating that you understand the risks involved in your participation in Assistance.

ASSUMPTION OF RISK
2. I am aware that my participating in Assistance may involve risk of personal injury from an equine or equines. I am also aware that unsanitary conditions increase the risk of infection in post-operation geldings. I am voluntarily participating in these activities with full knowledge of the risks involved, and hereby agree to accept any and all risks of harm that may result from my participation in Assistance.

RELEASE
3. As consideration for my being permitted by participate in the Assistance, I hereby agree that I, my assignees, heirs, distributees, guardians, and legal representatives will not make a claim of any kind against or sue APNM, their affiliates, employees, agents or volunteers for injury or damage of any kind resulting from my participation in Assistance, unless such injury or damage is the result of an employee, agent, or contractor of APNM exhibiting gross negligence or intentionally acting in a manner likely to lead to my being harmed. I hereby release APNM from all actions, claims or demands that I, my assigns, heirs, distributees, guardians, and legal representatives now have or may hereafter have for injury or damage resulting from my participation in Assistance, except when an employee, agent, or contractor of APNM exhibits gross negligence or intentionally act in a manner likely to lead to my being harmed. I further voluntarily agree and warrant to Release and Hold Harmless APNM and its representatives from any liability whatsoever, including, but not limited to, any incident or illness of horses believed to be caused by or related to care paid for through this Assistance.

KNOWING AND VOLUNTARY EXECUTION
4. I have carefully read this agreement and fully understand its contents. I am aware that this is a release of liability between myself and the APNM, and sign it of my own free will.