Rider Registration

Rider Registration Form

First name

Last name

Date of Birth

Weight

Height

Have you, or the rider you are signing for, ever sufferd a serious injury or discomfort while riding or been adcised not to ride?

Yes

If yes, please describe:

Please detail any disability or medical conditions that may affect your ability to ride. This may include but not be limited to any back problems and any condition, which can affect balance or cause blackouts/loss of consciousness/fitting etc.

Emergency Contact name and relationship

Telephone number

How many times have you or the rider ridden in the last 12months?

None

Under 12

12-40

40+

What do you believe your or the rider's capability on a horse or pony to be?

Riding at a walk

Trotting with stirrups

Trotting without stirrups

continued...

Cantering

Hacking

Riding over jumps up to 0.5m (18")

continued...

Riding over jumps up to 0.75m (30")

Riding over cross country jumps

I confirm that to te bes of my knowledge all the above details are correct.

I have read the Horse Rider's Cod of Conduct. I understand that riding at any standard has inherent risk that I may fall off an cold be injured. I accept that risk and agree that the riding establishment will not be liable for injury damage to property unless it is caused by their negligence.

Where I am signing on behalf of a minor I have exlplained the Riders' Code of Conduct to my child and we both acept the risk and agree that the riding establishment will not be liable for injury or damage to property unless it is caused by their negligence.

I have read and understand the lesson booking and cancellation policy and agree to abide by it at all times.

Data Protection Act 1998: Statement: I understand that information I have given will be held in accordanc with the Data Protection Act 1998 but may also be made available to Insurers and other concerned parties in the event of any injury or accident.

Your Signature

Select a date

Name

The Horse Riders' Code of Conduct. I understand that riding at any standard has inherent risk and that all horses may react unpredictably on occasions. I may fall off and could be injured. I accept that risk. I understand that instructions are given for my safety and agree to follow instructions given to me by staff and instructors of the riding establishment. I reserve the right not to ride a horse allocated to me. I understand that wearing an appropriate riding hat and body protector may reduce the severity of an injury should an accident happen and agree that I will always wear a riding hat whilst riding, leading and grooming horses and the riding establishment. I understand it is my choice whether or not I wear a body protector. I understand that the riding establishment will make decisions based on information I give them and agree to always be honest and volunteer information about: my abilities and riding experience, any previous riding accidents, any medical condition(s) which may affect my ability to ride. I understand that children are at particular risk around horses and agree that I will keep children that I am responsible for, under close supervision when they are not being instructed by the riding establishment. I understand that the riding school may refuse my request to ride for safety or operational reasons.

Your Signature

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Rider Registration

Rider Registration Form

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