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summer FORM

Name ……………………………………………………………………………….Date of birth if under 18 ………………………….

Height ............. .......................................Weight ................................................................

Address …………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………….

Email …………………………………………………………………………………………………………………………………………………………….

Mob number………………………………………………………………………………………………………………………………………………..

Have you ever suffered any serious injuries? / ANY FOOD REQUIRMENTS

If so tell in brief

Emergency contact numbers 1……………………………………………………………..2…………………………………………………………………………………………

3………………………………………………………………4………………………………………………………………………………………..

Doctor’s name and address……………………………………………………………………………………………………………….. …………………………………………………………………………………………………………………………………………………………….

I……………….. Would like Medical attention if I require it

Sign ……………………………………………………….parent or guardian

I also acknowledge that horse riding is a dangerous sport and holds risks at all times and that all staff will try their best at all times to be safe that horses are animals and can be unpredictable at all times and accidents may happen ………………………………………………………………………………………….sign if under 16 must be done by parent or gaurdian

I ……………. Have special requirements in my diet

Details ………………………………………………………………………………………………………………………………………..

I am a

Complete beginner been on a horse 6 times… yes/ no Beginner 7 – 15 times on board yes/no

Novice walk and rising trot yes/ no intermediate rising trot and canter yes/ no

Can you trot without stirrups safely? Yes/no