REGISTRATION FORM

First Name _________________________Last Name ____________________________

Address: ________________________________________________________________

________________________________________________Zip:  ___________________

Telephone:  _____________________ Cell Phone:  _____________________________

Email:  ________________________________  Date of Birth:  ____________________

Emergency Contact:  Name:  ____________________Phone:  ____________________

Please check :

Day Camp ___     Lessons  ____    Clinic ______ Western _______English  ______

3 Day Horse Clinic ____   Certification Class  ___Natural Horsemanship _____

I consider myself to be a :

Complete Beginner ___  Beginner  __  Novice  __  Intermediate  __  Advanced   ___

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

None __  Less than 12  __  12- 40 __  40 +  __

What do you believe your capabilities on a horse to be?

Riding at a walk  __  Trotting with stirrups  __  Trotting without stirrups  __Cantering __

Hacking __   jumps  __ Professional training  __

I acknowledge THAT RIDING IS A RISK SPORT AND HOLDS A POTENTIAL DANGER, and that all horses may react unpredictably on occasion I understand that I must obey the instructions of the instructor and must comply with the health & safety requirements of the establishments.  I reverse the right not to ride a horse allocated to me and request a change of instructor.

I confirm that top the best of my knowledge all the above details are correct.  A parent or uardian of riders under the age of 16 must sign this form.   I have read and understand the lesson booking and cancellation policy and agree to abide by it at all times. 

RIDERS AGED 16 YRS AND OVER:  I confirm that the above pre-assessed abilities are correct and I agree that I rede entirely at my own risk.

RIDERS UNDER 16 YRS OF AGE:  I accept full responsibility for my child and confirm that the above pre-assessed abilities are corredt.

If signing on behalf of rider please state relationship to rider __________________________________________

Signature  ___________________________________________Print Name  _________________________________

Date __________