Rider Registration – Ruth Baxter Equestrian

Rider Registration Form

Please complete and submit this form before your first lesson with Ruth.

Name *

First

Last

Mobile Telephone Number *

Home Telephone

Email *

House name/number and address line 1 and 2 *

Town/City *

Postcode *

Date of Birth *

dd/mm/yyyy

Have you ever suffered a serious injury? *

Yes - Related to riding
Yes - Unrelated to riding
No

If yes, please provide details

Have you ever suffered discomfort whilst riding? *

If yes, please provide details

Have you ever been advised not to ride? *

If yes, please provide details

Do you take any routine medication? *

If yes, please provide details

Do you have any medical conditions or allergies which may affect your ability to participate in activity or your treatment in an emergency? *

If yes, please add details

Emergency contact name *

Please provide the name and details of an appropriate person for us to contact in case of emergency

Relationship to you *

Emergency Contact Number *

Riding Level *

Please select the description which best fits you as a rider

Do you compete your horse? *

Yes
No
I would like to

Please give details, including competition level where appropriate

Please use this space to give further details about you and your horse.

If your horse has any specific handling needs, please mention these in case of emergency

Where is your horse stabled? *

In case of emergency where we are not at your yard.

General Declaration *

I agree

I confirm that to the best of my knowledge all of the above details are correct. I have read the Horse Riders’ Code of Conduct below. I understand that riding at any standard has inherent risk that I may fall off and could be injured. I accept that risk and agree that the Riding coach will not be liable for injury or damage to property unless it is caused by their negligence. Where I am signing on behalf of a minor I have explained the Riders’ Code of Conduct to my child and we both accept the risk and agree that the Riding coach will not be liable for injury or damage to property unless it is caused by their negligence. Data Protection Act 2018 (GDPR) Statement: I understand that the information I have given will be held in accordance with the Data Protection Act 2018 (the UK's implementation of the General Data Protection Regulation) but may also be made available to Insurers and other concerned parties in the event of any injury or accident.

Do you give permission for photos/videos to be taken in your lessson? *

Do you give permission for pictures or videos taken in your lesson to be shared on social media or promotional material linked to Ruth Baxter Equestrian? *

The Horse Riders Code of Conduct *

I agree to adhere to the 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. • 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 while riding. • I understand it is my choice whether or not I wear a body protector. • I understand that my riding coach 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 competing carries enhanced risk over and above general riding and agree that if I chose to participate in any competition or event, it is up to me to ensure that I have the experience and ability to undertake the ridden tasks including any jumps which form part of it. If I am in any doubt, I will use my judgment and experience and not enter.

CANCELLATION POLICY *

I agree

- All cancellations must be made a minimum of 48 hours before your session is due to start. This allows time to reallocate sessions to other riders. Cancellations given with less than 48 hours notice will be charged at 50% of the lesson fee. Cancellations made within 24 hours or 'no shows' will be charged 100% of the lesson fee. Please check the box to show that you understand and agree to this policy. Without agreement it will not be possible to book lessons. Where weather conditions are UNSAFE please contact Ruth to discuss.

Date *

Please enter todays date as dd/mm/yyyy

Signature (Over 18s)

Please write your full name to serve as a digital signature

Guardian name and relationship to rider (Under 18s)

Guardian Signature (Under 18s)

Please write your full name to serve as a digital signature

Phone

Name *

First

Last

Mobile Telephone Number *

Home Telephone

Email *

House name/number and address line 1 and 2 *

Town/City *

Postcode *

Date of Birth *

dd/mm/yyyy

Have you ever suffered a serious injury? *

Yes - Related to riding
Yes - Unrelated to riding
No

If yes, please provide details

Have you ever suffered discomfort whilst riding? *

If yes, please provide details

Have you ever been advised not to ride? *

If yes, please provide details

Do you take any routine medication? *

If yes, please provide details

Do you have any medical conditions or allergies which may affect your ability to participate in activity or your treatment in an emergency? *

If yes, please add details

Emergency contact name *

Please provide the name and details of an appropriate person for us to contact in case of emergency

Relationship to you *

Emergency Contact Number *

Riding Level *

Please select the description which best fits you as a rider

Do you compete your horse? *

Yes
No
I would like to

Please give details, including competition level where appropriate

Please use this space to give further details about you and your horse.

If your horse has any specific handling needs, please mention these in case of emergency

Where is your horse stabled? *

In case of emergency where we are not at your yard.

General Declaration *

I agree

Do you give permission for photos/videos to be taken in your lessson? *

Do you give permission for pictures or videos taken in your lesson to be shared on social media or promotional material linked to Ruth Baxter Equestrian? *

The Horse Riders Code of Conduct *

I agree to adhere to the code of conduct

CANCELLATION POLICY *

I agree

Date *

Please enter todays date as dd/mm/yyyy

Signature (Over 18s)

Please write your full name to serve as a digital signature

Guardian name and relationship to rider (Under 18s)

Guardian Signature (Under 18s)

Please write your full name to serve as a digital signature

Comment