Snainton Riding Centre
Rider Registration Form
CONFIDENTIAL - Please complete all Sections & Boxes
First Name							Surname
Address
Post Code
Tel (Home)						Tel (Mobile)
Email
Date of Birth
Age					Weight			Height
Occupation
Have you (or the person you are signing for) ever suffered a serious injury or discomfort whilst riding or been advised not to ride?								Yes		No
If yes, please describe
Please detail any disability or medical conditions that may affect your ability to ride or which your instructor should be aware of in case of emergency.
Emergency Contact & Doctor’s Details
Contact Name & Relationship								Tel
Doctor’s Name								Tel
Riding Ability – you MUST tick all boxes that apply
I consider myself (or the person for who I am signing on behalf as a minor) to be a:
Never ridden before		Beginner			Novice		Intermediate			Advanced
How many times have you/rider ridden in last 12 months?
None			Under 12			12-40		40+
What do you believe yours or the rider’s capabilities on a horse or pony to be?
Riding at a walk		Trotting with stirrups			Cantering		Hacking	Riding over jumps up to 0.5m
Over jumps 0.75m		Riding over cross-country jumps
Riders under 16 years of age: I accept full responsibility for my child and confirm that the above pre-assessed abilities are correct. I accept that my child rides at his/her own risk.
Riders aged 16 years and over: I confirm that the above pre-assessed abilities are correct and I agree that I ride entirely at my own risk.
Data Protection Act 1998: Statement: I understand that the information I have given will be held in accordance 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. I understand that I must obey the instructions of the instructor and must comply with the Health and safety requirements of the establishments. I reserve the right not to ride a horse allocated to my child or me and/or to request a change of instructor. I confirm that to the best of my knowledge all the above details are correct. A parent or guardian of riders under the age of 16 must sign this form.
I acknowledge THAT RIDING IS A RISK SPORT AND HOLDS A POTENTIAL DANGER, and that all horses may react unpredictably on occasions.
If signing on behalf of rider please state relationship to rider:
Signature					Print Name
Date
To Be Completed by Instructor/Supervisor on Behalf of Snainton Riding Centre
This client has been assessed and our judgment of their capabilities is as follows:
Complete beginner (Lead rein/Lunge)		Beginner (Beginning walk & Trot independently)			Novice (Walk, Trot, Canter independently)		Intermediate (Jumping, Stage 1)	Advanced (Stage 2, equivalent and above)
Assessment Lesson Content:
Walk		Trot			Canter		W/O Stirrups	Jump		Lateral
Office Use: Assessment Lesson
Horse Used					Lesson Type
Date					Time
Signature							Print Name
Position