Phone to book a ride      07980 225 295

Come riding Never ridden or Start riding again

No age limit


MEADOW-BANK RIDING CENTRE

 Hamnish, Leominster, HR6 0QN

 Tel: 07980 225 295

 RIDER REGISTRATION FORM CONFIDENTIAL – Please complete all Sections and Boxes

Name of Equestrian Establishment                    MEADOW BANK RIDING CENTRE,     HR6 0QN

RIDER’S First Name: .................................................................... Surname: ...........................................................  .. Date: ...................

Address: ................................................................................................................................................. Postcode: .....................................

Tel: (home): ................................................ Tel: (mobile) ....................................... Rider’s mobile: ...................................................

Email: .......................................................................................................................................

Date of Birth: if under 18  ........................................... Age if under 18: .................. Weight: ................... Height: ....................................

Occupation: ...................................................................................                   Would you like to receive info from us only:  YES / NO

Have you (or the person you are signing for) ever suffered a serious injury or discomfort while 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 & DOCTORS DETAILS  

Contact Name & Relationship: ................................................................................................................ Tel: ...........................................

Doctor’s Name: ........................................................................................................................................ Tel: ...........................................

RIDING ABILITY you MUST tick all boxes that apply

I consider myself (or the person riding for who I am signing on behalf as a minor) to be:

Never ridden before 􀂆Beginner 􀂆Novice 􀂆Intermediate 􀂆Advanced 􀂆

How many times have you/rider ridden in last 12 month:  None 􀂆under 12 􀂆12-24 􀂆24-40 􀂆40+ 􀂆

What do you believe yours or the person’s riding capabilities on a horse or pony to be?

Riding at a walk 􀂆Lead rein 􀂆Trotting with Stirrups 􀂆Trotting without Stirrups 􀂆Cantering in arena 􀂆Cantering in open field  􀂆Trekking 􀂆Hacking 􀂆

Riding over jumps up to 0.5m (18") 􀂆Riding over jumps 0.75m (30") 􀂆

Riding over cross country jumps 􀂆

I give permission for the rider or myself to ride without supervision.   YES/NO

I give permission for the rider or myself to go and catch horses/ponies in the field unsupervised.YES/NO

RIDERS UNDER 16 YRS OF AGE: I accept full responsibility for my child/rider and confirm that the above pre-assessed abilities are correct. I accept my child rides at his/her own risk.

RIDERS AGED 16 YRS 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 & Safety requirements of the establishments. I reserve the right not to ride a horse allocated to me or my child and or 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: ....................................................................................................

Date

Signature ........................................................................... Print Name .......................................................................Date ...................



011311


MEADOW-BANK RIDING CENTRE

HAMNISH, LEOMINSTER


RIDER REGISTRATION FORM

 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 instruct tors of the riding school.

• I reserve the right not to ride a horse allocated to me and may request a change of instructor.

• 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 at the riding school. I understand it is my choice whether or not I wear a body protector.

• I understand that the riding school 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 school.

• I understand that the riding school may refuse my request to ride for safety or operational reasons.

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 ride the course including any jumps which form part of it. If I am in any doubt, I will use my judgment and experience and not enter.


Signed: …………………………………………… Dated: ………………….……

Dated: ……………………………………………



TO BE COMPLETED BY INSTRUCTOR / SUPERVISOR ON BEHALF OF THE EQUESTRIAN ESTABLISHMENT

This client has been assessed and our judgement of their capabilities is as follows:

Complete Beginner (lead rein/lunge) 􀂆Beginner (Beginning walk, hint of a trot holding) 􀂆Beginner (Beginning Walk & Trot independently no holding) 􀂆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: ............................................................


Date: ……………….…


Name: …………………


Horse/pony: …………...

To save time, print this form and bring it with you