Rider Registration Form "*" indicates required fields Step 1 of 2 50% 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 at the establishment. 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 establishment. I understand that the establishment 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 at all times. I understand that the establishment may refuse my request to ride for safety or operational reasons. Digital Signature:*You can sign using your mouse / track-pad or touch screen.Dated:* MM slash DD slash YYYY Who are you Hiring from* Where are you hirring to* Confidential - Please complete all sections below:Name:* First Name Last Name Address:* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Tel. (Home):Tel.(Mobile):*Email* Age:* Weight:* KGsHeight:* Occupation:* Have you, or the rider you are signing for, ever suffered a serious injury or discomfort while riding or been advised not to ride?* Yes No Please describe:*Please detail any disability or medical conditions that may affect your ability to ride. This may include but not be limited to any back problems and any condition which may affect balance or cause blackouts/loss of consciousness / fitting etc:Emergency Contact:Contact Name:* Full Name Relationship:* Contact Number:*Rider Ability / Decleration - You must tick all boxes that apply:I consider myself (or the person riding for whome I am signing on behalf as a minor) to be a:* Complete Beginner Beginner Novice Intermediate Advanced How many times have your or the rider ridden in the last 12 months?* None Under 12 12-40 40+ What do you believe you or the rider's capability to be on a horse or pony?* Riding at Walk Trotting with Stirrups Able to ride all four gaits confidently Jumping up to 70cm Jumping up to 1m Hunting and riding cross country regularly Please give a brief description of your riding experience:* I can confirm to the best of my knowledge all of the above details are correct. I have read the Horse Riders' Code of Conduct overleaf. 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 establishment will not be liable for injury or damage to property unless it is caused by negligence. Where I am signing on behalf of a minor I have explained that the Horse Riders' Code of Conduct to my child and we both accept the risk and agree that the establishment will not be liable for injury or damage to property unless it is caused by their negligence. Data Protection Act 1998: Statement: I understand that 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. Name:* Full Name Date:* MM slash DD slash YYYY Digital Signature:*You can sign using your mouse / track-pad or touch screen.If Signed on behalf of a minor: NameRelationship: CAPTCHAPhoneThis field is for validation purposes and should be left unchanged.
