Rider Registration

Name of Group Booking *

First

Last

Date & Time of Booking *

Date

Time

Personal Information

Name *

First

Last

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date of Birth *

Occupation *

Height (Feet & Inches) *

Please ensure this is accurate. Each Horse has an individual height and weight limit. If you provide incorrect details, Rookin House reserve the right to weigh riders on arrival and in extreme cases refuse the individual to participate.

Weight (Stone & Pounds) *

Please ensure this is accurate. Each Horse has an individual height and weight limit. If you provide incorrect details, Rookin House reserve the right to weigh riders on arrival and in extreme cases refuse the individual to participate.

Have you or the rider you are signing for ever suffered serious discomfort while riding or been advised not to ride? *

Yes
No

If Yes, Please give details.

I or the rider DO NOT have any medical conditions that may prohibit or impair your ability to easily do the following: *

Get on and off the horse.
Balance while on the horse.
Sit centrally while on the horse.
Hear/follow instructions whilst on the horse.
Communicate effectively with the instructor.
Stay in the saddle comfortably for the duration of your riding experience.
'I DO have a condition that effects the above tasks and need to provide details.'

Details of conditions that may effect my riding. (Please note this is hopefully just so we can provide the right horse and best experience.)

Emergency Contact

Name *

First

Last

Phone *

Relationship *

Rider Ability & Declaration

I consider myself (or the person for whom i am signing on behalf as a minor) to be a: *

Complete Beginner (never ridden before)
Beginner (ridden infrequently and no formal training)
Novice (Balanced and knows correct basic controls of the horse)
Intermediate (Can ride in full control both in an arena and in the open, Had formal training.)
Advanced ( Usually had their own horse and/or competed. Knows how to balance, stay in control and ride in all paces and disciplines.)

If you consider yourself advanced, please detail the type of riding, frequency and type of horses you are used too.

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

None
Under 12
12-40
40+

What do you believe your (or the rider's) capability to be while on a horse or pony? (Tick all that apply) *

Horse Riders' Code of Conduct. *

Declaration. *

I can confirm that to the best of my knowledge all of the above details are correct.
I have read the horse riders code of conduct, 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 school 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 Horse Riders Code of Conduct to the minor and we both accept the risk and agree that the riding school will not be liable for injury or damage to property unless it is caused by their negligence.
I have read and understand the lesson booking and cancellation policy and agree to abide by it at all times.
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 Injury or Accident.
First Aid: I give permission for myself/ my child to be given appropriate first aid if needed.

Signature *

Date / Time on signing. *

Date

Time

Name *

First

Last