Rider Declaration Form

 NORTHFIELD FARM RIDING CENTRE

 

GROUP/ Rider 1…………………………………………………………………….   Age/s …………..

 

Rider Name 2……………………………………………………………………….          No in party ……….

 

ADDRESS……………………………………………………………………………………………..

 

………………………………………………………………………………………………………….

 

……………………………………………………………………  Post Code …………………………              Tel;…………………………………………………..      Mobile………………………………………

 

Emergency contact name & Tel;……………………………………………………………………

 

Medical or any other conditions, including pre existing, which may affect your ability to ride or in case of an emergency, e.g.; asthma, back problems. Continue overleaf if necessary.

 

………………………………………………………………………………………………………..

Please tick box at whatever level best describes your ability to control and influence a horse.

PLEASE do not OVER ESTIMATE your ability!

                               

 

Can you control your horse at;

 

Rider 1

Height/weight

Rider 2

Height/weight

1

Never ridden

 

 

 

 

 

2

Walk

Beginner

 

 

 

 

3

Walk, trot (rising)

Novice

 

 

 

 

4

Walk, Trot, Canter at basic level

Basic rider

 

 

 

 

5

Walk, Trot, Canter in open country

Intermediate

 

 

 

 

6

All paces on a forward going horse

Experienced

 

 

 

 

 

Riding school only

 

 

 

 

 

 

One of the above but rusty!!

Rusty

 

 

 

 

 

INFORMATION

·        Horse riding is a risk sport, participation therefore holds potential danger.

·      Horses can be unpredictable and do not always respond as expected.

·       We advise all persons participating in equestrian activity to ensure they have adequate personal accident insurance.

·       We allocate horses to riders taking into account experience, suitability and the information given above.

·       All riders have the right not to ride the horse allotted to them.

·       Hats to current BSI standards must be worn and fastened securely whilst participating in riding activities.

·       Riders are advised to wear the correct footwear and gloves.

·       Clients are asked to remove earrings and any other jewellery whilst riding.

·        Mobile phones and cameras must be left at the stables

·        Smoking and chewing gum are strictly forbidden whilst mounted and smoking at all times in the stable area.

·        Regular clients are requested to inform the stables of any alteration to the information given above.

·        Riders must accept any decisions made by the ride escorts with regard to safety.

·        The terrain covered is very rocky in places so extra vigilance to instructions should be taken.

·        Riders should be aware that the terrain covered is rocky and undulating and horses may trip or slip.

 

ACCEPTANCE

·        I declare that the details supplied by myself are correct and that I will inform the stables of any changes.

·        I declare that I have read the information above and agree to the conditions.

·        I understand that signing this form does not affect my statutory rights.

·        I am signing this form on behalf of a group of which I am the leader.

·       I acknowledge that horse riding is a risk sport, participation therefore holds potential danger.

 

All Clients must Sign;.                                                                                                         Date

 

 

(To be signed by parent/guardian if client under 18yrs old)