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Lee Valley Rider Registration Form

_____________________________________________________________

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Mike
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190 views2 pages

Lee Valley Rider Registration Form

_____________________________________________________________

Uploaded by

Mike
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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Rider Registration and Instructor:

Horse:
Permission Form Date:
Time:
Lee Valley Riding Centre Level:

Confidential – please complete all applicable sections below and read and sign the declaration overleaf
Rider’s First name: Surname:
Address:

A Tel:
Email:
Date of birth:
Postcode:
Mobile:
Gender:
Height:
Have you, or the rider you are signing for, ever suffered a serious injury or
Weight:

Yes No
discomfort while riding or been advised not to ride?
If yes, please describe:

B 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 conditions which can affect balance or cause blackouts/loss of
consciousness/fits, allergies, etc:

Emergency contact name/relationship: Tel:


I confirm that 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 of any type has an
inherent risk and that I or the rider I am signing on behalf of 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

C
their negligence. When I am signing on behalf of a minor I have explained the Riders’ code of Conduct to
them 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.
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.
Signature: Name: Date:

If signed on behalf of a minor


Rider’s name: Your relationship to rider:

For assessment lessons and memberships:


Riding ability – please tick all statements that apply
How many times have you/rider ridden in the last 12 months? 0 1-12 12-40 40+
What do you believe your/rider’s capability to be on a horse or pony:
Riding at walk Trotting with stirrups Cantering
Riding over jumps 0.5m/18” Riding over jumps 0.75m/30” Cross country jumping

To be completed by instructor on behalf of Lee Valley Riding Centre


This rider has been assessed and our judgement of their capabilities is as follows:
Have a Go (lead rein) New Rider (beginning trot Beginner (beginning canter)
independently)
Novice (confident canter) Intermediate (lateral work) Advanced
Jump level (if assessed) Beginner Novice Intermediate
Stage 1 course: Stage 2 course:
Horse used: Date:
Instructor name: Signature:
Rider Registration and
Permission Form
Lee Valley Riding Centre

The Horse Riders Code of Conduct


The H
 I understand that riding at any standard has inherent risk and that all horses may react
unpredictably on occasions.
 I / the rider who I am signing for may fall off and could be injured. I / we accept that risk.
 I understand that instructions are given for my safety and agree to follow instructions
given to me by staff and instructors at 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 whist riding, leading and grooming horses at the riding school. I understand it is my
choice whether or not I wear a body protector for flat work lessons. It is compulsory for
riders on all Lee Valley’s jump lessons to 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
any children that I am responsible for under close supervision when they are not being
instructed by the riding school.
 Children aged under 8 years – their parent or responsible adult must remain on site for
the duration of their activity;
 Children aged between 8 and 15 years – their parent or responsible adult need not be on
site for the duration of the activity but must either:
a. be present to supervise the child immediately before and after, or
b. ensure that their child arrives not more than 15 minutes before their activity and
leaves immediately afterwards, as children are not supervised by riding centre staff
before or after their activity
 Children found here unaccompanied will be asked to wait in Reception while their parent or
guardian is contacted to collect them

 I understand that the riding school may refuse my request to ride for safety and
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 judgement and experience and not enter.

Signed: ______________________________________Date: ____________________

Print Name: ____________________________________________________________

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