Rider Registration Form

Prior to attending Ballawhetstone Stables all riders must complete the form below.

Details of Rider

Are you completing this form on behalf of someone else/or under the age of 16(Required)

Yes

If yes state relationship to rider:

Rider First name(Required)

Rider Last name(Required)

Rider D.O.B(Required)

Day

Month

Year

Email(Required)

Phone(Required)

Address

Rider Height (ft) (Required)

Rider Weight (kgs)(Required)

Medical Details

Has the rider ever suffered serious injury or discomfort while riding or been advised not to ride?(Required)

Yes

If yes please provide details:

Please let us know if the rider has any medical conditions, disabilities, or allergies that we should be aware of.(Required)

Yes

If yes please provide details:

Does the rider take any medication that we should be aware of?(Required)

Yes

If yes please provide details:

Emergency Contact Name(Required)

Emergency Contact Number(Required)

This is a checkbox.

Relationship to Rider(Required)

Riding Ability

I consider the rider to be a : (Required)

Complete Beginner

Novice (Limited Riding Experience)

Intermediate

Advanced

How many times has the rider ridden in the past 12 months:(Required)

None

Fewer than 12

More than 12

Identify if the rider can do any of the following on horse back:(Required)

Walk

Trot

Canter

Jump

To comply with the Data Protection Act 2018, I consent to having my/my childs photograph taken, and I agree that it can be used on your website, social media profile, or any other media including printed material.(Required)

Yes

I consent to the Riders Code of Conduct Policy https://www.ballawhetstonestables.com/general-5-1

I consent to the Terms of the Social Media Policy https://www.ballawhetstonestables.com/general-clean

stella.hampton@me.com

07624 472580

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