SCEC Rider Registration Form

Rider Registration Form

South Cambridgeshire Equestrian Centre
To be completed BEFORE INITIAL ASSESSMENT LESSON but AFTER INITIAL ASSESSMENT LESSON BOOKED WITH CENTRE

For general enquiries please use the contact form on our website.

https://www.scec.co.uk/contact-us

Confidential - Please full out all information below. Details on how we store and use data can be found on our website
Rider Name

First NameLast Name
Birth Date

MonthDayYear
Gender

MaleFemale
Age (if under 18)
Height
Weight
Address

Street Address

Street Address Line 2

CityCounty

Postcode Country
Contact / Parent or Guardian Information
Name

First NameLast Name
Home Number

Area CodePhone Number
Mobile number

Area CodePhone Number
E-mail
Emergency Information
Emergency Contact's Name

First NameLast Name
Relationship
Phone Number

Area CodePhone Number
Alt. Phone Number

Area CodePhone Number
Have you, or the rider are signing for, ever suffered a serious injury or discomfort while riding or been advised not to ride
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/ fitting and so on
The Horseriders' 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 and instructor(s) at the riding school.

- I reserve the right not to ride a horse allocated to me and may request a change of instructor ( if available )

- 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 hat whilst riding, leading and grooming horses at the riding school. I understand it is my choice whether or not I 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:

- my abilities and riding experience

- any previous 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.

- 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 choose 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.
Riding ability/ declaration - Answer ALL questions
I consider myself (or the person riding for whom I am signing on behalf of as a minor) to be a

Complete BeginnerBeginnerNoviceIntermediateAdvanced
How many times have you / rider ridden in the past 12 months

NoneUnder 1212-4040+
What do you believe your or the rider’s capability to be on a horse or pony?

Riding at WalkTrotting with stirrupsTrotting without stirrupsCanteringHackingRiding over jumps up to 0 5mRiding over jumps 0.75mRiding over cross country jumps
Confirmation

I confirm to the best of my knowledge that all of the above details are correct.

I have read The Horserider's 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 riders code of conduct to my child 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 bide by it at all times.

Data Protection Act 1998: Statement: I understand that the information given will be held in accordance with the data protection act 1998 but may also de available to insurers and other concerned parties in the event of any injury or accident.

BY ACKNOWLEDGING AND SIGNING BELOW, I AM DELIVERING AN ELECTRONIC SIGNATURE THAT WILL HAVE THE SAME EFFECT AS AN ORIGINAL MANUAL PAPER SIGNATURE. THE ELECTRONIC SIGNATURE WILL BE EQUALLY AS BINDING AS AN ORIGINAL MANUAL PAPER SIGNATURE.
Should be Empty: