REGISTRATION FORM -

REGISTRATION FORM
To help us correctly process your registration, please input your User Name and User Email.

If you subscribed already and received an email, please use the User Name and User Email that was provided in our previous email communications.

If you have have not subscribed through our website, then input the Rider's first name and email address to proceed.
Additional reg check (1=Yes)
Came from Request lesson form (2=Yes)
Online Registration Completed

Please proceed to register another person.
User Name*
Rider's first name.
User Email*
Email

REGISTRATION FORM

PERSONAL INFORMATION
User Name*
Rider's Name used in your first request
User E-mail*
Email used in your first request
Rider's First Name*
Rider's Last Name*
Cell No*
Rider's Date of Birth*

MonthDayYear
Gender

MaleFemaleOther
Address (Residence)*
City*
Province*
Postal Code*
Country*
Current Date

MonthDayYear
Age
Parent/Guardian's First Name*
If rider is under 19 years of age
Parent/Guardian's Last Name*
If rider is under 19 years of age
Tel. No*
If rider is under 19 years of age
Emergency Contact
Relationship to Rider
Tel. No.
E-mail
example@example.com
Where did you first learn about Riverside?

MEDICAL INFORMATION
List any limiting factors or medical concerns:
List any allergies and medications:
Medical Insurance No.
Name of Physician
Physician's Email
example@example.com
Tel. No

REGISTRATION FORM
LESSON RULES & POLICIES
RIDERS AND THEIR GUARDIANS ARE REQUIRED TO SIGN THIS RULES & POLICIES AND WAIVER AGREEMENTS.
1. Riders must wear boots with a heel (one inch minimum), long pants, and a proper riding helmet. Baggy clothes are not suitable. Form fitting clothes with the tops tucked-in is appropriate wear. After the first lesson, riders must acquire proper riding attire.
2. All students 19 years or older must sign a waiver of right to sue. All students under the age of 19 must have a parent or guardian sign a waiver of right to sue. All students must fully complete a registration form. All lessons are taught in English.
3. Riders should arrive a minimum of 30 minutes before their riding lesson. Lessons end on time even if the rider is late to start. Riders who are late for their riding lesson may lose the opportunity to ride.
4. The scheduling and cancellation policy, viewed here, is strictly enforced.
5. Instructors and horses may change without notice.
6. Recurring weekly lessons have scheduling priority over non-weekly recurring lessons. This means that students who have booked single or ocassional lessons may have to re-schedule their time, if another student requests recurring weekly lessons for that time slot.
7. We accept payment only by credit card or pre-authorized debit, using the secure payment system, Plooto. Payment for all lesson and lesson packages are due in advance. No refunds for lessons or lesson packages. NSF charge is $40.
8. Payment Processing can be made by automatic pre-authorization or by manual payment processing. For manual payment processing, payment must be successfully completed manually within 48 hours of the request. If payment is late more than once, automatic pre-authorization will be required for future transactions.
Rider's First Name
Rider's Last Name
Parent's First Name
If rider is under 19 years of age
Parent's Last Name
If rider is under 19 years of age
Parent/Guardian Signature (digital or sign with mouse) *

Clear
Date

MonthDayYear
Date
Signature (digital signature or sign with mouse)*

Clear
Date

MonthDayYear
Date

REGISTRATION FORM
COVID WAIVER
The novel coronavirus, COVID-19, has been declared a worldwide pandemic by the World Health Organization. COVID-19 is extremely contagious. The virus that causes COVID-19 spreads in several ways, including through droplets when a person coughs or sneezes, or from touching a contaminated surface before touching the face. As a result, federal, provincial, and local governments and federal and provincial health agencies recommend physical distancing and have, in many jurisdictions, restricted the congregation of large groups of people.

Riverside Equestrian Centre Inc. and Linda English has put in place preventative measures to reduce the spread of COVID-19 at Riverside Equestrian Centre., which include, but are not limited to, adherence to the orders issued by B.C.’s Provincial Health Officer and compliance with WorkSafeBC’s COVID-19 Guidelines. Nevertheless, Riverside Equestrian Centre Inc., Riverside Farm, and Linda English cannot guarantee that you will not become infected with COVID-19.
Rider's First Name
Rider's Last Name
Parent/Guardian's First Name
If rider is under 19 years of age
Parent/Guardian's Last Name
If rider is under 19 years of age
Parent/Guardian Signature (digital or sign with mouse) *

Clear
Date

MonthDayYear
Date
Signature (digital signature or sign with mouse)*

Clear
Date

MonthDayYear
Date

REGISTRATION FORM
PHOTO RELEASE
I, the undersigned, do hereby grant or deny permission to Riverside Equestrian Centre Inc. to use my image or the image of the minor in my care, identified below, as marked by my selection below.

Permission includes the display, distribution, publication, transmission, or otherwise use of photographs, images, and/or video taken of my child for use in materials that include, but may not be limited to, printed materials such as brochures and newsletters, videos, and digital images such as those on the Riverside Equestrian Centre website, advertisements, or related social media sharing platforms.
Grant PermissionDeny Permission
Rider's First Name
Rider's Last Name
Parent/Guardian's First Name
If rider is under 19 years of age
Parent/Guardian's Last Name
If rider is under 19 years of age
Parent/Guardian Signature (digital or sign with mouse) *

Clear
Date

MonthDayYear
Date
Signature (digital signature or sign with mouse)*

Clear
Date

MonthDayYear
Date

REGISTRATION FORM
WAIVER OF RIGHT TO SUE
Rider's First Name
Rider's Last Name
Parent/Guardian's First Name
If rider is under 19 years of age
Parent/Guardian's Last Name
If rider is under 19 years of age
Parent/Guardian Signature (digital or sign with mouse) *

Clear
Date

MonthDayYear
Date
Signature (digital signature or sign with mouse)*

Clear
Date

MonthDayYear
Date
If you are registering an additional person, please select "Additional Registration"

Additional Registration
To complete the signature process for the registration, please enter the appropriate name and email address below and click the yellow "Sign with DocuSign" button.

You will be directed to a DocuSign page to complete the signature steps.
Hidden field, do not delete
WE WILL EMAIL YOU A PDF COPY
Please Submit and Complete Additional Registration
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REGISTRATION FORM

REGISTRATION FORM

REGISTRATION FORM

LESSON RULES & POLICIES

REGISTRATION FORM

COVID WAIVER

REGISTRATION FORM

PHOTO RELEASE

REGISTRATION FORM

WAIVER OF RIGHT TO SUE