• BOOKING ENQUIRY FORM

    BOOKING ENQUIRY FORM

    HORSE RIDING

  • ENQUIRY TYPE

    Please contact Reception on 01-6209160 for Equine assisted activities and Therapeutic Riding.

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  • CONTACT DETAILS

  • Riders DOB*
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    2 digit month, 2 digit day, 4 digit year
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  • RIDING HISTORY

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  • Day's & Times applicant is available to attend lessons:

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    Until
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    Until
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    Until
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    Until
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    Until
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    Until
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  • RIDING HISTORY

  • Has the applicant been diagnosed with a medical condition/ disability?*
  • Has the applicant ever had epileptic episodes?*
  • Does the applicant have any physical difficulties in any of the following areas? Mobility, balance, posture, does the applicant wear orthopaedic supports – e.g. back brace, splints etc.*
  • Does the applicant need a hoist?*
  • Does the applicant have any sensory difficulties? Sight, sound, smell, touch, taste, vestibular?*
  • Does the applicant have any psychosocial difficulties: social interaction, self-esteem, mood disorder – depression, anxiety, OCD etc.?*
  • Does the applicant have any allergies that we need to be aware of?*
  • Has the applicant been referred by a medical practioner or other ?*
  • Should be Empty: