Intermediate Holiday Programme January 2023

DRDA Intermediate Holiday Program Registration Form January 2023

Catering for riders over 8 years of age, who can independently walk and trot. The theme is 'Own your own pony' holiday programme and it runs from 9am to 3pm. We cover horse care (including, feeding, grooming, bathing, mucking), horse knowledge, liberty, games and flat work. Drop off no earlier than 8.40am - Pick up no later than 3:20. The cost is $75 per day. Riders can attend single or multiple days.
Rider Information
* Please fill out one form for each rider you wish to enrol
Rider's Name*

First NameLast Name
Birth Date*

DayMonthYear
Please click on the dates you would like to book
prevnext( X )
Thursday 19th January $75.00NZD

Friday 20th January$75.00NZD

Wednesday 25th January$75.00NZD

Thursday 26th of January$75.00NZD

Friday 27th January$75.00NZD

Total $0.00NZD
Parent/Guardian Information
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityRegion

Post Code
Contact Number*

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

First NameLast Name
Relationship
Phone Number*

Area CodePhone Number
Does the rider have any allergies, chronic illness, or medical conditions? If yes, please describe.
Does the rider require special medication during the day or programme? If yes, please describe
Dietary requirements or allergies? Children eat their packed lunch together and feed the horses. If there is an ingredient your child cannot be around, please let us know here.
Terms and Conditions:
- I understand that horse-riding and related activities carry inherent risks and that Dunedin RDA has a duty to take reasonable care to prevent injury, accidents can still happen. I agree that Dunedin RDA will not be liable for any accident that could not have been prevented by the reasonable care of its coaches.
- In the event of an emergency, I understand that as soon as reasonably possible Dunedin RDA will endeavour to contact the emergency contact using the details provided on this registration form.
- I understand that both coaches on site have a current first aid certificate and authorise the administration of first aid to my child if deemed necessary by the responsible coach
- If immediate medical attention is deemed necessary by the responsible coach, I authorise Dunedin RDA to contact emergency services and authorise diagnosis and treatment of my child by a qualified and licensed medical professional.
I agree/disagree to the above terms and conditions

AgreeDisagree
Initial Here
Administration of Sunscreen

I understand that the RDA provides UVA and UVB sunscreen for children with an SPF of 15 or above and I give them permission to apply this to my child as needed.

OR

I will provide my own sunscreen for my child. It will be in its original container labelled with my child’s name on it. I also understand that it should have the minimum requirements as listed above for full sun protection. This sunscreen will be given to the teachers and not left where my child can self-administer.
I'm happy for RDA to use its sunscreen on my child.I will provide my own sunscreen
Photo Release

Please initial one choice regarding the photographing of your child(ren). At RDA we document activities and learning through photographs and would like your consent to possibly use these on our website or social media (Facebook and Instagram)
Please Tick :

Photos OKNo Photos
Anything else you would like us to know about the rider? (interests, fears, learning strengths, goals, concerns)
Signature (By signing, I confirm the above information and choices)

Clear
Once your payment and registration has been submitted you will be an official camper! Please remember there are no refunds UNLESS camp is cancelled. You will receive an email or two before camp starts with some details about food, clothes, etc. Thank you!
Please pay total fee to the account below or to pay by stripe refer to invoice:

Dunedin RDA
Westpac
03-0903-0385183-000

Ref Holiday/ Riders name

Thank you
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DRDA Intermediate Holiday Program Registration Form January 2023