Alyesford Arena Eventing Clinic March 24th 2024

"Barrowcliffe Cross Country "

Cross Country Training on Grass
Date of Clinic:

Friday 5th April 2024Sunday 7th April 2024
Preferred level of training of Clinic:

Novice and Nervous, Young Horse80-90cm90- 100cm100cm +BE NoviceBE intermediateBE Advanced
Name of person/ people you need to have similar times to, (for example those who are travelling together)
Name:

First NameLast Name
Date of birth DD/MM/YYYY
Email:
example@example.com
Address:

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number:
Emergency Contact Details (Name, Telephone Number & Relationship).
Doctors Name and Contact Number:
Please detail any disability or medical condition that may affect your ability to ride or which your instructor should be aware of in case of emergency:
Horse's Name:
Horse's Age:
Horse has received a booster annual vaccination within 12 months and not within 7 days of arrival. (Please bring passport with you):

Vaccinations up todate
Disclaimer: I can confirm that the information I have provided is correct to the best of my knowledge. I understand that riding at any standard has inherent risk and agree that both the coaches and the venue 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 (under the age of 18 years old) we both accept the risk and agree that both the coaches and the venue will not be liable for injury or damage to property unless it is caused by their negligence. Data Protection Act 1998: Statement: I understand that the information that I have given will be held in accordance with the Data Protection Act 1998, but may also be made available to insurers and other concerned parties in the event of an injury or accident.

By ticking this box I agree to the above Statements / Disclaimer
Rider age

16 years and under18 years and under19 years and over
Full Name (Rider)

First NameLast Name
Full Name (Parent or guardian when signing on behalf of a minor)

First NameLast Name
Tick this box to represent your signature

Signature
Date of signature

MonthDayYear
Date
Payment: In order to secure your place on the clinic payment in full with this booking, BACS: Miss S J York Sort code: 40-42-42 Account Number: 11114727 Ref: Surname, Barrowcliffe clinic £55

Payment complete
!! Please wear a Body protector, Ideally of the latest standard !!

it is strongly suggested you a neck strap and studs if you have stud holes.
Please arrive in plenty of time to sign-in and do the disclaimer at the cross-country office, and please be on your horse and warmed up in the non-jumping, lower paddock only, before your start time, please do not go onto the course until Sam is ready for you and you are in your group as there will be others on the course.

Please be reminded that cross country is a high-risk sport and be aware of the potential risks involved although the coach will obviously aim to provide a safe and progressive session.

DIRECTIONS
Barrowcliffe Farm, South Croxton Road, Queniborough, Leicester, Leicestershire.
LE73RX
Should be Empty:

"Barrowcliffe Cross Country "