Polo Coaching Form
Rider/Guardian Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Child Name if applicable
First Name
Last Name
Child's Date of Birth
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Day
-
Month
Year
Date
Have you ridden before? If so what level?
Any previous polo experience?
I, {riderguardianName},the guardian and/or rider of the child,{childName}, agree with the following statements:
I understand that there are inherent dangers in horse riding/polo sincehorses are powerful and potentially dangerous animals and I also understand the risk and the need for the rider to take all reasonable precautions.
I, release the Club, its officers, stewards, agents, representatives from liability of any claim that could arise from my and/or his/her participation in horse riding/polo or any related activities, or of any loss of or damage to my and/or his/her property.
I understand that such horse riding activities will include but not be limited to riding, working with horses on foot or any other activity undertaken by participants in riding lessons.
In the event of an accident involving me and/or my child there is no obligation on the club to secure for me and/or my child’s medical treatment; however I do hereby authorise the club to act in my and/or his/her best interest, which may include the obtaining of the necessary emergency medical treatment.
The club or its staff or agents shall not be liable for any loss or damage of property brought to the club, including money, cell phones, tack and clothing.
Date
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Day
-
Month
Year
Date
Signature
Submit
Submit
Should be Empty: