Registration Form Prior to your first lesson and on a yearly basis, please fill in the registration form. Save a Copy of the Information Sheet Name * First Name Last Name Date Of Birth * Weight * Height * Occupation Home Address * Email * Tel (Mobile): * Tel (Home): Please write below the address of the yard or field where you will be having lessons with Anna Bonnage: * what3words for Yard Directions to the yard/field if the postcode doesn’t take Anna directly there: Have you the client ever suffered serious injury or discomfort while riding? If yes, please describe: As the client please give details of any disability or medical condition that may affect your ability to ride or that Anna Bonnage should be aware of in the case of an emergency (e.g back problems, diabetes, pregnancy): As the client please give details of any medication, prescribed to you or you are allergic to which Anna Bonnage would need to know about in the case of an emergency (e.g. allergic to anaesthetic) : Client’s Emergency Contact's Name * Client’s Emergency Contact's Telephone * Client’s Emergency Contact's Relationship to Rider * Client’s riding experience * I the client consider myself to be riding and handling horses as: Complete beginner Beginner Novice Intermediate Advanced Roughly how many times have you ridden in the last twelve months? (e.g. twice a week) : * What do you the client believe your riding abilities to be Riding at a walk Trotting with stirrups Trotting without stirrups Cantering Hacking Bareback riding Riding over jumps up to 0.5m Riding over jumps 0.75m Riding over cross country jumps What do you the client believe your in hand/ ground work abilities to be Complete beginner Beginner Novice Intermediate Advanced What would you the client like to achieve from having lessons? Horse(s) Information Please provide the information below for the horse or horses who you would like Anna to help you with. Horse 1 Horse 1: Name Horse 1: Gender Horse 1: Date of Birth Horse 1: Owner Horse 1: Vet Horse 1: Relevant medical history prior to training sessions Horse 2 Horse 2: Name Horse 2: Gender Horse 2: Date of Birth Horse 2: Owner Horse 2: Vet Horse 2: Relevant medical history prior to training sessions Horse 3 Horse 3: Name Horse 3: Gender Horse 3: Date of Birth Horse 3: Owner Horse 3: Vet Horse 3: Relevant medical history prior to training sessions Horse 4 Horse 4: Name Horse 4: Gender Horse 4: Date of Birth Horse 4: Owner Horse 4: Vet Horse 4: Relevant medical history prior to training sessions If you do not wish to hear from Anna about her courses and events Opt Out Terms and Conditions * Cancellations: There will be a cancellation fee if the lesson is cancelled without 24 hours notice. The fee will be the full cost of the lesson, unless cancellation is due to a death, sudden severe illness or severe weather conditions. In situations of moderate wind and rain lessons will still commence. If Anna Bonnage has to cancel your lesson within 24 hours due to a death, sudden illness or severe weather conditions, then a new appointment will be arranged as soon as possible. Insurance: It is the client’s responsibility to take out insurance to cover themselves and the horse for injury and consequential loss. The client’s responsibility: I, the client, acknowledge that riding is a risk sport and is potentially dangerous, and that all horses may react unpredictably on occasions. I understand that I must obey the instructions of Anna Bonnage and that, when I handle or ride a horse in Anna Bonnage’s presence, it is done entirely at my own risk. If Anna Bonnage warns that riding or handling a horse is of particular risk and I the client continue to handle or ride the horse in Anna’s presence then this is done entirely at my own risk. I, the client, am responsible for my own equipment which will comply with legal, health and safety standards (e.g riding hat, back protector). I accept that what I choose to wear whilst riding is done entirely at my own risk. I reserve the right not to ride or partake in a lesson activity. I acknowledge that riding bareback, without stirrups or reins, holds a particular danger and I choose to do this at my own risk. I, the client, am responsible for taking out insurance to cover myself and my horse for injury and consequential loss while working with Anna Bonnage in my lesson. I, the client, am responsible for the horse that I handle and ride in the lesson and I the client accept responsibility for any costs due to the horse getting injured or becoming unwell during a lesson or while being trained by Anna Bonnage. This is unless the horse is owned by someone else who has, prior to the lesson, accepted to take responsibility for any costs due to the horse getting injured or becoming unwell during a lesson or whilst being trained by Anna Bonnage. I, the client, confirm that to the best of my knowledge all the above details are correct. A parent or guardian of riders under the age of 16 yrs must sign this form. I have read and understand the lesson-booking and cancellation terms and conditions and agree to abide by them at all times. I, the client, agree not to film or photograph any lessons without prior knowledge and agreement from Anna Bonnage. If any filming or photography is agreed, I, the client, will not share this with anyone, post on social media platforms or make public in any way. The footage or photographs are purely for personal use and must be kept private. Riders aged 16 yrs and over: I confirm that the above pre-assessed abilities are correct and I agree that I ride entirely at my own risk. Riders under 16 yrs of age: I accept full responsibility for my child and confirm that the above pre-assessed abilities are correct. Documenting your lessons via film or photography: By Signing the Rider Registration form you agree not to film or photograph any lessons without prior knowledge and agreement from Anna Bonnage. If any filming or photography is agreed, it will not be shared with anyone, posted on social media platforms or made public in any way. The footage or photographs are purely for your personal use and must be kept private. Data Protection Act 2018: I understand that the information I have given will be held in accordance with the Data Protection Act 2018 but will only be made available to insurers and other parties in the event of any injury or incident. Your data and information is kept secure and private. The information we hold can be checked by you at any time by contacting us at horsemanship@annabonnage.com. In writing down your emergency contact you agree to informing these people that their name and number is held securely with us for use only in an emergency to yourself. Covid-19 Measures: While Covid-19 is present in the UK I agree to follow the changes in Government guidelines during my lessons. Agreed (ticking box acts as signature) Date of Signing * Thank you!
