The person completing this form needs to be the bill payer OR over the age of 18 years

Full Name of Student *

Postal Address *

Age *

Contact Details: (Parent or Guardian / Bill Payer)

Parent or Guardian / Bill Payer - Name *

Parent or Guardian / Bill Payer - Email Address *

Parent or Guardian / Bill Payer - Best Contact Phone Number *

EMERGENCY CONTACT DETAILS Or same as above

EMERGENCY - Name *

EMERGENCY - Relation ship to rider *

EMERGENCY - Best contact phone number *

PERSON RESPONSIBLE FOR DROP OFF AND PICK UP

PERSON RESPONSIBLE - Name *

PERSON RESPONSIBLE FOR DROP OFF AND PICK UP - Contact phone number *

Please tick what camp you would like to attend? *

Beginner/Advanced Beginner Course 1

Beginner/Advanced Beginner Course 2

Summer Camp

Are you bringing your own pony to camp? *

NO I don’t have a pony

YES I will be bringing my pony

LEVEL OF EXPERIENCE (Please tick) *

No experience

Some experience (Have ridden for approx. 5 hours riding lessons)

Can ride independently (Walk, Trot)

Can ride independently Walk, trot, canter and jump

LEVEL OF EXPERIENCE

HEALTH:

It is the parent/guardian responsibility to inform the Riding Academy of any information regarding the health of the applicant. We ask that you disclose the information that we may find helpful and useful to prepare our staff & horses to accommodate for any of the below with the best interests of the rider. These details remain confidential and only used to prepare our staff and horses.

(Please tick those that apply and specify details below with any information necessary for us to provide adequate care during the programme)

Any medical conditions

Any disabilities; Including speech, sight, hearing or physical

Difficulty working or socializing in a group

Allergies, including Food Allergies

Are any special medications required while at camp? Does student know how to use this item?

Recently had any injuries or surgery’s that may compromise riding a horse

If this application is for an overnight camp, Will you be staying overnight? *

Yes

N/A

How did you hear about Bartley Academy Camps?

TERMS & CONDITIONS

FEE POLICIES & PROCEDURES

Camp fees are strictly payable in full on the due date of the invoice. No payment of fees may result in the loss of enrolment position.

Camp fees invoices are sent via email before commencement of the camp.

If a student fails to pay by the due dates for any reason, Riders will loose their position on the course.

ATTENDANCE

There will be an allocated drop off and pick up time, we ask that those times a strictly adhered by.

Riders will start straight into camp schedule so we ask that parents leave us to carry out the proceedings of the camp as we find the students settle in better once they are in the programme.

REFUND POLICES

NO refund will be given, unless- Unable to ride due to illness OR injury and a medical certificate is produced 24 hours before the start of the camp which redeems you a 50% refund.

HEALTH, SAFETY, INJURY & MEDICAL CONDITIONS POLICES AND PROCEDURES

Bartley Riding Academy is not liable for personal injury sustained or any loss or damage of personal property whilst on the premises.

Bartley Riding Academy will aim to provide a safe learning environment to reduce risk of injury. It should be recognized by all students, parents/guardians that horse riding by its very nature carries a risk of accident and/or injury.

Bartley Riding Academy provides qualified and/or experienced instructors and/or staff, who actively promote safe practice on and around horses. This being the case should it be realized that injuries do occur from time to time and students must accept this element of risk.

It is the student/parent/ guardian’s responsibility to notify their teacher in the event of injury, medical condition, or learning disability prior to class commencement.

All riders MUST wear their helmet while in the yard at all times. NO exceptions. This exempts staff. We supply helmets for students but cannot guarantee the snug fit needed so we recommend buying your own fitted helmet for your safety.

Students are required to wear long pants, covered shoes and a helmet at all times. It is recommended to buy your own horse riding gear for comfort and safety after 1 terms riding if not before.

If a student has a fall OR injury during class time a parent or guardian will be notified. If a student falls and has contact with their head on the ground they will not be able to mount the horse again due to possible concussions. This decision is made by the instructor present that the fall.

All non riders must abide by our rules at the yard by not stepping into the areas that only riders OR horses are allowed and follow instructions of our staff

Non riders are allowed to watch the lessons from our viewing areas but must reframe from interfering while the student is in class. This is a quiet area as horses are sensitive to noise and this is for horse and rider safely. No running around the premises, driveway, walk way of any persons. If you have children it is your responsibility to supervise at all times on our premises.

DISCLAIMER

The disclaimer form has to be completed before pupils attend camps.

It is the parents/ guardians responsibility to inform the riding academy of any information that is going to be important to us regarding adequate staff and horses for the rider to safety participate in riding school activities.

I confirm that all details on this form are correct and that I have read and agree to the Bartley Riding

Academy’s Terms and Conditions (sign) *