CLIENT DETAILS
| Name : | D.O.B. |
| Postal Address & postcode : |
| Height | Weight (stones) |
| Home Tel | other tel |
HEALTH & SAFETY
Medical details that may
affect your ability to ride or of which your instructor should be informed in
case of emergency
|
|
Name |
Relationship |
Tel |
Relative/friend
|
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|
|
|
Your Doctor |
|
|
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Has the rider ever :-
|
|
Yes |
No |
|
Suffered a serious injury |
|
|
|
Experienced pain or
discomfort while riding |
|
|
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Been advised not to ride. |
|
|
Previous riding
experience (tick where appropriate)
|
None |
|
Beginner |
|
Novice |
|
Intermed. |
|
Advanced |
|
|
How many times have you ridden in last year. |
None |
|
Less than 12 |
|
12 to 40 times |
|
More than 40 times |
|
You are able to :-
|
Mount/dismount |
|
Ride on lead rein |
|
walk |
|
Trot |
|
Canter |
|
|
Gallop |
|
jump |
|
Trek |
|
Hack |
|
Hunt |
|
|
Ride without stirrups:- |
At walk |
|
At canter |
|
At trot |
|
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Your purpose for becoming a client at Copley Stables :-
Please Read information over the page and
sign the declaration