Christine Johnson – Equestrian Services
44 Nelson Rd, Nelson, 2765 NSW
Phone 029 6791 221, Mobile 0412 405079
Email [email protected]
Web page- http://www.geocities.com/chrissiegogallop/index.html
ABN 42 667 969 743

RIDING CAMP ENROLMENT FORM

NAME:-_______________________________________________________

AGE:-____________________SEX:-___________________

ADDRESS:-_____________________________________________________

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PHONE HOME______________________

WORK:-____________________________

MOBILE:- ___________________ _

EMAIL:-_____________________________

DATES OF CAMP YOU WISH TO ATTEND_____________________________

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DO YOU SECOND PREFERENCE FOR CAMP ATTENDANCE?

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PLEASE CIRCLE YOUR ANSWER(S) BELOW:

I WILL BRING MY OWN HORSE? YES / NO

IF YES, PLEASE GIVE DETAILS OF HORSE, I.E.:

NAME _________________________________

AGE___________________________________

HEIGHT ________________________________

COLOUR_______________________________

TEMPEREMENT____________________________________________________________

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EXPERIENCE ETC.__________________________________________________________

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I WOULD LIKE TO BOARD MY HORSE? YES / NO

I WOULD LIKE TO RIDE A JOHNSON HORSE? YES / NO

I AM MOSTLY INTERESTED IN: SHOW JUMPING / DRESSAGE /

CROSS-COUNTRY / LEVEL 1 COACH TRAINING / LEARNING TO RIDE

GAMES / HORSE MANAGEMENT LESSONS / TRAIL RIDES / LUNGING.

LIST ANY OTHER INTERESTS?____________________________________________

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Do you have any medical or physical problems that might affect your riding training?

If so please list these______________________________

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What previous experience have you had with horses?

Please list________________________________________

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I understand that a 10% deposit will secure my place in the camp but that this amount is non-refundable in the case of cancellations.

I understand that horse riding is a high risk sport and I agree to obey all directions and requests and behave in a safe and considerate manner.

SIGNED:_____________DATE:_

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SIGNED:___________________________DATE:_______________

SIGNED:_____________DATE:_