[{"type":"header","label":"Broadmeadow (AIRE REGISTRATION FORM AND RISK ADVISORY) ","className":"waiver-header-element"},{"type":"paragraph","label":"This section is for an Adult and/or\na Parent or Guardian of Child rider (under 18)","className":"waiver-legal-element"},{"type":"paragraph","label":"I hereby apply for myself and/or on behalf of my child to participate in\nequestrian programmes or activities organised or operated by your Riding\nEstablishment. I attach to this application the completed form giving details\nof my and/or child’s riding experience which I understand will form the basis\nof the agreement between me and the Riding Establishment."},{"type":"paragraph","label":"I do hereby acknowledge and accept the following:

1. That all sporting activities have an element of danger and riding is\nno exception.

2. That I or my child may suffer serious personal injury as well as loss\nof property as a result of exposure to risks and hazards associated\nwith riding as a sport.

3. I hereby agree to abide by all rules and regulations laid down by the\nRiding Establishment, I hereby agree that:

a. I and/or my child will wear approved head gear and suitable\nclothing and footwear when riding.

b. I and/or my child will follow all instructions meticulously.

4. I clearly understand that by accepting the Riding Establishment’s\nterms and signing this agreement, I am accepting the risks. I will\nexercise due care and attention. It is my decision whether or not to\ncarry insurance against loss.

"},{"type":"checkbox-group","required":true,"toggle":false,"name":"checkbox-group-1711020747340","other":false,"values":[{"label":"I and/or my child acknowledge and accept that riding is a risk sport. I acknowledge that this Establishment may use my address and telephone number to contact me in the future. The information will not be shared by any other party.","value":"option-1"}]},{"type":"checkbox-group","required":true,"toggle":false,"name":"checkbox-group-1711020778176","other":false,"values":[{"label":"I agree that photographs or recorded images may be taken during or at AIRE related activities, which may include myself or my child, may be used in the promotion of this centre.","value":"option-1"}]},{"type":"signature","required":false,"label":"Signature","name":"signature-1711020675072"},{"type":"header","label":"Section A"},{"type":"text","required":true,"label":"Rider Name/Child's Name","className":"form-control","name":"text-1711019200754"},{"type":"textarea","required":true,"label":"Address","className":"form-control","name":"textarea-1711019222604"},{"type":"text","required":true,"label":"Tel. No","className":"form-control","name":"text-1711019271068"},{"type":"text","required":true,"label":"Email","className":"form-control","name":"text-1711019290553"},{"type":"text","required":true,"label":"Age","className":"form-control","name":"text-1711019303287"},{"type":"text","required":true,"label":"Years Riding","className":"form-control","name":"text-1711019312129"},{"type":"text","required":true,"label":"Emergency Tel: No","className":"form-control","name":"text-1711019338455"},{"type":"header","label":"Section B"},{"type":"textarea","required":true,"label":"How ofter do you/your child ride?","className":"form-control","name":"textarea-1711019422352"},{"type":"textarea","required":true,"label":"Level of riding experience","className":"form-control","name":"textarea-1711019441980"},{"type":"textarea","required":true,"label":"Details of previous riding","className":"form-control","name":"textarea-1711019455321"},{"type":"header","label":"Section C"},{"type":"radio-group","required":true,"label":"Do you or your Rider have now, or have you ever had any of the following: ASTHMA, AUTISM, DYSPRAXIA, DIABETES, DYSLEXIA, EPILEPSY, HEART, HEARING, BACK or SIGHT PROBLEMS, NERVOUS DISORDERS, OTHER (State)","name":"radio-group-1711019538525","other":false,"values":[{"label":"Yes","value":"option-1"},{"label":"No","value":"option-2"}]},{"type":"text","required":false,"label":"Please add details if selecting yes above","className":"form-control","name":"text-1711019723599"},{"type":"radio-group","required":false,"label":"If yes to any of the above medical conditions is your doctor in agreement with you riding?","name":"radio-group-1711019842218","other":false,"values":[{"label":"Yes","value":"option-1"},{"label":"No","value":"option-2"}]},{"type":"text","required":false,"label":"Doctors name & contact number","className":"form-control","name":"text-1711020036019"},{"type":"textarea","required":false,"label":"Is there any further information that the Coach should be aware of to make\nthe lesson more beneficial to the Rider?","className":"form-control","name":"textarea-1711020117529"},{"type":"paragraph","label":"LADIES, it is advisable to let the management know if you are pregnant."},{"type":"header","label":"Section C"},{"type":"paragraph","label":"1. The Proprietors and Management reserve the right to refuse an\napplicant permission to ride at this Establishment.

2. Accurate information on previous riding experience must be\nsupplied before acceptance (see Registration Sheet).

3. Regulation headwear, footwear and clothing must be worn.\nHeadwear and footwear brought by clients may be examined by\nmanagement for suitability. All instructions from management and\nstaff must be meticulously followed in the interest of safety.

4. Horses will be matched to riders in accordance with rider’s\nstatement of experience.

5. Riders are recommended to have Personal Accident Insurance\nCover.

"},{"type":"paragraph","label":"This Establishment is approved and makes every reasonable effort to\nensure the safety of the rider. Horses are unpredictable and there is\nalways a risk that a rider and/or horse may fall or a horse go out of\ncontrol. These risks can never be eliminated. In the interests of\nproviding a good and reasonable service without fear of unreasonable\nclaims for injuries, we do require the following disclaimer to be\naccepted as part of the conditions of riding at this Establishment:
"},{"type":"paragraph","label":"“The proprietor(s), management and employees of this Establishment\nshall not be liable for, nor do they accept responsibility for, any personal\ninjury, loss or damage sustained by any person or persons (including\ncustomer/rider) whether arising under the express or implied terms of\nthis contract, whether direct or indirect and including consequential\nlosses arising out of any of the activities of this Establishment or in any\nother way whatsoever which does not arise from a negligent act or\nomission of the proprietor(s)/management/employees.”
"},{"type":"checkbox-group","required":true,"label":"Electronic signature consent","className":"waiver-accept-element","name":"checkbox-group-1711019079195","values":[{"label":"I understand and agree that by accepting the Riding Establishment’s terms and signing this agreement, I am accepting that there are risks of injury and I must exercise due care and attention.","value":"option-1"}]},{"type":"signature","required":true,"label":"Signature","className":"waiver-signature-element","name":"signature-1711019079201"}]

Broadmeadow Equestrian Centre

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