Carriage Driver Registration Form

(Sandside Farm- Chris Ainscough Carriage Driving Instructor and Coach Confidential Information)

Name of Participant*

Age of Participant*

Date of Birth*

Address of Participant*

Participants email Address

Participants contact Number:*

Weight of Participant*

Height of Participant

Emergency Contacts Details:*

Have you or the driver you are signing for ever suffered a serious injury or discomfort while driving or been advised not to carriage drive:

Please give details of any disability, special needs, allergies or conditions along with any relevant information that would assist the instructor

Driver Ability/ Declaration I consider myself (or the person driving whom I am signing on behalf of) to be:*

Complete Beginner

Beginner

Novice

Intermediate

Advanced

Approximately how many times have you driven in the last 12 months:*

None

Under 12

12-40

40+

I understand that carriage driving at any standard carries inherent risk and that all horses/ponies may react unpredictably on occasions.*

I Accept Terms

I may fall off the carriage, the carriage may overturn or lose control, and I could be injured. I accept that risk.*

I Accept Terms

I understand that instructions are given for my safety and agree to follow instructions given to me by staff and instructors of Sandside farm.*

I Accept Terms

I understand that wearing an appropriately fitting riding hat and body protector may reduce the severity of an injury should an accident happen.*

I Accept Terms

I understand that it is my choice whether I wear a body protector or not and I understand that gloves and appropriate sturdy footwear should be worn.*

I Accept Terms

I agree to wear a riding hat whilst carriage driving at Sandside Farm or under the instruction of Chris Ainscough.*

I Accept Terms

I understand that the coach Chris Ainscough will make decisions based on information provided by me and agree to always be honest and volunteer information regarding: My ability and driving experience Any previous driving accidents Any medical conditions which may affect my ability to drive*

I Accept Terms

I understand that children are at a particular risk around horses and agree that I will keep children that I am responsible for under close supervision when they are not being instructed by Chris Ainscough.*

I Accept Terms

I understand that Chris Ainscough may refuse my request to drive for safety or operational reasons.*

I Accept Terms

I understand that competing carries enhanced risk over and above general carriage driving and agree that if I choose to participate in any competition or event, it is my responsibility to ensure that I have the experience and ability to drive the course, including any obstacles which form part of the course. If I am in any doubt, I will not enter the competition.*

I Accept Terms

I agree that neither Sandside farm nor Chris Ainscough nor his staff will not be liable for injury or damage to property unless it is caused by their negligence.*

I Accept Terms

I understand that the information I have provided will be held in accordance with the Data Protection Act 1998 but may be made available to insurers and other concerned parties in the event of any injury or accident.*

I Accept Terms

Signed by the participant or their representative who has read, understands and consents to the participant taking part in carriage riding.*

Yes I Sign this Carriage Driver Registration Form

Date This form was filled out and Signed*

Carriage Driver Registration Form

Chris Ainscough Carriage Driving

07743 554 202