Real World Riding

Please note that we require full disclosure of medical information as detailed in the terms and conditions – this is for your safety.

When you press the SUBMIT button at the end of the form, it will automatically be sent straight to RWR by email

Your Name

Your Home address

Your Mobile phone number

Your Email address

Your Next of Kin, address and contact number

IF Staying away from home, your accommodation contact details

Your Date of Birth

Your Gender

Female
Male
Other non binary
Prefer not to say

Please give details of any of the following if you answer yes to the questions below and overleaf, including dates and or medication if necessary. Please note that these questions are to make sure we won't injure you or put you at unecessary risk. If you answer Yes to any of these questions it doesn't mean we won't take you, just that we can bear this in mind.

Please tick any that apply and then enter details at the end of any you have ticked:

A respiratory condition such as asthma
A circulatory condition
A skeletal ailment, injury or weakness
Do you suffer from any muscular, tendon or ligament ailment injury or weakness?
Have you received medical treatment for activity restricting ailment or injury?
Do you have any allergies? - please list below any that you have an epi-pen for
Are you pregnant?
Do you suffer from any psychological conditions?
Are you taking any medication not already listed? (Please detail below)
Do you suffer from fainting attacks?
Do you suffer from ABI or Epilepsy?
Are you receiving medical treatment not already listed?
Are you suffering from any other medical condition not listed above? (Please detail below)

Details for any of the above that you have ticked

Is there any other relevant information you would like us to be aware of?

User Agreement

MEDICAL DECLARATION

I have given a full account of my medical condition in this form, and understand that I must declare any further treatment, diagnosis, or medical changes that occur before the start of my experience.

I understand that failure to declare medical information may put my welfare at risk should it prove that this would have informed the decision making of my guide/trainer.

I also understand that failure to declare relevant medical information may hinder any medical treatment I may require should I suffer an injury on my experience.

Please type your name below to acknowledge

Your Name:

User Agreement

ACKNOWLEDGEMENT OF RISK 

Please read the Safety and acknowledgement of risk document.  LINK

I Have read, understood, and accept the statement of risk

Please type your name below to acknowledge

Your Name

This box will need to be ticked even if you are an adult

User Agreement

FOR PARENTS/GUARDIANS OF RIDERS AGED UNDER 18

Please indicate that you give permission for your charge to take part in RWR activities.

Please Type your name below if this applies

Your Name if you are signing for a rider aged under 18

MARKETING and contact

I would be happy to be kept in touch with by RWR only
I am happy for photos of me to be used for marketing RWR only
I am happy for video of me to be used for marketing RWR only

PLEASE NOTE information held on this form will be treated in strictest confidence and will be disclosed only to medical practitioners should you require urgent medical treatment.

User Agreement

Information gathered here will only be used within RWR's data protection policy (LINK) as indicated above.