R18, 2023-07-13

NOTE: Chapman Valley Horse Riding does not accept paper waivers, please submit electronically.

RIDING APPLICATION FORM

IMPORTANT! This is a LEGAL DOCUMENT - and must be signed by the Rider themselves (or Parent/Guardian if under 18yrs).

DO NOT SIGN ON BEHALF OF ANOTHER RIDER. Please forward this document to them to sign, or contact us if you are unable to obtain their signature.

I am applying to/for my child to ride with Chapman Valley Horse Riding.

I agree to ensure the following:
✓ I will only ride the horse in a safe and controlled manner
✓ I will wear an Approved helmet and the correct footwear at all times
✓ I will read and follow all signs on the property and follow all instructions
✓ The Instructor/Guide may cancel my ride without refunding any fee if I do not comply with any of these terms and conditions.

By completing this form you are supplying the Provider with personal

information about yourself/your child. This information is needed to

ensure your safety during your time with us. We are required to collect

this information by our insurance company and by the department of

Workplace Health and Safety. The information you provide will not be

supplied to any other organization or used for any other purpose than

that which is stated above.

RISK WAIVER

Horse Riding is a Dangerous Activity
ADULT: I understand and acknowledge that horse riding is a dangerous activity and that horses can act in a sudden and unpredictable (changeable) way, especially when frightened or hurt.
I understand and acknowledge that serious INJURY or DEATH may result from horse riding activities and in particular this ride/lesson. I agree that I RIDE at my OWN RISK.
I agree not to drink alcohol or take drugs prohibited by law before or during this ride.
CHILD: (if signing as a parent/guardian) I, the undersigned, am aged over 18 years of age and am a parent or legal guardian of the below named (Rider).
I consent to the Rider attending Chapman Valley Horse Riding (the Centre)
for the activities of horse riding, including participating in the
events and activities offered by the Supplier or otherwise in connection
with it (Activities). I have made the rider aware of the possible risks, and that they ride at their own risk.

Risk warning and acknowledgment
Participation in the recreational activities supplied by Chapman Valley Horse Riding may involve risk. The risks involved may result in personal injury including death. Prior to undertaking any such recreational activity, you should ensure that you (and the Rider) are aware of all of the risks involved, including those risks associated with any health condition you/they may have.

By signing below, you acknowledge, agree, and understand that participation in the recreational services provided by Chapman Valley Horse Riding may involve risk. You agree and allow/undertake any such risk voluntarily and at your (the Rider's) own risk. You also acknowledge that the risk warning above constitutes a 'risk warning' in accordance with the Civil Liability Act 2002 (NSW).

Exclusion, restriction or modification of rights under the Australian Consumer Law (NSW) and Australian Consumer Law (Commonwealth)
Under the Australian Consumer Law (NSW and Commonwealth), statutory guarantees apply to the supply of certain goods and services, including recreational activities.

It is possible for a supplier to ask you to agree that these statutory guarantees do not apply to you. If you sign this form, you will be agreeing that your rights to sue the supplier because services provided were not in accordance with the guarantees are excluded, restricted or modified as set out below.

By signing below, you agree that the liability of for any harm, including:
• death;
• physical or mental injury (including the aggravation, acceleration or recurrence of such an injury);
• the contraction, aggravation or acceleration of a disease;
• the coming into existence, the aggravation, acceleration or recurrence of any other condition, circumstance, occurrence, activity, form of behaviour, course of conduct or state of affairs:
- that is or may be harmful or disadvantageous to you or the community,
- that may result in harm or disadvantage to you or the community, - that may be suffered by you (or a person for whom or on whose behalf you are acquiring the services) resulting from the supply of recreational services is excluded.

If I elect to provide my own helmet, I take full responsibility for the safety, structural soundness and care of the helmet. I certify that it abides by Chapman Valley’s Accepted Helmets Policy, and that I have thoroughly checked that it is safe and fit for use.

By signing this document, I give permission for Chapman Valley Horse Riding to use images of me/the Rider in marketing and on social media. This waiver is valid for rides that occur within 12 months of the date of completion.

Please enter your full legal name as it appears on your ID.

In the case of any emergency the following information is intended to assist.



Name, Phone Number, Relationship to rider of who we should call in the case of an accident.

Please see our Accepted Helmets policy if bringing your own.

I authorise the instructors to administer first aid and to call an ambulance at their discretion. I agree to bear any cost thereby incurred.

This is a LEGAL DOCUMENT, and must be signed by the Rider named above (or their Parent/Guardian). Do not sign on behalf of anyone in your riding party.

Click to Sign
Signature

This form must be signed by the rider who's name appears above. It must not be signed by anyone else on their behalf. By checking here, you acknowledge you have read and understand the above terms, and are consenting to the use of your electronic signature in lieu of an original signature on paper.You have the right to request that you sign a paper copy instead.By checking here, you are waiving that right.You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.