Riding Sessions

Participant Application

We welcome riders with a wide range of physical and mental disabilities. Tell us about the participant so we can support them safely.

About the participant

Who is filling in this form? *

ParticipantParentGuardian / Carer

First name(s) *

Last name *

Preferred name

Preferred pronouns

Date of birth *

Sex

Languages spoken

Address line 1 *

Address line 2

Postcode *

Telephone

Mobile

Email *

Parent / guardian

Name

Relationship

Address line 1

Address line 2

Postcode

Telephone

Mobile

Health & support

Your information is shared only with the coaches and trustees who need it, kept securely, and never used for any other purpose. In line with the Data Protection Act 2018.

Tell us about the disability or medical condition and how it affects the participant *

Please tick all that apply

We may contact you for more detail where needed.

Do you have any allergies we need to be aware of?Do you have any known triggers, physical, emotional or environmental?Would it help if we used very simple instructions?Do you have a learning disability?Are you neurodiverse?Are you sensitive to strangers or crowds?Are you sensitive to light, temperature, noise, clothing or hats?Do you experience anxiety, depression or low mood?Do you experience panic attacks?Do you have difficulty with speech or making yourself understood?Do you use a communication system such as Makaton, PECS or AAC?Do you wear a hearing aid?Do you have a cochlear implant?Do you use BSL to communicate?Are you blind?Are you partially sighted beyond what glasses or lenses correct?Do you have dexterity difficulties?Do you have problems with balance?Can you take weight through your feet, for example sit to stand?Do you need any help with walking?Can you walk up a few steps, for example onto a mounting block?Are you a wheelchair user?Do you use any walking aids or supports?Do you wear a prosthetic limb?Do you experience long-term pain?Do you have difficulties with breathing or stamina?Do you have epilepsy, and is it controlled by medication?

Height

Height unit

Weight

Weight unit

Height and weight are used to match the participant with a suitable pony in line with welfare guidelines.

Activities

Previous experience with these activities

Select all that apply.

RidingVaulting

Interested in competing?

Already classified?

Classification details

Classification date

Emergency contact & consent

Name and relationship *

Phone number *

I confirm that I have the consent of the person named above to be contacted in an emergency during RDA activities.Photographs and videos consent *I also consent to be sent RDA newsletters and updates from the group.

Declaration

I wish to join an RDA group as a participant and confirm that the information provided on this form is true and accurate to the best of my knowledge. *I agree to provide additional details about medical conditions if requested, and to obtain a medical report where needed.I will notify RDA immediately of any changes to the details or information given on this form.I understand that horse-related activities carry inherent risks and agree to take reasonable precautions and follow advice and instructions.For vaulting only — I understand the specific risks involved in participating on the barrel or horse without a hat.

Signature (type your name)

Date