HORSE RIDING AGREEMENT FORM

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					                                        2008 HORSE RIDING AGREEMENT FORM


                                                                    GYPSIE LODGE EQUESTRIAN CENTRE
                                               198 Kobble Creek Road, Kobble Creek, QLD, Australia, 4520
                                                                    Ph: 07 3289 9393 Fax: 07 3289 9408
                                                                         Web: www.gypsielodge.com.au
                                                                       Email: leasa@gypsielodge.com.au

Riders Name: ________________________________ Age: __________________

Weight (approx for school horse riders only): __ kg

Riding Experience :                    None/Little                   Some                 Average               Experienced

Does the rider have any Physical and/or Mental Health Conditions and/or Disabilities, which may affect
his/her safety and ability to ride a horse? ............................................................ Yes/No

If yes please describe ............................................................................................................................

..............................................................................................................................................................

Does the Rider Speak English ............................................................................ Yes/No

RIDER/GUARDIAN’s EMAIL Address:________________________________________________

Postal Address:____________________________________________________________________

Home Phone Number: ________________Mobile:________________ Work:____________________

Contact Person’s Name:_______________________Phone:_________________________________

                PLEASE NOTE: A late cancellation fee of $20 will be charged in the event of a rider
                        cancelling a lesson booked within 24 hours of scheduled time.
This agreement shall be legally binding upon the Rider and if the Rider is a minor or mentally
handicapped, on the legal guardians of the rider. In Consideration of the Services of Gypsie
Lodge Equestrian Centre and its employees, agents and associates, the rider or guardian
acknowledges as follows:
    Horse Riding is a physical activity that is not without risks or personal injury to the rider, including
     permanent disablement or death in extreme cases. A number of injury risks are present, including
     collisions and falls, despite all safety precautions being taken.
    Horses are strong, living animals with wills of their own that act on instinct, cunning and fear.
     Horses can be trained to respond to stimuli, but the behavior of individual horses cannot always be
     predicted or anticipated and a fall from a horse cannot always be prevented. If a horse is
     frightened, provoked, hurt or mistreated, it may divert from its training and behave according to its
     natural survival instincts. That behavior may include stopping short, changing speed or direction,
     shifting its weight, bucking, rearing, falling, kicking, biting or running from what it perceives as
     danger.
     Gypsie Lodge Equestrian Centre provides the rider with skilled instructors and competent
     supervisors (E.F.A and AHRC Instructors and Trainees), suitable equipment and protective gear

Created by SLM Services                                  cf8e3fa2-e213-49fb-be69-8681e46ea10e.doc                                                   26/03/10
    (AS/NZS 3838), if required. Gypsie Lodge Equestrian Centre also selects its horses for their
    suitable temperaments and sound basic training for the required horse riding activities provided and
    Gypsie Lodge Equestrian Centre follows a recognised risk reduction program.
   Gypsie Lodge Equestrian Centre relies upon the details provided by the rider or guardian as to the
    rider’s age, weight, riding experience, and physical and mental capability in matching horse and
    rider. Subject to having been adequately instructed and/or assessed capable by skilled Gypsie
    Lodge Equestrian Centre representatives, the rider, upon mounting a horse selected for its
    suitability and taking up the reins, is in primary control of the horse. The rider’s safety is largely
    dependent upon the rider’s ability to carry out instructions given appropriate to the rider’s assessed
    capability and the rider’s ability to remain balanced in the riding position on the moving horse.
   Should a rider provide his/her own mount for any activities associated with Gypsie Lodge
    Equestrian Cenre (ie Clinics, assessments, instruction, competition, camps etc) the onus will be on
    the rider/guardian to provide safe tack and equipment, as well as assuring suitability of the
    combination (rider and mount) for the activity to be pursued.
   Gypsie Lodge Equestrian Centre has fist aid treatment for injuries available and will arrange for
    riders to receive, or be transported to receive, medical treatment in urgent circumstances as soon
    as possible, should it be required.
   The rider shall request the ride assistant to assist in the adjustment of all equipment prior to or
    during the ride as necessary.
   Riders must obey information signs encountered during the horse ride and all instructions by
    Gypsie Lodge Equestrian Centre representatives whilst on the property and during the ride.
   The rider or guardian understands the Gypsie Lodge Equestrian Centre and its associates agrees
    to take all reasonable precautions but is not responsible for acts, occurrences or elements of nature
    beyond their control that can scare a horse, cause it to fall or react in some potentially unsafe way.
    If a rider does not comply with the conditions set out herein, or, in the opinion of Gypsie Lodge
    Equestrian Centre representatives, engages in inappropriate or hazardous behavior, the ride may
    be cancelled and monies charged need not be refunded in part or full.
   Gypsie Lodge Equestrian Centre reserves the right to refuse to allow a person to participate in any
    horse riding related activity whilst on the premises on the basis of a disclosed disability.
   All accidents or personal injury or loss or damage to property must be reported to Gypsie Lodge
    Equestrian Centre representatives before leaving the property. If this is not possible due to injury,
    such report must be made in writing within 14 days thereafter and all claims must be made within
    12 months of the date of injury, loss or damage. The rider or guardian agrees that any claim not
    made within the 12-month period will be waived.
   The rider or guardian acknowledges the risks of horse riding as stated on this form and the rider or
    guardian has read and understood the terms and conditions of this contract and signifies that this
    agreement shall be effective and binding.
   The rider or guardian acknowledges that this form covers all riding activities associated with Gypsie
    Lodge Equestrian Centre and its employees/representatives for the year of 2008.

RIDERS SIGNATURE ______________________________ Date _______________

GUARDIAN’s SIGNATURE __________________________ Date _______________
(if the rider is under 18 years of age)




Created by SLM Services               cf8e3fa2-e213-49fb-be69-8681e46ea10e.doc                   26/03/10