WHICH COURSE WOULD YOU LIKE TO APPLY FOR?

June 15 - 16, 2018July 20 - 22, 2018August 25 - 26, 2018September 28 - 30, 2018October 12 - 14, 2018December 21 - 23. 2018


YOUR NAME

First name (required)

Last name (required)

Date of birth (required)



ADDRESS AND CONTACT DETAILS

House/Flat no. (required)

Address Line 1 (required)

Address Line 2

Address Line 3

Town / City (required)

County (required)

Post Code (required)

Email address (required)

Mobile number (required)

HEALTH & SAFETY

Do you have a medical condition(s) or a disability which may require special facilities or support?
YesNo

If so, please provide details, including a list of any medication you are taking:

CONTACTS IN CASE OF EMERGENCY

Full name (required)


Relationship (required)


Contact's number (required)




HORSE DETAILS:

Your horse's name:

Horse age:

Breed:


Height (hh):

Horse type: MareGeldingStallion

Stable vices:

Any medical conditions:

Goals for your horse in next 6-8 months:

What is holding you back in your own / your horse's training?:

Reasons: ---Rider Lack of KnowledgeHorse physical limitationsHorse is too greenRiders physical limitationsOther

If you have chosen 'Other', please explain further:


ACCOMMODATION ARRANGEMENTS:

Where will you be staying whilst on the course?:

If you are staying in a lorry on site will you need hook up? (extra £15 – 3 days) (extra £10 – 2 days):
YesNo

What bedding wil your horse require?: Shavings (£5 per bag)Straw (free)



PAYMENT:
The total cost of the course is shown on our site. This includes all meals, lessons, stabling and rider assessment. If you would like your horse treated by Katherine Allard, this is an extra £40 and to be arranged with her whilst on the course.

Please pay £100 deposit as soon as possible. This is non-refundable unless space is filled.

How will you be paying?: ---CashChequeBank transfer

Cheques: Please make out to Collective Equestrian Limited
Please note the full amount (£250 for 3 day courses) (£200 for 2 day courses) must be paid no less than two weeks prior to the start of the course.

Address:
Curls Farm
Moorledge Lane
Chew Magna
Bristol
BS40 8TJ

Banking details:
Collective Equestrian Limited
Sort code: 30-96-26
Account number: 24188868

Declaration:
I confirm that the information provided on the form is both truthful and accurate. I have not omitted any information that could affect my acceptance on a Short Course.


Full name:

Date

Please leave this field empty.