Name

Address & Postcode

Telephone

Email Address

Day                                                     Evening

Emergency Contact

Name                                                   Contact Number

About You

I Have Attended Previous Courses – NO / YES   
Had lessons with a RWYM coach – NO /YES

If NO, how did you hear of these courses?  FRIEND / BOOKS / DEMONSTRATION / MAGAZINE ARTICLE / INTERNET / INTELLIGENT HORSEMANSHIP / WHERE ?  

Age Group:  Under 16 / 16 – 25 / 26 – 35 / 36 – 50 / 50+

Your Health

Do You Have Any Medical Conditions That May Affect Your Ability To Ride, Or That We Should Know About In Case Of Emergency?                                           YES / NO

Have You Ever Suffered Any Serious Injury Or Discomfort Whilst Riding?     YES / NO           IF YES, PLEASE DESCRIBE ON REVERSE OF FORM

Accommodation

Please arrange for me to stay with a local family, £27.50 cash per night  (shared rooms, in walking distance,  min 2 nights) – YES / NO, my 1st night will be _______ day, my last night ______day

Your Horse

(Mounted courses only)

I will be bringing my own horse YES / NO – please provide a horse for me.

If 'NO' My Height ________  Weight _________ please indicate your experience on reverse of form.

If 'YES' please state size & type.

Will his flue vaccination be up to date? YES If no, we will deny entry.

Does he chew wood /crib/ kick doors/ escape /weave /bite ...etc? (or is he the kind of well behaved horse we most like to have around?!)   
I would prefer a small paddock to a stable if available (not guaranteed – numbers/ground conditions may make this impossible.  Horses must respect electric fencing) – YES / NO

Your choice of 2^nd session  (circle)

  Supervised flatwork   / extra dismounted session  / pole work (4 day only)  / jumping (4 day only)

COURSE

2 DAY
MOUNTED

4 DAY
MOUNTED

THEMED TT

TEACHER TRAINING

1^ST CHOICE DATES

BASIC/ADVANCED

2^ND CHOICE DATES

Deposit payable to
Mary Wanless

£260(MW) /£220(KM+LD)

£430(MW) /£370(KM+LD)

£240

£160