Equilibrium Therapeutic Riding Birthday Party
Application Form
Basic Registration
Child’s Name: _____________________________ Age:______________
Height:_______________ Weight:________________ (required for matching rider to horse)
Parents or Guardian: ______________________________ Phone:__________________
Address:_______________________________________________________________
Street/Box #
City/Town
Prov
Postal Code
In case of emergency, contact: ________________________ Phone: ______________
Does your child have any allergies or medical conditions? ____yes ____ no
If yes, please list them: (further information may be required)
Sask Health #:___________________________________
Liability Release
_____________________________ would like to participate in _____________________
Child(ren)’s Name(s)
Birthday child’s name
Birthday Party on _____________________.
Date (Month, day, year)
I acknowledge the risks and potential for risk, of horseback riding. However, I feel that the
possible benefits to my son/my daughter/my ward are greater than the risk assumed. I hereby,
intending to be legally bound for myself, my heirs and assigns, executors or administrators,
waive and release forever, all claims for damages against Equilibrium Therapeutic Riding, its
owner, Instructors, Therapists, Aides and employees for any and all injuries and/or losses I/my
son/my daughter/my ward may sustain while participating in Equilibrium Therapeutic Riding.
Date:___________________ Signature:_____________________________________
(Rider over 18 yrs, parent or guardian)
Witness:___________________________
* Please read the General Site Rules on the back of this form.
Your child will only be allowed to participate if in full compliance with these rules.
Equilibrium Therapeutic Riding
General Site Rules
1. Minimum Age: 3 years (children under 6 require additional assistance
from parent/guardian during the riding lesson)
2. A Registration Form and Liability Release Form must be completed,
signed and witnessed for each participant.
3. All riders must wear long pants and boots with a heel (suggestion:
Rubber boots) while riding or handling animals
4. We provide helmets – riding helmets (not bike) are mandatory during
riding and when handling horses.
5. We ask that you leave your dogs at home or keep them on-leash at all
times. For the safety of our students, no dogs will be permitted in or near
the arena during riding lessons. Service dogs are excluded from this
policy.
6. No smoking in the arena or near the hay storage areas.
7. Corrals, pastures, hay and straw stacks are off limits to all riders and
families.