Registration Form

Instructions Please complete this form to begin the registration process. * indicates a required field. All of your information will be kept confidential and is for registration purposes only

Event *Please select the program or lesson type you would like to register for.

What is the date and time of the session(s) your are registering for? *Please state the specific session(s) you are registering for. For example: Mondays @ 4:00-4:30 PM, April 12,19,26 (this information can be found on our Facebook page)

First Name *

Last Name *

Type *

Home Phone

Cell #

Email *

Address

Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry

Emergency Contact Information *

Child's first name:

Child's last name:

Child's Age:

Allergies and/or any relevant medical information we should be aware of? Leave blank if NONE

Do you and/or your child have any limitations, challenges, disabilities, anxiety, etc. that our staff should be aware of *

Agreement

Absolutely NO smoking is allowed on the property. Due to the highly flammable materials found on a farm, smoking is strictly prohibited. NO DOGS or PETS are allowed on the farm for the safety of our guests, and for the health and safety of the animals on the property.I've read the above and agree.

Agreement For Acceptance Of Risk And Waiver Of Liability

I understand I must complete the required liability waivers, outlined on the "Booking, Rates, and Cancellations" page. I will sign a copy of the form (on behalf of myself and/or my child) and either send via email prior to my first lesson, or bring with me in person on the day of my first lesson.I've read the above and agree

Please review carefully yourself and/or with your child (as applicable) I understand that horses are independent living beings with their own minds and, as such, can never be entirely predictable. I understand that there are always elements of risk in Equestrian activities including permanent disability or death. I am aware that at all times when in the stables or working around horses it is MY RESPONSIBILITY to: -Be alert and respectful of horses intentions signalled with their ears and eyes and carried out with their teeth and hooves. -Speak in a reassuring tone when approaching horses and avoid sudden movements or noises. -Never leave horses unattended with the stall door open, in the stable aisles, while they are cross-tied, or in the riding area. -Always lead horses properly with a lead shank. -Always wear appropriate clothing including rugged boots. -Pick up and replace tack equipment I have used in the barn or arena. -Know the locations of emergency telephones, ambulance phone numbers, and farm staff on duty. -Know all fire emergency procedures and never smoke or be intoxicated in the stable or allow others to do so. -Read and obey all posted information and warnings. -Comply promptly with all verbal directions of stable personnel, officers, and instructors unless I believe that by so doing I will endanger myself, other people, or horses, in which case I will immediately express my opinion to the person involved. -Refrain from acting in any manner that may cause or contribute to my injury or the injury of other people or horses. I am aware that at all times when riding, it is MY RESPONSIBILITY to: -Never ride alone. -Check all equipment and tack including the saddle, stirrups and stirrup leathers, girth straps, bridle, bit prior to use for signs of weakness and proper adjustment. -Use proper equipment and attire including a regulation hard-hat with the chin harness snugly fastened at all times and boots with heels. -Ride in control ONLY on horses rated with my ability level. -Be constantly aware of, anticipate, and be able to avoid nearby horses, people, obstacles, natural and man-made hazards. -Never tailgate and always audibly alert riders and people on the ground in advance of changes in direction or when overtaking another horse. I understand that this is only a partial list, and I must be safety conscious and exercise safety and judgment AT ALL TIMES. ANYONE found to be endangering themselves, other people, or horses faces immediate revocation of riding privileges.

Please verify that you and your child have read and understand the above participant responsibilities.

I've read the above and agree

Payment instructions

To confirm your spot payment must be received by e-mail money transfer sent to: munchkinsandminis@gmail.com Once this form is complete, and the e-transfer complete, I will call Jensen Equestrian Center at 905-260-2339 to confirm my registration and schedule. Please review and confirm the total pricing (including HST) for the program you are registering for by checking our Booking, Rates, and Cancellations page. Spots are first come first serve. Missed and Make-up lesson policies are outlined on our Booking, Rates, and Cancellation page. I understand that I must arrive 15-30 minutes prior to my booked lesson time to sign in. I will bring a helmet. I will be dressed for the weather with riding gear or long pants, rubber boots or similar footwear, NO OPEN-TOED SHOES (FLIP FLOPS, SANDALS, ETC.)!I've read the above and agree

Consent for photography / videography

I hereby authorize and consent that any images or video taken of myself and/or my child, in whole or in part, individually or in conjunction with other images, photographs, video footage in any format whatsoever as part of the above selected program, event and activities as part of a collection of images of the Jensen Equestrian Center, to be displayed on the website, to be used for media purposes, including, without limitation, promotional presentation and marketing purposes. I hereby waive any rights to privacy and compensation, which I may have in connection with such use of my name and likeness, including rights that may be created in connection with any photographic or video production, editing and promotion therewith. I AM OVER 18 YEARS OF AGE AND I HAVE READ THIS WAIVER AND I AM FAMILIAR WITH ITS CONTENT AND I AM SIGNING THIS DOCUMENT VOLUNTARILY AND WITHOUT INDUCEMENT.I've read the above and agree

Do you have any additional comments or questions for us?

Please enter your full name: *

Your Information

Please fill out the below if you are registering on behalf of a minor (under 18)

Additional Information

NO SMOKING OR PETS

LIABILITY WAIVER

PARTICIPANT RESPONSIBILITIES

PAYMENT

PHOTOGRAPHY CONSENT

FINAL QUESTIONS

SIGN OFF

Verification