1. Rider Information

Rider's name *

Date of birth *

Nationality *

Native language *

English level *

Email *

Phone number *

FFE License *

Riding level *

2. Legal Representative

Representative's name *

Phone number *

Email *

Address *

3. Emergency Contact

Name *

Relationship to the child *

Phone number *

4. Stay

Program *

Arrival date *

Departure date *

5. Medical Record

Blood type

Current treatmentYesNo

Medical history

If yes, please specify the treatment

6. Allergies & Diet

Allergies

Dietary requirements

Intolérances

7. Authorizations & Declarations

I authorize any necessary medical care.I authorize EquiEnglish to transport the participant.I accept and acknowledge the inherent risks of equestrian activities.I authorize the administration of medication provided with a prescription.

Image rightsChooseI acceptI refuse

8. Insurance

Travel/holiday insurance purchasedNo suitable insurance

Insurance company

Policy number

9. Swimming

Can swim aloneCannot swim

10. Acceptance and Signature

Location *

Date *

Name of legal representative *

I have read and approved, I agree to the terms.

Please consult our Terms and Conditions.