Details Form

Jessie's Riding Academy (JRA)

* Indicates required field

Riding Participants Name *

First

Last

Parents Name *

First

Last

Postal Address *

Phone Number *

Date of Birth *

Email *

Where did you find out about JRA *

If other please advise here *

Check the activities that most interest you *

Sporting Jumping Trail rides Beach rides Horsemanship/Equiskills Fun days Showmanship Jumping days Competition preparation program Camps Other

To help you achieve the most from your riding, please tell us about your goals. *

Describe your riding experience (approx number of riding hours, competition experience etc.) *

Tick yes or no to give permission for you/your child's pictures to be published on the web page or facebook page. *

No do not publish any pictures Yes publish pictures please

If other please advise here *

I acknowledge that horses are dangerous and I agree to participate at my own/own child's risk *

I agree

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