Please contact June on 07788 407409

Application Form
BISSELL WOOD FUN RIDE
Saturday 5th May 2012

RIDERS DETAILS

Name………………………………………………………….......................

Address………………………………………………………………………

…………………………………….................................................................

…………………………………..Postcode…………………………………

Email address……………………………………...................................

Telephone number………………………………........... Age (if under 18)……

Signature of Parent/Guardian if Rider is under 18.........................................
........................................................................................................................
EMERGENCY CONTACT DETAILS

Next of Kin…………………………………………......................................

Contact number ……………………………………………..........................

I hereby certify that I have read, understood and will abide by the conditions of the Fun Ride, and that the details on this form are correct to the best of my knowledge. By signing this form I accept that I ride at my own risk / and / or by signing this form I accept responsibility for any persons under 18 years old who are in my care.
I hereby release, remise and forever discharge from any claims and liabilities, whatsoever without limitation that I might have against the organisers and the owners of the property on which I am riding, and I make this release on behalf of myself, my heirs, executors, assignees and administrators.
I acknowledge that riding is a risk sport, and that riding over jumps, especially fixed cross-country jumps increases that risk. If I have any concerns about my safety or the safety of others in connection with the jumps or any other facilities at Bissell Wood Equestrian Centre I will inform the owners immediately.

Signature……………………………………………..............

Date………………………………………………………......

Print Name……………………………………………………
How did you hear of this event?......................................................................


FUN RIDE

At Bissell Wood Equestrian Centre, Deansford Lane, Blakedown, Kidderminster, Worcestershire, DY10 3NN,
June on 07788 407409 general-info@bissellwood-equestrian.co.uk


SATURDAY 5th May 2012

Start 9:30am, last ride to start at 12.00pm

· A ride of approximately 7 miles around farm land and the Bissell Wood Estate, surrounding lanes and bridleways, finishing with UK Chasers Course jumps if of interest.
· No gates
· Optional jumps.
· Refreshments available to purchase at the start/finish
· Photographer will be in attendance
· Rosettes for all riders




1. Riders must report to the secretary for registration, payment of entry fee (if not paid in advance), and collection of number before starting the course.

2. Any rider not wearing a number will be asked to leave the course by the Stewards.

3. STARTING: Riders may start at any time between 9:30am and 12.00pm in pairs or groups and MUST finish the course by 4.00pm. Any rider dropping out on route PLEASE follow signs back to the FINISH.

4. All tack must be appropriate and in good repair. Whilst mounted ALL riders must wear properly fastened hard hats conforming to BHS standards (PAS015, BSEN1384 or ASTM F1163 with kitemark or SNELL). All riders must wear suitable clothing and footwear. Body Protectors are recommended.

5. The organisers their helpers, agents, employees, landowners and all persons involved with the ride accept no liability for any injury to person, horse, or spectator, or any damage to the property of riders or spectators however caused, whether it be by negligence or otherwise. It is up to the participants and spectators to make their own insurance arrangements.

6. Entry fees cannot be refunded to intending participants who are unable to ride on the day. No dogs on the course, dogs in the parking area and at the start of the course must be kept on a lead.

7. No horses or ponies under the age of 4 years old

8. The organisers reserve the right to refuse permission to start to any rider not observing these conditions or attempting to ride an unsound horse.

9. The organisers reserve the right to ask any rider to leave the course for dangerous riding or ill treatment of their animal including excessive use of the whip or abusive language.




ENTRIES

Advanced Entries (by post): £13.50 (including £1 donation to the Air Ambulance)

Post to:- N Cope Bissell Park Deansford Lane Blakedown Nr Kidderminster Worcs DY10 3NN

Entries on the day: £16 (including £1 donation to the Air Ambulance)

Please Make Cheques Payable to
N. Cope

DIRECTIONS

The Bissell Wood Equestrian centre is situated on Deansford Lane between Kidderminster and Blakedown. Take the turning into Deansford Lane from the A456 Birmingham Road or the A450 Worcester Road.