Consent form

Name of participant……………………………………………………………………….…D.O.B………………….

Name of horse……………………………………………Mare/ Gelding*  Height…………..Age………….

Relevant medical information? (include any known allergies, medical conditions and medications)

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

Name of parent/carer ………..……………………………………………………………………………………………………………….

Address……………………………………………………………………………………………………………………………………….

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

If required I consent to emergency medical treatment being sought by the organisers for the participant named in this form including anaesthetic and blood transfusion.

If required I consent to emergency veterinary treatment being sought for the horse/ pony named on this form, including euthanasia on the advice of a qualified veterinary surgeon.

I consent to the participant named in this form taking part in the activity of

____________________________________ (enter details of event(s) here). 

and confirm that the information provided on this form is accurate and complete and the participant has no undisclosed medical or physical conditions that will prevent them from doing these activities safely. I will inform the organiser if there are any changes to information on the form prior to any event.

I consent to photos of the participant named on this form being taken and used on the internet and in publicity regarding the British Juniors/ U21. (please delete if consent is not given)

I understand that if the participant named on this form does not follow the BHA code of conduct, directions of organisers, or behaves in a way that is offensive, unacceptable or dangerous then they will be asked to leave the venue immediately.

I confirm that I will be responsible for the welfare of the participant during the course of the training weekends, or will ensure that another appropriate adult is present to do so (please provide name.........................................................)

Signed (participant or person with parental responsibility if U18)………………………………………………………………………

Name……………………………………………………………………………………………… Date………………………………………….