Horse Rider Registration: Intermediate Ride

Booking Contact Name*

Booking Contact Phone Number*

Date of your upcoming ride*

How many riders are you completing the waiver for today?*

How many riders need to complete the waiver at another time (eg. who live at another address)?*

Please type in their email addresses below, and we will email them the waiver to complete.

Rider #1 Email*

Rider #2 Email*

Rider #3 Email*

Rider #4 Email*

Rider #5 Email*

How did you find out about The Ranch?

Rider #1 Details

Riders Name*

Postcode*

Do you have any pre-existing injuries?*

Yes
No

Please describe your injuries:*

Age*

Under 7
7–12
13–17
Adult

Height*

Under 120cm
120–170cm
170cm +

Weight*

Under 60kg
60–80kg
80–100kg
100kg +

Riding Experience*

Experienced (excellent horse control and capable of a quick canter)
Moderate Experience (moderate horse control and can rise to the trot comfortably)
Inexperienced (minimal horse control learning or want to try to do a seated trot)
Novice (never ridden)

Rider #2 Details

Riders Name*

Postcode*

Do you have any pre-existing injuries?*

Yes
No

Please describe your injuries:*

Age*

Under 7
7–12
13–17
Adult

Height*

Under 120cm
120–170cm
170cm +

Weight*

Under 60kg
60–80kg
80–100kg
100kg +

Riding Experience*

Experienced (excellent horse control and capable of a quick canter)
Moderate Experience (moderate horse control and can rise to the trot comfortably)
Inexperienced (minimal horse control learning or want to try to do a seated trot)
Novice (never ridden)

Rider #3 Details

Riders Name*

Postcode*

Do you have any pre-existing injuries?*

Yes
No

Please describe your injuries:*

Age*

Under 7
7–12
13–17
Adult

Height*

Under 120cm
120–170cm
170cm +

Weight*

Under 60kg
60–80kg
80–100kg
100kg +

Riding Experience*

Experienced (excellent horse control and capable of a quick canter)
Moderate Experience (moderate horse control and can rise to the trot comfortably)
Inexperienced (minimal horse control learning or want to try to do a seated trot)
Novice (never ridden)

Rider #4 Details

Riders Name*

Postcode*

Do you have any pre-existing injuries?*

Yes
No

Please describe your injuries:*

Age*

Under 7
7–12
13–17
Adult

Height*

Under 120cm
120–170cm
170cm +

Weight*

Under 60kg
60–80kg
80–100kg
100kg +

Riding Experience*

Experienced (excellent horse control and capable of a quick canter)
Moderate Experience (moderate horse control and can rise to the trot comfortably)
Inexperienced (minimal horse control learning or want to try to do a seated trot)
Novice (never ridden)

Rider #5 Details

Riders Name*

Postcode*

Do you have any pre-existing injuries?*

Yes
No

Please describe your injuries:*

Age*

Under 7
7–12
13–17
Adult

Height*

Under 120cm
120–170cm
170cm +

Weight*

Under 60kg
60–80kg
80–100kg
100kg +

Riding Experience*

Experienced (excellent horse control and capable of a quick canter)
Moderate Experience (moderate horse control and can rise to the trot comfortably)
Inexperienced (minimal horse control learning or want to try to do a seated trot)
Novice (never ridden)

Rider #6 Details

Riders Name*

Postcode*

Do you have any pre-existing injuries?*

Yes
No

Please describe your injuries:*

Age*

Under 7
7–12
13–17
Adult

Height*

Under 120cm
120–170cm
170cm +

Weight*

Under 60kg
60–80kg
80–100kg
100kg +

Riding Experience*

Experienced (excellent horse control and capable of a quick canter)
Moderate Experience (moderate horse control and can rise to the trot comfortably)
Inexperienced (minimal horse control learning or want to try to do a seated trot)
Novice (never ridden)

Agreement

Ride Type*

I understand this ride has trotting

Terms & Conditions*

I understand and accept the information below.*

TERMS & CONDITIONS

I understand all rides are supervised by staff at The Ranch. I will listen to and heed all directions prior to and during the ride. I further acknowledge that I MUST wear an approved riding helmet and boots with a heel at all times.

I understand a horse is a large, heavy herd animal, a creature of flight that can react without warning. A horse has highly developed senses of hearing, sight and smell which can make its behavior towards sounds, sudden movement, unfamiliar objects, people or other animals, unpredictable and potentially harmful to the rider.

A horse can (without limitation) bite, buck, bolt, fall, kick, pig-root, rear, roll, shy, stumble or stand on you whilst in their surrounds (the Risks). The Risks are greatly increased when more than one horse is handled or ridden at the same time, and when riders and handlers have different levels of skill and experience.

I am aware of the Risks I will be exposed to by riding and/or handling a horse including the possibility of death, physical or mental injury even if I act safely and wear an approved riding helmet and heeled boots.

I, the Rider freely, without any inducement or coercion whatsoever, accept and undertake the Risks by riding and/or handling a horse in connection with activities conducted by Bass Strait Views Pty Ltd ACN 068 766 156 trading as The Ranch (the Provider).

LIMITATION OF LIABILITY

In consideration of being permitted to participate in the Provider’s horse related activities, the Rider acknowledges and agrees as follows:

that participating in the horse related activities operated by the Provider constitutes “recreational services” because there is:
(a) a significant degree of physical exertion or physical risk; and
(b) is undertaken by the Rider for the purposes of recreation, enjoyment or leisure

to the maximum extent permissible by law, the Provider is not liable for the Rider’s death, physical or mental injury and disease as permitted under the Australian Consumer Law and Fair Trading Act 2012 that relates to the following guarantees:
(a) to provide the services with due care and skill;
(b) that the services will be reasonably fit for the purposes for which the services are provided; and
(c) that the services will be of such a nature, quality, state or condition that they might reasonably be expected to achieve their purpose.

to the maximum extent permissible by law, the Provider is not liable for negligence under common law or statute whatever the cause.

WARNING UNDER THE AUSTRALIAN CONSUMER LAW AND FAIR TRADING ACT 2012

Under the Australian Consumer Law (Victoria), several statutory guarantees apply to the supply of certain goods and service. These guarantees mean that the supplier named on this form is required to ensure that the recreational services it supplies to you-

are rendered with due care and skill; and

are reasonably fit for any purpose which you, either expressly or by implication, make known to the supplier; and

might reasonably be expected to achieve any result you have made known to the supplier.

Under section 22 of the Australian Consumer Law and Fair Trading Act 2012, the supplier is entitled to ask you to agree that these statutory guarantees do not apply to you. If you sign this form, you will be agreeing that your rights to sue the supplier under the Australian Consumer Law and Fair Trading Act 2012 if you are killed or injured because the services provided were not in accordance with these guarantees, are excluded, restricted or modified in the way set out in this form.

NOTE: The change to your rights, as set out in this form, does not apply if your death or injury is due to gross negligence on the supplier’s part. “Gross” negligence, in relation to an act or omission, means doing the act or omitting to do an act with reckless disregard, with or without consciousness, for the consequences of the act or omission. See regulation 5 of the Australian Consumer Law and Fair Trading Regulations 2012 and section 22(3)(b) of the Australian Consumer Law and Fair Trading Act 2012.

All the information I have provided is true and correct. I understand and accept the responsibilities and dangers of horse riding.

THE RIDER UNDERSTANDS THAT BY SIGNING THIS AGREEMENT, IMPORTANT LEGAL RIGHTS ARE LOST

Riders Signature*

Parent/Guardian Name*

Parent/Guardian Signature*