Carrington Riding Centre

Staff Registration Form

Employee Name*
Job Title*
Start Date*
Address*
Postcode*
Date of Birth*
Home Telephone Number
Mobile Telephone Number*
Email*
National Insurance Number*
How many times have you ridden in the last 12 months?
- 0
- 1-12
- 13-40
- More than 40
Height
Weight
Medical Conditions or Previous Serious Injury
Ethnicity
Emergency Contacts
Contact 1 Name*
Contact 1 Address*
Contact 1 Telephone Number
Contact 1 Mobile Telephone Number*
Contact 1 Relationship*
Contact 2 Name
Contact 2 Address
Contact 2 Telephone Number
Contact 2 Mobile Telephone Number
Contact 2 Relationship
Health and Sickness
Dates and Details of any boosters due during employment period
Detail any periods of sickness
Please detail the nature of any illness and dates from / to
Experience
Qualifications and dates obtained
Please include First Aid, Safeguarding and DBS Information where applicable
Previous Horse Related Experience
Including Riding School Teaching, Own Horses, Working with challenging behaviour students, and Dog related experience
Payment Details
Name on Account
Sort Code
Account Number
Data Protection Act 2018: Statement: I understand that the information I have given will be held in accordance with the Data Protection Act 2018 but may also be made available to Insurers and other concerned parties in the event of any injury or accident.*
Carrington Riding Centre's Privacy Policy can be found here
- I agree