Learn to Ride/Drive – Rider Application – Alberta Equestrian Federation

Date of Asssessment

Name of Coach

First

Last

Name of Assessor

First

Last

Rider's Name

First

Last

Email

Phone

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Date of Birth

Is the Rider over the age of 18?

Discipline

PTSO

PTSO Membership #

Rider Acknowledgement

I understand that my Instructor/Coach needs to submit the Recommendation of Equestrians form in order for me to be evaluated.
I confirm that I have reviewed with my instructor/coach the skills required at this level and are satisfied that the equestrian is mentally and physically able to complete all phases. The equestrian is responsible for his or her own equipment and safety thereof.
I agree that by submitting this application, I am electronically signing the application. I, the undersigned, solemnly declare that the information I have provided is true to the best of my knowledge.

Signature

Clear Signature

Name Parent/Guardian Acknowledgement

Parent/Guardian Acknowledgement

I understand that the rider’s Instructor/Coach needs to submit the Recommendation of Equestrians form in order for them to be evaluated.
I confirm that I have reviewed with the rider’s instructor/coach the skills required at this level and are satisfied that the equestrian is mentally and physically able to complete all phases. The equestrian is responsible for his or her own equipment and safety thereof.
I agree that by submitting this application, I am electronically signing the application. I, the undersigned, solemnly declare that the information I have provided is true to the best of my knowledge.

Parent/Guardian Name

First

Last

Parent/Guardian Signature

Clear Signature