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EA Membership No (if applicable)
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Riding History
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Riding years of experience
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Other Equestrian clubs or interests (previous or current)
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Horse's Name/s
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First Aid Information
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1. Any physical limitations or medical conditions e.g Asthma
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2. Any other relevant information concerning yourself e.g fainting, nose bleeds, long term therapy
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3. Any allergies you have e.g bee stings, penicillin (Please include any anaesthetic allergies)
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4. Have you had full Tetanus immunisation
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If yes, when
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5. Medicare Number
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6. Private Health Insurance
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If yes, Fund and number
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7. Ambulance Cover
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8. Family Doctor - Name
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Family Doctor Number
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Privacy Legislation - YVRC Member Approval
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Are you happy for the YVRC to supply your name and address details to any club, YVRC or EFA sponsors?
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YVRC
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EFA Sponsors
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Are you happy for the YVRC to publish your name or captioned photograph on the YVRC website, Facebook or other promotional materials?
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YVRC Website
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Facebook
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Other
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