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Rider Information Form
Rider Information
First name
Last name
Email
Phone
Birthday
Year
Month
Month
Day
Address
Parent/Guardian name (if under 18)
Emergency Contact
Emergency contact name
Relationship
Phone number
Health and Safety
Does the rider have any medical conditions, allergies or learning needs that the coach should be aware of?
Yes
No
If yes, please explain:
Has the rider ridden before?
Yes
No
If yes, please describe experience (disciplines, years of riding, etc.):
Goals
What are your riding goals (recreational, competitive, confidence building, fitness, etc.)?
Submit
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