Minis

         Your details:

Name	Age 4 5 6 7 8 9 10 11
Horse or Pony Name	Height > 10 hh 10 hh 10.1 hh 10.2 hh 10.3 hh 11 hh 11.1 hh 11.2 hh 11.3 hh 12 h 12.1 hh 12.2 hh 12.3 hh 13 hh 13.1 hh 13.2 hh 13.3 hh 14 hh 14.1 hh 14.2 hh 14.3 hh 15 hh 15.1 hh 15.2 hh 15.3 hh 16 hh 16.1 hh 16.2 hh 16.3 hh 17 hh < 17 hh Age 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31
Address
Postcode
Telephone Number (Home)	Mobile

email address

Experience of Rider and Horse/Pony: Briefly outline of relevant levels of experience
On or off lead rein	On  Off

Please Select the relevant boxes:
Walk	Nervous  Able   Competent

Trot	Nervous  Able   Competent
Canter	Nervous  Able   Competent
Gallop	Nervous  Able   Competent
Jump 1ft	Nervous  Able   Competent
Jump 2ft	Nervous  Able   Competent
Coloured Fences	Nervous  Able   Competent
Working Hunter Fences	Nervous  Able   Competent
Cross Country Fences	Nervous  Able   Competent

Any additional information we may need:
Please state any medical conditions or allergies to this member and state any current medications