top of page

Participant Application Form

RDA Application Information

RDA Group Name - Broadlands Equine Therapy & RDA

Charity Number - 117098

Group Contact Name - Paige Parsons

Contact Address - Lower Paice Lane, Medstead, GU34 5PX

Contact Email Address - office@broadlandsgrouprda.org.uk

Contact Telephone Number - 01420 375767

All information provided on this form will remain strictly confidential, for use by relevant RDA personnel only, in compliance with the statutory requirements of the Data Protection Act 2018. It will be used to help us to understand any specific needs you may have and to support you. We will also use this information to contact you in relation to your activities with RDA - this may include sending you important information about your involvement in your RDA Group, or any other activities you may take part in within RDA.

Part 1 - Your Details (Participant)

DOB
Do you have previous RDA Experience
Yes
No
Are you joining us from a school. college, group or similar?
Yes
No
Preferred Days

Part 2 - Specific information about you

Please note that the applicant’s height and weight details will be used discreetly by the group’s coach, to assess the suitability of available horses or ponies. Applicant’s height and weight may be reviewed periodically.

Part 3 - Additional Information

Please tick all that apply

PARTICIPANT IN EDUCATION

Part 4 - Declaration

·       I wish to apply to join an RDA Group as a participant, and confirm that all details given on this form are true and accurate, to the best of my knowledge

·       I agree that should the RDA Coach require additional information on my medical condition at any time, I will provide what is needed and will be willing to obtain a medical report from a medical professional, if necessary, who is familiar with my condition/s. I understand that I may be required to pay a fee for such a report.

·       I confirm that I will notify RDA immediately if any of the details or information provided on this form should change in any way

·       I recognise that this activity involves risk, and that I, the participant, must take all reasonable precautions and follow all advice properly given, at all times

·       I understand that horses and ponies, by nature, are unpredictable and as such they may react to a situation or to the local environment in such a way that the rider/ vaulter/ carriage driver may be unseated by accident

In the absence of any negligence on the part of the RDA Group or RDA UK, I fully understand and accept that no liability will attach to either party.

I give my consent to photographs or videos of me being taken during RDA activities for training and/or publicity (including, but not limited to, websites, social media, newsletters and marketing materials for the RDA Group and RDA UK). I give this consent
Yes
No
Would you like to stay updated with news via our Pony Express Newsletter?
Yes
No

If you are under 18 this form must also be signed by a parent or guardian.

The information provided on this form will only be used for the purposes stated above in relation to RDA volunteering activities.

bottom of page