Learn to Ride Host Application Form

Host Information

Host Name(Required)

First Last

Host Email(Required)

Enter Email Confirm Email

Facility Name(Required)

Date of Evaluation(Required)

Facility Location(Required)

City/Town Province

Evaluator Information

Evaluator Name(Required)

First Last

Evaluator Email(Required)

Enter Email Confirm Email

OE Membership #(Required)

NCCP #(Required)

Second Evaluator Name (If applicable)

First Last

Second Evaluator Email (If applicable)

Enter Email Confirm Email

Second OE Membership # (If applicable)

Second NCCP # (If applicable)

Candidate Details

Number of Riders Evaluated(Required)

Please select the appropriate number of riders, as this will calculate your amount owing to OE. Note: At this time we are only able to process a maximum of 10 riders at a time. To submit more then 10 riders, please complete this form again.

Rider 1

Rider 1 Name(Required)

First Last

Rider 1 Email(Required)

Enter Email Confirm Email

Rider 1 OE Number(Required)

Rider 1 Coach Name(Required)

Discipline(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

Drive Level Evaluated(Required)

Rider 2

Rider 2 Name(Required)

First Last

Rider 2 Email(Required)

Enter Email Confirm Email

Rider 2 OE Number(Required)

Rider 2 Coach Name(Required)

Discipline(Required)

Drive Level Evaluated(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

Rider 3

Rider 3 Name(Required)

First Last

Rider 3 Email(Required)

Enter Email Confirm Email

Rider 3 OE Number(Required)

Rider 3 Coach Name(Required)

Discipline(Required)

Drive Level Evaluated(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

Rider 4

Rider 4 Name(Required)

First Last

Rider 4 Email(Required)

Enter Email Confirm Email

Rider 4 OE Number(Required)

Rider 4 Coach Name(Required)

Discipline(Required)

Drive Level Evaluated(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

Rider 5

Rider 5 Name(Required)

First Last

Rider 5 Email(Required)

Enter Email Confirm Email

Rider 5 OE Number(Required)

Rider 5 Coach Name(Required)

Discipline(Required)

Drive Level Evaluated(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

Rider 6

Rider 6 Name(Required)

First Last

Rider 6 Email(Required)

Enter Email Confirm Email

Rider 6 OE Number(Required)

Rider 6 Coach Name(Required)

Discipline(Required)

Drive Level Evaluated(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

Rider 7

Rider 7 Name(Required)

First Last

Rider 7 Email(Required)

Enter Email Confirm Email

Rider 7 OE Number(Required)

Rider 7 Coach Name(Required)

Discipline(Required)

Drive Level Evaluated(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

Rider 8

Rider 8 Name(Required)

First Last

Rider 8 Email(Required)

Enter Email Confirm Email

Rider 8 OE Number(Required)

Rider 8 Coach Name(Required)

Discipline(Required)

Drive Level Evaluated(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

Rider 9

Rider 9 Name(Required)

First Last

Rider 9 Email(Required)

Enter Email Confirm Email

Rider 9 OE Number(Required)

Rider 9 Coach Name(Required)

Discipline(Required)

Drive Level Evaluated(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

Rider 10

Rider 10 Name(Required)

First Last

Rider 10 Email(Required)

Enter Email Confirm Email

Rider 10 OE Number(Required)

Rider 10 Coach Name(Required)

Discipline(Required)

Drive Level Evaluated(Required)

English Level Evaluated(Required)

Western Level Evaluated(Required)

OE Acknowledgment of Risk and Release of Liability(Required)

Every Person must Read and Understand this form before Participating in Equine Activities

TO: ONTARIO EQUESTRIAN AND EQUESTRIAN CANADA their directors, employees, officers, volunteers, business operators, and site property owners. (all of them collectively called the HOST)

I Understand there are Inherent DANGERS, HAZARDS and RISKS, (collectively called RISKS) associated with Equine Activities and injuries resulting from these “RISKS” are a common occurrence.

I Acknowledge that the Inherent “RISKS” of Equine Activities mean those DANGEROUS conditions which are an integral part of Equine Activities, including but not limited to:
• The propensity of any equine to behave in ways that might result in injury, harm or death to persons on or around them and to potentially collide with, bite or kick other animals, people, or objects.
• The unpredictability of an equine’s reaction to such things as sounds, sudden movement, tremors, vibrations, unfamiliar objects, persons or other animals and hazards such as subsurface objects.
• The potential for other participant (s) to act in a negligent manner that might contribute to injury to themselves or others, such as failing to act within their ability or to maintain control over an equine. _

I Freely Accept and Fully Assume All Responsibility for the Inherent “RISKS” and the possibility of personal injury, death, property damage or loss resulting from my Participation in Equine Activities.
I Acknowledge that it remains my Sole Responsibility to act in such a manner as to be responsible for my own safety and to Participate Within My Own Limits.

In addition to consideration given for my Participate in Equine Activity, I and my heirs, executors, administrators and assigns (collectively called my “Legal Representatives”) agree
• To Waive All Claims that I might have against the “HOST”; and
• To Release the “HOST” from Any and All Liability for any loss, damages, injury, or expense that I or my “Legal Representatives” might suffer as a result of my Participation due to any cause whatsoever including any NEGLIGENCE ON THE PART OF THE “HOST”; and
• To HOLD HARMLESS AND INDEMNIFY THE “HOST” from any and all liability for property damage or personal injury to any third party which might result from my Participation in Equine Activities. Before signing this form I read it (as indicated by my initials above) and I stated that I understand it. I know that signing this form, waives certain legal rights I or my “Legal Representatives” might have against the “HOST”.

I agree