Susanna Hurley’s Adult Camp 2017

At MK Eventing Centre, Castlethorpe Road, Hanslope, Milton Keynes, MK19 7HQ (

Mon 15th – Weds 17th May 2017

***Weekday Camp***

Training with Susanna Hurley BHS Int (SM) Regd.

Name of Rider ……………………………………………………………………………………………………......

Address ………………………………………………………………………………………………………………......

DOB ……………………………………Email …………………………………………………………

Contact numbers inc mobile ………………………………………………………………………………......

Emergency contact name & numbers ………………………………………………......

Medical conditions/medicines taken …………………………………………………………………......

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You will be camping in (please give reg number of vehicle)…………………………………… ......

**Visitors are welcome at camp by prior agreement, please notify me in advance of any visitors**

Dietary requirements/allergies etc ……………………………………………………………………………………………………………..

Horse Name ………………………………………………….Horse Age ……………………………

All current vaccinations up to date YES / NO **only horses with current up to date vaccinations will be allowed on site**

Details of Horses Insurers (company & policy number)…………………………………..………………………...... …………

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**Horses will require a minimum of Third Party Insurance to attend camp, any queries regarding level of insurance, please feel free to contact me for verification, BHS Gold Members will have sufficient cover**

Level Horse working at on flat, at present, W&T, Prelim, Novice, Elementary - please include lateral work & anything you would like to improve……………………………………………………………………………......

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Height jumping at home and competing (please list both XC & SJ if differing heights), any areas need working on (ditches/grids/jump off lines/fillers/etc)…......

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Aims/Ambitions for horse (short term or long term)……………………………………………………......

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Any Equine Medical condition/previous injury/ops etc …………………………………………………......

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About your horse in general, any overall issues/quirks/fears/vices or ‘special needs’……………………………………….

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2nd Horses, please complete above details on a separate sheet

Cost of camp £230.00 inc stabling, camping, tuition

Cost of camp including Hay/haylage £240.00

**please indicate whether hay/ haylage on site is required by circling the price above**

An early bird saving of £10 is available for all bookings made prior to 28/2/17 with form and deposit received.

Please find enclosed my deposit of £120 to secure a place, balance (inc additional £10 hay) to be paid at camp. I agree that neither the organisers, Susanna Hurley or venue accept responsibility for any accident, injury, loss or illness to horse, rider, spectator or property while present at this event.

I confirm I have my own Public Liability/Third Party insurance or I am a BHS gold member.

Signed Date

Name in full

Form to be posted to; Miss S Hurley, 17 Crittall Court, Braintree Road, Witham, Essex, CM8 2GD

Transfer or cheque are accepted for deposit, cheques payable to ‘S Hurley Riding Instructor’, account details supplied upon request.