New Rider Application New Rider Survey Step 1 of 5 20% Name(Required) First Last Age(Required)Date of Birth(Required) MM slash DD slash YYYY Is rider under the age of 18?(Required) Yes No Parent/Guardian Name (If rider is under 18)(Required) First Last Parent/Guardian Phone Number(Required)Parent/Guardian Email(Required) Emergency Contact Name(Required) First Last Emergency Contact Phone Number(Required)Emergency Contact Relation(Required)Riding BackgroundHas the rider taken riding lessons before?(Required) Yes No How long did they ride and where?(Required)Please describe the rider's past experience (check all that apply)(Required) First time rider Walk only Walk/Trot Comfortable on trails Has ridden lesson horses Has leased a horse Has owned a horse Has taken a break from riding (explain below) If the rider took a break from riding, how long was the break and why?(Required)Does the rider have experience in any specific discipline?(Required) Western English Dressage Hunt Seat Saddle Seat Eventing Jumping Not Sure Other Other(Required) Rider Self-AssessmentWhat level does the rider believe they are?(Required) Beginner Advanced Beginner Intermediate Strong Intermediate Unsure How confident is the rider around horses?(Required) Very confident Somewhat confident Nervous but willing Very nervous I'm not sure Please list three riding goals the rider hopes to accomplish in the next 6–12 monthsGoal 1(Required)Goal 2(Required)Goal 3(Required)What type of lesson environment does the rider enjoy?(Required) Structure and disciplined Friendly but focused Relaxed and slow paced Competitive and goal-oriented Not sure Showing & Future AmbitionsHas the rider shown before?(Required) Yes No If yes, what show level(s)?(Required) In-barn shows Schooling shows Local day shows Breed shows Class “A” Regionals Nationals Other Other(Required)If the rider has not shown before, are they interested in showing in the future?(Required) Yes, very interested Possibly Not at this time No Membership & Leasing InterestWhistlejacket Academy is a membership-based program. Are you interested in becoming a member?(Required) Yes Possibly I need more information No Would you be interested in leasing a horse in the future?(Required) Yes, a quarter lease Yes, a half lease Possibly No Not sure what leasing means If yes or possibly, what interests you about leasing?(Required)Rider Safety & ReadinessDoes the rider have any medical conditions that may be relevant to riding or handling horses?(Required) Yes No Prefer to disclose privately later If yes, explain if comfortable(Required)Can the rider follow detailed instructions from adults without resistance?(Required) Always Usually Sometimes Rarely Does the rider handle correction or redirection well?(Required) Yes Sometimes No Unsure Is the rider able to maintain a respectful attitude toward instructors and horses?(Required) Yes Usually Sometimes No Note: Whistlejacket Farm has a zero-tolerance policy for disrespectful behavior toward instructors, assistants, or horses Family Readiness & CommitmentAre you prepared to arrive on time and consistently for scheduled lessons?(Required) Yes No Unsure Are you aware that Whistlejacket Farm maintains a strict 24-hour cancellation policy and no-refund policy?(Required) Yes No I need clarification Do you understand that parents must remain on site for a rider’s first lesson evaluation (and supervise siblings at all times)?(Required) Yes No How committed is your family to the rider’s long-term growth and consistent attendance?(Required) Very committed Somewhat committed Not sure We are exploring and not ready for commitment yet Are you primarily looking for:(Required) A long-term structured program Occasional recreational riding Summer-only riding A competitive show-track environment Unsure How did you hear about Whistlejacket Farm?(Required) Final NotesIs there anything else we should know about the rider or your goals?Do you have any concerns or questions you would like addressed before scheduling an evaluation? Δ
