The Learn to Ride Assessment Coordinator (or Host) is the individual legally responsible for the assessment.
Please list each candidates full name and rider levels they are challenging. Separate candidates with a comma.
Ex.
John Smith - Level 6, Jane Doe - Level 8, Ben Dover- Level 2
I understand that a $25 fee per certificate is required for each candidate listed in this application. I will list the full names of all candidates being tested in the space provided above and ensure that the total payment submitted through this form matches the number of candidates listed.
Example: 3 candidates listed = $75 total payment.
I agree that as the host conducting assessments, I will ensure to provide safe facilities, have an emergency action plan in place, and have valid liability insurance and agree to accept full responsibility for this assessment.
I agree that by submitting this application, I am electronically signing the application. I, the undersigned, solemnly declare that the information I have provided is true to the best of my knowledge.
I understand that all fees submitted with this application are non-refundable, regardless of changes or cancellations related to the assessment.
Please type the name of the undersigning party for the following acknowledgements
Total payment must match the number of candidates listed above.
FEES ARE NON-REFUNDABLE.
