Application Form

Your Name

Your Phone Number

Your Email

Your Sex

Your date of birth

How many people travelling in your group

Your Nationality

Your Home Address

Detail your other interests/hobbies

Are you in good health

Please provide details of any medical conditions, medications, allergies or dietary requirements

Holiday Options:

Please indicate your preference for one of the following Holiday dates

Please select one of the following options:

Please select one of the following accomodation options:

Transport to/from Dublin Airport required

Personal Details

What is your level of English?

Upper Intermediate - I can speak confidently and quickly with a few mistakes

For Horse Riders, which of the following are you competent at?

Riding at walkTrotting with stirrupsTrotting without stirrupsCanteringCan Jump to 70cmCan jump above 80cm

Your weight

Your height

Any additional information

Important information:

Emergency Contact Name

Relationship to Student

Emergency Phone number

Emergency email

Name of person making payment

Where did you hear about us?

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Please note that the information collected on this Application Form will be held in the strictest confidence and will not be shared with any third party.

By submitting this Application Form you agree that your personal data can be processed by Lakelands Language Equestrian School for the purposes set out above. All of your information will be handled in accordance with General Data Protection Regulation (GDPR).