|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
APPLICATION - AFFILIATED INSTRUCTOR
|
|
|
|
|
|
Term of Application
|
|
|
|
|
|
|
Applicant Details
|
|
|
|
Name
|
|
|
|
|
Address 1
|
|
|
|
Address 2
|
|
|
|
Suburb
|
|
|
|
Postcode
|
|
|
|
Email
|
|
|
|
Mobile Phone
|
|
|
|
|
|
|
|
Club Membership:
|
|
|
|
I am a member of the following Affiliated Club
(list main Club only):
|
|
|
|
|
|
|
Qualifications
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Background: Details to appear on A.E.C. Website
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
I hereby agree to abide by the Constitution,
Policies and the Rules and Regulations
|
|
|
|
|
|
of the Albany Equestrian Centre Inc, and I am aware
these are available on
|
|
|
|
|
|
the Centre's website
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
1 January - 31 December
|
|
|
|
|
|
|
Members
|
|
|
|
|
|
|
Non-Members
|
|
|
|
|
|
|
1 July - 31
December
|
|
|
|
|
|
|
Members
|
|
|
|
|
|
|
Non-Members
|
|
|
|
|
|
|
Total Fees Due
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Your Application will not be accepted without
payment of the above fee
|
|
|
|
|
|
|
|
|
|
|
|
|
Direct Transfer
|
|
|
|
|
|
|
Account Name
|
Albany Equestrian Centre Inc
|
|
|
|
|
|
BSB
|
633-000
|
|
|
|
|
|
Account Number
|
143217743
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
|
Horse Sports are a Dangerous Activity
|
|
|
|
|
|
I understand and acknowledge that horse sports are a
dangerous activity and
|
|
|
|
|
|
that horses can act in a sudden and unpredictable
way, especially if
|
|
|
|
|
|
frightened or
hurt.
|
|
|
|
|
|
I understand and acknowledge that serious INJURY or
DEATH may result from
|
|
|
|
|
|
horse
sport activities and in
particular from events in which I participate.
|
|
|
|
|
|
I agree that I PARTICIPATE at my OWN RISK.
|
|
|
Effect of this Document
|
|
|
I understand that submission of this Application for
Membership constitutes
|
|
|
a complete
and unconditional release of the
Equestrian Federation of
|
|
|
Australia Ltd including all of its state bodies,
coaches and Southern Districts
|
|
|
Dressage Club, to the greatest extent allowed by
law in the event of me and/or
|
|
|
the children under my care, suffering injury or
death.
|
|
|
By submitting this Membership application, I ACCEPT I confirm having
|
|
|
read and understood the contents of this disclaimer.
|
|
|
|
|
|
|
|
|
Should you wish to includea photograph on website,
email it to:
|
|
|
[email protected]
|
|