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 that by submission  of this application form, I state that I have read and understand this Declaration, full particulars of which are available on the A.E.C. website at:        
  www.albanyequestrian.net/Waiver%20-%20Events%20-%2022%20Dec        
   (including the risk warning, indemnity, release and waiver) and agree to the terms and conditions as stated.        
  I understand the Albany Equestrian Centre accepts no liability for the loss of, or damage to, vehicles, or any other goods or articles, and does not offer any personal insurance.
       
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/activities in which I participate.  
  I agree that I PARTICIPATE at my OWN RISK.  
  Name  
  Date  
     
  Should you wish to include a photograph on website, email it to:  
  [email protected]