AEC-2024-Unofficial Dressage Competition-Entry Form

Unofficial Dressage Competition

Sunday, 19 May 2024

Entry Form

Entries Close:

(Late entries may be accepted)

Rider Details

Rider Name

Address

Suburb/City

PostCode

Mobile Phone

Rider Club

Rider Category:

Guardian (if rider under 18-years)

Horse/Pony Details

Horse Name

Emergency Contact at Event:

Name

Mobile Phone

Helper Duties

Helper Name

Helper Duty Preference

Classes: To enter please indicate 'X' alongside the particular test

Led or First Ridden Preparatory 1

Led or First Ridden Preparatory 2

Preparatory 1

Preparatory 2

Preliminary 1.1

Preliminary 1.2

Novice 2.1

Novice 2.2

Elementary 3.1

Elementary 3.2

Medium 4.1

Medium 4.2

Camping?

Yes

Fees

Tests: Number of Tests

Entry Fees ($25/first test; $20 all other tests)

Ground Fees

No ground fees for this event

AEC Day Membership ($10)

Late Entry Fee ($15/horse)

Helper Fee ($25 if no helper duty indicated)

Total Fees:

Your Entry will not be accepted without payment of the above fee

Direct Transfer

Account Name

Albany Equestrian Centre Inc

BSB

633-000

Account Number

143217743

Payment Receipt Details

Date

Amount

Receipt Number

Reference

Dangerous Activity Acknowledgement - Entrant Declaration

Horse Sports are a Dangerous Activity

I agree to participate in the Albany Equestrian Centre Unofficial Dressage Day to be held on 19 May 2024

I understand that by submission of this entry form, I state that I have read and understand this Entrant 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 to riders.

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.

Name

Date

My Emergency Contact for the activity

and they can be contacted on:

Third party indemnity where participant is under 18 years of age

being the parent/guardian of the Rider, hereby acknowledge through the submission of this entry form:

· I have read the whole of this document and understand it.

· I consent to the Rider participating in the Equestrian Activity.

· I am aware of the risks, dangers and obligations set out in the E.A. Waiver of Events (2022) document.

· I acknowledge that the Rider is bound by and subject to the rules, regulations, guidelines, policies and codes of conduct of EA and the Albany Equestrian Centre.

In consideration of the Rider being accepted as a participant in the Equestrian Activity I hereby indemnify and release the Organiser/s and the Associate/s in the same manner and to the same effect as if I was the Rider and agree to personally accept all terms and conditions and obligations set out in this declaration.

AGREEMENT ON BEHALF OF ONE PARENT OR GUARDIAN IS AGREEMENT ON BEHALF OF ALL PARENTS AND/OR GUARDIANS OF THE RIDER.

Parent/Guardian

Date