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"Albany
Horseworld"
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Albany Equestrian
Centre Eventing Grand Prix
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Sunday, 22 August
2021
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Entry Form
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(Separate Entry for
Each Horse)
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(Closing Date: 16 August 2021)
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Class
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Rider Details
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Rider Name
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Address
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Suburb/City
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PostCode
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Mobile Phone
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Email
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Rider Club
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Rider Age Category:
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Horse/Pony Details
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Horse Name
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Owner (if not
Rider)
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Stallion:
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Emergency Contact at Event:
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Name
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Mobile Phone
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Helper Duties
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Helper
Name
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First Preference
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Second
Preference
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Helper
Experience
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Helper Age
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Helper
Duty - Special Request
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Fees
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Entry Fees
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Camping Fees
($5.00/Night)
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Number of Nights
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Camping Fee
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Late Entry Fee ($15)
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Helper Fee ($35 if no helper duty indicated)
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Total Fees:
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Your Entry will
not be accepted without payment of the above fee
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Direct Transfer
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Account Name
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Albany Equestrian Centre Inc
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BSB
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633-000
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Account Number
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143217743
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Payment Receipt Details
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Date
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Amount
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Receipt
Number
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Dangerous Activity
Acknowledgement
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Horse Sports are a Dangerous Activity
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I understand and acknowledge that horse sports are a dangerous
activity and
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that horses can act in a sudden and unpredictable way,
especially if
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frightened or hurt.
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I understand and acknowledge that serious INJURY or DEATH may
result from
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horse sport activities and in particular from events in
which I participate.
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I agree that I PARTICIPATE at my OWN RISK.
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Effect of this Document
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I understand that submission of this Entry Form constitutes
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a complete and unconditional release of the Equestrian
Federation of
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Australia Ltd including all of its state bodies, coaches and
Albany Equestrian
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Centre Inc, to the greatest extent allowed by law in the event of me and/or
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the children under my care, suffering injury or death.
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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.
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By submitting this Entry Form,
I ACCEPT and confirm I have
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read and understood the
contents of this disclaimer.
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