Albany Equestrian Centre Showjumping Day    
  Sunday, 13 February 2022    
  Entry Form    
  (Separate Entry for Each Horse)    
  (Closing Date:  9 February 2022)    
  Rider Details      
  Rider Name    
  Mobile Phone    
  Rider Club
  Rider Age Category:
  Guardian (if rider 16-yrs & Under)      
  Horse/Pony Details      
  Horse Name    
  Owner (if not Rider)    
  Emergency Contact at Event:      
  Mobile Phone    
  Helper Duties    
  Helper Name    
  First Preference
  Second Preference
  Helper Experience
  Helper Age
  Entry Fees    
  Camping Fees ($5.00/Night)      
  Number of Nights    
  Camping Fee    
  Late Entry Fee ($10)    
  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      
  Receipt Number    
  Dangerous Activity Acknowledgement      
  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 Entry Form constitutes    
   a complete and  unconditional release of the Equestrian Federation of      
Australia Ltd including all of its state bodies, coaches and Albany Equestrian
  Centre Inc, to the greatest extent allowed by law  in the event of me and/or     
  the children under my care, suffering injury or death.    
  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.
  By submitting this Entry Form,  I ACCEPT and  confirm I have    
  read and understood the  contents of this disclaimer.