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Albany Equestrian Centre Showjumping Day
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Sunday, 13 February 2022
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Entry Form
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(Separate Entry for Each Horse)
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(Closing Date:
9 February 2022)
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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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Guardian (if rider 16-yrs & Under)
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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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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 ($10)
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Helper Fee ($25
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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