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Unofficial Dressage Day
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Sunday, 12 March 2023
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Entry Form
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(Entries Close:
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No Late Entries Accepted
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(Separate Entry for Each Horse)
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Rider Details
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Rider Name
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A.H.A. Member Number
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Mobile Phone
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Email
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Rider Age Category
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Guardian (if rider under 18-years)
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Horse/Pony Details
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Horse Name
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Horse's Age
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Helper Duties
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Helper duties are
compulsory. NO
HELP, NO RIDE!
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Helper Name
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First Preference
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Second Preference
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Classes: To enter please complete below
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Test 1
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Test 2
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Fees
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No. of Tests
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Entry Fee: $20 per test
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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 Horsemen's Association
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BSB
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066-500
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Account Number
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0080 0052
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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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Reference
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Dangerous
Activity Acknowledgement - Release & Waiver of Liability
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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 (changeable) 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 from events in which I participate.
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I agree that
I PARTICIPATE at my OWN RISK.
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I UNDERSTAND
AND ACKNOWLEDGE THE DANGERS RESULTING FROM THE
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CONSUMPTION
OF ALCOHOL OR ANY MIND-ALTERING DRUGS WHILE
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RIDING AND I
TAKE FULL RESPONSIBILITY FOR ANY INJURY, LOSS OR DAMAGE
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ASSOCIATED
WITH THEIR CONSUMPTION.
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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 all liability of
the Equestrian Federation
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of Australia
Ltd including all of its state bodies, coaches and Albany
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Horsemans
Association Inc, to the greatest extent allowed by law in the event
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of me
and/or the children under my care,
suffering injury or death.
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By
submitting this Entry Form, I ACCEPT I
confirm having
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read and
understood the contents of this
disclaimer.
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Parent/Guardian
Acknowledgement (for riders under the age of 18-years)
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This is to certify that I, as a Parent/guardian with legal
responsibility for this participant, acknowledge, understand and accept ALL
OF THE ABOVE and consent and agree to my minor child’s involvement or
participation in horse sport activities.
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