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Unofficial Dressage
Day
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Saturday, 9
October 2021
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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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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
for first test; $15 for subsequent tests
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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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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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Rider Name
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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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