for the year ended 31 December 2023  
     
  Membership Type Friend of the AEC Membership  
     
  Member's Name    
  Surname  
  Given Names  
  Date of Birth(if under 18)  
  Parent/Guardian Name (if Member under 18 years)  
  Surname  
  Given Names  
       
  Contact Details    
  Address 1  
  Address 2  
  Suburb  
  Postcode  
  Mobile Phone  
  Home Phone  
  Work Phone  
  Email  
     
I hereby agree to abide by the Constitution, Policies and the Rules and Regulations 
of the Albany Equestrian Centre Association.
  Fees Due:    
  Friend of the A.E.C. Membership  
  Membership Discount  
  Total Fees Due  
       
  Your Membership will not be accepted without payment of the above fee, and expires on 31 December  
       
  Direct Transfer    
  Account Name Albany Equestrian Centre Inc  
  BSB 633-000  
  Account Number 143-217-743  
       
  Payment Receipt Details    
  Date  
  Amount  
  Receipt Number  
  Reference  
Horse Sports are a Dangerous Activity
I understand that by submission  of this application form, I state that I have read and understand this Declaration, full particulars of which are available on the A.E.C. website at:
  www.albanyequestrian.net/Waiver%20-%20Events%20-%2022%20Dec  
 (including the risk warning, indemnity, release and waiver) and agree to the terms and conditions as stated.
  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.
 
  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/activities in which I participate.  
  I agree that I PARTICIPATE at my OWN RISK.  
  Name  
  Date  
     
  Third party indemnity where participant is under 18 years of age  
  I,  
  being the parent/guardian of the nominated Member, hereby acknowledge through the submission of this allication form:  
  ·         I have read the whole of this document and understand it.  
  ·         I consent to the Member participating in the Equestrian Activity.  
  ·         I am aware of the risks, dangers and obligations set out in the E.A. Waiver of Events (2022) document.  
  ·         I acknowledge that the Rider is bound by and subject to the rules, regulations, guidelines, policies and codes of conduct of EA and the Albany Equestrian Centre.  
  In consideration of the nominated Member being accepted as a Member I hereby indemnify and release the Organiser/s and the Associate/s in the same manner and to the same effect as if I was the Member and agree to personally accept all terms and conditions and obligations set out in this declaration.  
  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.
 
  AGREEMENT ON BEHALF OF ONE PARENT OR GUARDIAN IS AGREEMENT ON BEHALF OF ALL PARENTS AND/OR GUARDIANS OF THE RIDER.  
  Parent/Guardian  
  Date