West Plantagenet Pony Club  
Proudly presents  
   
     
     
Unofficial Dressage Day   
23rd February 2020  
Entry Form  
(Entries Close: 16 February 2020)  
     
Rider Details    
Rider Name  
Address  
   
Suburb/City  
PostCode  
Mobile Phone  
Email  
Membership Type
 
PCWA Member Number  
PCWA Open Rider number  
Age at 1/1/2020  
Guardian (if rider under 18-years)
     
Horse/Pony Details    
Horse Name  
Horse's Age  
     
Helper Duties  
Helper Name  
Job Preference
 
N.B. The only self-help jobs are set up Sat and set up Gazebos Sun morning  
(If unable to  self-help or supply a helper please pay $30)  
     
Classes: To enter please indicate  'X' alongside the particular test  
Preparatory A - Led Class (2013)  
Preparatory A (2013)  
Preparatory C (only for Prep Level) (2013)  
Preliminary 1A (2019)  
Novice 2A (2019)  
Elementary 3A (2019)  
Medium 4A (2019)  
Advanced 5A (2019)  
Prix Caprilli 2018  
     
"Off the Track" Award
 
OTT: Racing Name  
OTT: Brands/Microchip Number  
     
     
Lunch Order (Also available: Morning/Afternoon Teas & Drinks)  
     
Roast Beef & Salad Sandwich - $6  
Cost  
Roast Chicken & Salad Sandwich - $6  
Cost  
Sausage Sizzle - $4  
Cost  
Salad Box - $4  
Cost  
Total Cost  
     
Fees    
     
Tests: Number of Tests
Entry Fee @ $25.00 per test  
Ground Fee ($5.00/horse)  
Lunch Payment  
Helper Fee ($30 if no helper duty indicated)  
Total Fees:  
     
Your Entry will not be accepted without payment of the above fee
Direct Transfer
Account Name WPPC
BSB 633-000
Account Number 112370697
Reference "DD" & Surname  
     
Payment Receipt Details    
Date  
Amount  
Receipt Number  
     
     
Dangerous Activity Acknowledgement    
Horse Sports are a Dangerous Activity  
In consideration for being permitted to participate in any way in horse sport activities, I, the undersigned, understand, acknowledge and accept that:  Horse sports are a dangerous recreational activity and horses can act in a sudden and unpredictable (changeable) way, especially if frightened or hurt.  There is a significant risk that serious INJURY or DEATH may result from horse sport activities.  I knowingly and freely assume all such risks, both known and unknown, and I voluntarily PARTICIPATE at my OWN RISK and assume sole responsibility for any injury, death or property damage I may suffer that arises from my participation in horse sport activities.  I understand and acknowledge the dangers associated with the consumption of alcohol or take drugs prohibited by law before or during any horse sports activities.  I agree not to drink alcohol or take drugs prohibited by law before or during any horse sports activities.  I agree to follow the directions of any event organizer or official and that any misconduct or refusal by me to follow any direction of any organizer or official can result in the CANCELLATION of my participation in the activities and my immediate removal from my horse NO MATTER where that may occur.  I understand that any such non-compliance may result in injury, death and/or permanent disability as a result of my failure to comply.  I agree to wear a helmet at all times whilst riding and agree that I am solely responsible for ensuring that I wear a suitable helmet at all times whilst riding and take sole responsibility for my actions.  I have had sufficient opportunity to read this assumption of risk agreement, fully understand its terms and sign it freely and voluntarily.  
   
  Rider Name  
     
Parent/Guardian Acknowledgement (for riders under the age of 18-years)  
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.  
   
   
   
West Plantagenet Pony Club  
 
   
Unofficial Dressage Day   
Sunday, 23rd February 2020  
 Frost Oval, McDonald Avenue, Mt Barker  
 
Classes – Preparatory to Advanced level, Prix Caprilli, led, PCWA and Open  
Part of the PCWA  Dressage Leaderboard  
EA Competitor/Participant members on official horses are welcome to enter with a PCWA Open Riders public liability.
  
Part of the 3-Competition Challenge (Highest scorers in each level at 3 competitions)  
OTTWA sponsorship with 1st place $100 cash/prize/rosette and 2nd place $50 cash/prize/rosette for OTT.  
   
Championship rugs for PWA and Open classes  
(Sponsored by Southern Haulage Industries)  
 
Entries close - Sunday 16th February 2020  
WPPC, PO Box 564, Mt Barker WA 6324  
 
Enquiries - Angela Shepherd: [email protected]   
                                                                                               
   
Championship Prizes:  For the horse/rider combination entering 2 tests with the highest totalled score.  Age classes to be decided by the committee.  
3-Competition Challenge: Consisting of highest point scorers from Prep to Advanced over 3 events covering Mt Barker DD, "No Frills" and the Albany Show. Prizes awarded at Albany Show competition.  
OTTWA Prizes:  1st and 2nd prize awarded to the OTT thoroughbred or standardbred with highest totalled 2 tests at any level. Rider must supply horses racing name and microchip or brand with entry.  
   
Please Note:  
A horse may only be ridden for a total of 3 tests for the day.  A rider may only ride 2 horses for the day.  Horses must be 4 years of age.  A rider may only ride the 2 preparatory tests if not riding at the preliminary level.  
   
Get your entry in early as there are only 120 tests that can be ridden for the day.  Refunds will only be given after the draw (17th February 2020) with a vet or medical certificate.  
   
All open riders must have one of the following:  
1.   PCWA competition participant $61 with own alternate insurance like EA.  
2.   PCWA Open Rider $162 which includes insurance.    
Apply online on the PCWA website to become an Open Rider. Click on Participate and then Join & scroll down for Open Rider.  Pony club members (<25years of age) will    automatically be entered in the dressage series with PCWA.  Age as at 1st January 2020.  Pony club uniform to be worn as a PCWA event.  
   
EA Competitor and Participant members on official horses are also welcome to enter (at the level in which they are graded) with a PCWA Competition Participant insurance.  Open riders to wear neat attire (jacket).  
   
Tests ridden can be used to qualify for PCWA State Dressage Championships and EA Interschools.  
 
The Prix Caprilli jumps will be set at a lower height for the youngest age group.  No bandaging.  Plaiting required.  
 
The Prix Caprilli 2018 Test Sheet can be found on the PCWA website, click on Ride, then Dressage, then Test Sheets and scroll down to Prix Caprilli 2018 Test Sheet.  All other tests are available on on the EA website. Test sheets will be available for collection after the last test is ridden (please don’t ask, they can be mailed if requested).  
 
Great prizes for all classes.  
 
Many thanks to our generous sponsors:  
Southern Haulage Industries, Hillside Equestrian & OTTWA