Scheduled Weekend Squad Dates for 2016:
May 21/22nd, June 4/5th, June 25/26th, July 9/10th and Aug 20/21st
Name:Address:
Date of Birth / Phone Number:
Membership Number: / Mobile Number
Email address
Who is your current instructor: Contact. No:
Name of horse/s and grading pointsIf any
1 . ( ) pts 2 ( ) pts
3 ( ) pts 4 ( )pts
List any clinics you have attended either as a participant or as an observer:
Your contribution of Jumping: please list the ways that you have contributed to jumping over the past year-
Please attach a List of your Performances achieved over each selection criteria listed below bothin the last twelve months together with Best ever performances . These performances can include EV events, Interschool events or Pony Club events.
1Aust Champs & World Cup Shows:
2Royals: (not including Summer Royal)
31.30m and above:
41.20m:
51.10m:
61.05m:
71m and below:
8Titles:
9Other relevant information of achievements or aims with your team of horses you would like the selectors to be aware of.
Attached is an Agreement that must be completed in order for this application to be considered.
Proposed Timeline
March 15th Applications close on March 15th
March 25th is the date by which Nina will have finalizedall applications being sent through to each member of the selecting panel.
April 1st-7th Selectors will meet and finalise their selections
Publication of final lists will be shortly after this date.
Contact for queries, etc.: Nina Lewis
JV Jumping Coordinator
Mobile: 0432077028
Email:
Conditions for Junior / Young Rider Squad Members
This must be returned!
Conditions are to be acknowledged by riders by signing and must be returned with application forms.
Please note: Riders who do not return the signed conditions will not be eligible for selectionto a squad.
1.I am a current financial member of EA and will ensure my membership is current at the commencement of training weekends
2.As a representative of the Jumping VictoriaJunior Young Rider Squads I am also an ambassador for Jumping Victoria and any sponsors that the squad may have and in doing so I will conduct myself in a positive and professional manner at all times. I will endeavour to show good sportsmanship and team spirit at all times.
4.As this is a Sport training weekend, appropriate standards must be set to protect the younger members of the group - No underage consumption of alcohol will be permitted at any time and there will be no consumption of alcohol by squad members of the legal age at the official Sat. night meal or guest speaker sessions.
5.I accept I am committed to financially pay a minimum amount of $800 for the training costs of this squad made up of four payments of $200 due 1st May, 1st June, 1st July and 1st August regardless of attendance to the training weekend.
6.I will endeavour to be of assistance to the organisers of my local shows to help my understanding of my sport.
- It is your(and your parents) responsibility to make yourselves aware of the FEI and EA National Jumping Rules.
- Riders 16 years and under must have adult supervisionwhile at the training venue. Parents accept they are still responsible at all times for the conduct of their children.
- Sponsors and media may require information about you. As the Privacy Act does not allow us to divulge this information without your permission, we would like you circle the relevant response to the following questions. If no circle is recorded, your signature below indicates it is agreed that your response is in the affirmative.
Yes / No I give my consent to the publication of any photographs or results to the media and sponsors
Yes / NoI consent to my email address being given to be used in mailing lists relevant to my sport.
(If you don’t give consent for your photo, it is your responsibility to remove yourself from any group photos when they are taken with the squad.)
I, ______(Name) do accept and will adhere to the above conditions;
Signature of rider: ______Date: ___/___/___
If rider is under 18yrs, this waiver must be signed by responsible parent or guardian
Signature of parent or guardian: ______Date: ___/___/___