N.T.E.C. ENTRY FORM To be used from 1st August, 2014
EVENT NAME: LPPC/NTEC ODE – Trevallyn Reserve / DATE: 23 / 11 / 14
NAME: / Entries Close: 13th November 2014
ADDRESS:
Home phone: / Email: / Mobile phone:
RIDER EA Number (EVA 80 & Above):
TEA No: / Age in years (If junior):
CLASS / HORSES NAME / HORSES EA No. / ENTRY FEE

EVA 95 AND ABOVE

I am currently, and will be, at the time of competing, a financial member of EA & TEA (NTEC, STEA, or NWEA). The owners of all registered horses entered, are currently, and will be at the time of competing, financial members of the EA. The horse is currently registered with EA and has a current EA Eventing License

EVA 80

I am currently, and will be at the time of competing, at least a PARTICPANT financial member of EA & a financial member of TEA (NTEC, STEA, or NWEA)

EVA 65 and EVA 50

I am at least a current financial member of TEA (NTEC, STEA, or NWEA).

TO BE COMPLETED BY ALL RIDERS

I have read and understand the National Eventing Rules and both I and the horse are qualified for the class entered above.

(For clarification of the rules please refer to the 1st January 2014 EA National Rulebook)

Release and Waiver of Liability

Horse Sports are a Dangerous Activity

I understand and acknowledge that horse sports are a dangerous activity and that horses can act in a sudden and unpredictable (changeable) 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 in which I participate. I agree that I PARTICIPATE at my OWN RISK.

I agree not to drink alcohol or take drugs prohibited by law before or during competition.

Effect of this Document

I understand that my signature to this document constitutes a complete and unconditional release of all liability to Equestrian Australia Ltd including all of its state bodies, coaches and affiliated clubs, to the greatest extent allowed by law in the event of me and/or the children under my care, suffering injury or death.

I acknowledge the information provided on this form is correct and in doing so also acknowledge the terms of the waiver.

For family membership all members must sign the waiver.

Date:…../……./……Name…………..………………….Signature of competitor/guardian…………………

Event Assistance

Riders are asked to assist or provide a helper for the events to go ahead. Riders who do not offer assistance will be required to pay double entry fees. Details of each job are outlined in the club handbook. Please indicate below how you are able to assist. Please contact the committee or event secretary if you have any questions.

Assistance/Job / Date/Time / Please Select
Helper: (Please circle preferred job)
Fence Judge / Marshalling /
XC starter or finisher / scoring helper /
SJ Penciller / Dressage Penciller / On the day / Name:
Mob:
Pre – Event Working Bee / 16th Nov @ 9am
Pre-flagging of XC course / 22nd Nov @ 2pm
Dismantling of Dressage arenas: / On the day / COMPULSORY FOR ALL TEA RIDERS
Setup and dismantling of SJ: / On the day / COMPULSORY FOR ALL TEA RIDERS
Towing of club trailers: (please circle) / Deliver / Pickup / Dressage Trailer / Caravan
Set-up of NTEC Dressage Arenas: / 23rd Nov 7.30am

Entry Fees

Grade / Entry Fee / Entry Fee
EVA 105 Test EA 2.1 1.05cm / $30.00
EVA 95 Test 1.3 95cm / $25.00
EVA 80 Test 1.2 80cm / $25.00
EVA 65 Test 1.1 65cm / $25.00
Double Entry Fee (If unable to assist)
TEA Levy (Compulsory fee per horse) / $10
Equipment Levy (per rider) / $9
Total

MAIL TO:The Event SecretaryEvent Co-coordinator: Bec Evans

C/o Leonie BlackwellMob: 0407 736 007

23 Beefeater St. Email:

Deloraine 7304

Email:

Mob: 0417 322 105

ENTRIES CLOSE: 10 Days before the competition. (No late entries or cash accepted).

Please send SSAE with your entry if you do not have email for your draw details. Withdrawals and scratching’s to the Event Secretary Ph 0417 322 105. Vet/Medical Certificate will be required for refunds, less club administration fee of 10% of the entry fee.

Please Note: Prize money will only be offered pending entries in each class at the committee’s discretion.