World Class Podium Potential Programme

WORLD CLASS PODIUM POTENTIAL PROGRAMME

REGISTRATION FORM

Please complete this form to register that you wish to be considered for the World Class Podium Potential Programme. It is not necessary to have achieved minimum performance standards for the registration stage of the process.

This form must be completed in full, SIGNED and returned by Thursday 12th May 2016 to allow an athlete to be considered for any further stages of the selection process

It is advised that written forms are sent recorded delivery, those received electronically will receive an acknowledgement email.When completing the form electronically, please remember to save it as your own document and retain the email trail in case of query.

PLEASE COMPLETE ALL PAGES OF THE FORM IN BLOCK CAPITALS

For Office use only: / Received:
Discipline: / Membership Number:
Surname: / First Name(s):
Address:
Postcode:
Date of Birth: / Age: / Home no:
Email address: / Mobile No:
Horse Name(s): / Year of Birth: / Reg. Nos.
Horse Name(s): / Year of Birth: / Reg. Nos.
Horse Name(s): / Year of Birth: / Reg. Nos.
Horse Name(s): / Year of Birth: / Reg. Nos.

ALL REGISTRATION FORMS MUST BEFULLYCOMPLETED, SIGNEDAND RETURNEDBY 12 May 2016

INITIAL REGISTRATION FORMS ARE REQUIRED FOR AN ATHLETE TO CONTINUE WITH ANY STAGE OF THE SELECTION PROCESS

see WCP-PP Selection Policy 2016

Please return your completed application form to:

Lucy Phillips

World Class Programme

British Equestrian Federation

Abbey Park, Stareton, Kenilworth, Warwickshire CV8 2RH

E-mail:

Tel: 02476 698876

RIDER NAME: / Date of Birth: / Age: / DISCIPLINE:
PARA EQUESTRIAN ATHLETES ONLY MUST COMPLETE THIS SECTION
Name of your disability:
Your Classification (Grade): / Profile Number: / Do you have an FEI card:
What compensatory aids do you use, if any?
Are you on any medication? If so please list:
ALL ATHLETES MUST COMPLETE THIS SECTION
I confirm that the information given by me on this form is correct to the best of my knowledge. I also certify that I have read and understood the World Class Podium Potential Selection Policy 2016.
Signed (Athlete): / Print Athlete Name: / Date:
Signature of Witness: / Print Witness Name: / Date:
(or parent/guardian or person with parental responsibility if Athlete is under the age of 18) / Relationship to the Athlete:

Data Protection

The British Equestrian Federation and the discipline member body to which your application relates (the “Member Body”) undertake to respect the privacy of the individual and have implemented strict procedures

to protect the individual’s rights under the Data Protection Act 1998. By submitting this application you consent to the British Equestrian Federation and/or the Member Body holding, processing and disclosing your personal information (including sensitive personal data within the meaning of the Act) for the purposes of efficiently administering the British Equestrian Federation’s and/or the Member Body’s business and in order

to process your application. Personal data will only be disclosed to third parties, unless required by law, with the consent of the individual concerned. Please note that information supplied to the British Equestrian and/or the Member Body for the purposes of your application and may be retained in a confidential file for a maximum period of three months following the end of the Selection period and will be securely disposed

of thereafter.