N.T.E.C. ENTRY FORM
To be used from 1st August, 2014
EVENT NAME: LPPC/NTEC ODE – Trevallyn Reserve
DATE: 23 / 11 / 14
Entries Close: 13th November 2014
NAME:
ADDRESS:
Home phone:
Email:
RIDER EA Number (EVA 80 & Above):
TEA No:
CLASS
Mobile phone:
Age in years (If junior):
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
Helper: (Please circle preferred job)
Fence Judge / Marshalling /
XC starter or finisher / scoring helper /
SJ Penciller / Dressage Penciller
Date/Time
On the day
Pre – Event Working Bee
16th Nov @ 9am
Pre-flagging of XC course
22nd Nov @ 2pm
On the day
Dismantling of Dressage arenas:
Setup and dismantling of SJ:
Towing of club trailers: (please circle)
On the day
Deliver / Pickup
Set-up of NTEC Dressage Arenas:
23rd Nov 7.30am
Please Select
Name:
Mob:
COMPULSORY FOR ALL TEA RIDERS
COMPULSORY FOR ALL TEA RIDERS
Dressage Trailer / Caravan
Entry Fees
Entry Fee
Grade
EVA 105
Test EA 2.1
EVA 95
EVA 80
EVA 65
1.05cm
$30.00
Test 1.3
95cm
$25.00
Test 1.2
80cm
$25.00
65cm
$25.00
Test 1.1
Entry Fee
Double Entry Fee (If unable to assist)
TEA Levy (Compulsory fee per horse)
$10
Equipment Levy (per rider)
$9
Total
MAIL TO:
The Event Secretary
C/o Leonie Blackwell
23 Beefeater St.
Deloraine 7304
Email: leonieb@bigpond.net.au
Mob: 0417 322 105
Event Co-coordinator: Bec Evans
Mob: 0407 736 007
Email: northerntaseventingclub@hotmail.com
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.