This competition will be run under RDA(NSW) Dressage and Equestrian Australia Para Equestrian Rules and Conditions of Entry.
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1 06 STATE DRESSAGE CHAMPIONSHIPS & GYMKHANA GALA RIDING FOR THE DISABLED ASSOCIATION NSW Friday th, Saturday 3 th and Sunday 4 th August, 06 Sydney International Equestrian Centre, Saxony Road, Horsley Park 75. This competition will be run under RDA(NSW) Dressage and Equestrian Australia Para Equestrian Rules and Conditions of Entry. FEI Para Equestrian Dressage Tests 03 & specified EA National Tests DRESSAGE CHAMPIONSHIPS & GYMKHANA GALA ENTRY FORM Entries close: 6 July 06 Enquiries: Nicole King on dressage@rdansw.org.au Website: go to Dressage Link Postal address for entries RDA NSW Dressage Sub Committee State Dressage Championships PO BOX 70 SYDNEY MARKETS NSW 9 These Championships are being conducted with support from: Sydney International Equestrian Centre NSW Department of Sport and Recreation OPPORTUNITIES TO SPONSOR THIS EVENT ARE OPEN Enquiries: Nicole King Page of 7
2 RDA(NSW) STATE DRESSAGE CHAMPIONSHIPS & GYMHKANA GALA 06 To be completed and returned no later than 6 th July 06 to: RDA(NSW) Dressage Sub Committee, State Dressage Championships, PO BOX 70, Sydney Markets, NSW 9 RIDERS ENTRY FORM Incomplete entries will not be accepted NAME DATE OF BIRTH (if under 8 years of age) ADDRESS TELEPHONE NUMBER (H and M) ADDRESS GRADE Please circle please circle a b II III IV SECTION please circle A B C D DISABILITY PARA-EQUESTRIAN (formerly IPEC) PROFILE NUMBER classified riders must state Do you require a Mounting Ramp or Block? Please circle Wheelchair Ramp Block Nil Will you be attending the Friday PM Sound check? Please circle YES NO Do you agree that any image taken of the named participant taking part in this event may be used to further the objects of RDA (NSW) generally and this event. YES NO HORSE NAME SUBSTITUTE HORSE NAME see Conditions of Entry Rule 8. NAME OF NOMINATED WARM-UP PERSON For Grades a, b and and Profile 39 Section C only & Walk & Trot Gymkhana Competitors Membership Category: Member of RDA(NSW) Centre: Centre name: PCANSW Member: Club Name: Interstate RDA Rider : Centre name: RDA(NSW) Associate Rider It is expected that all competitors assist the organisers of the event with tasks such as set up & packing up of equipment, pencilling, stewarding arenas and ensuring the venue is kept clean & tidy. I agree for the above-named participant to be allowed emergency medical treatment, if necessary, whilst taking part in any RDA (NSW) activity. I understand that no liability can be accepted by RDA (NSW) or Centre concerned In the event of an injury or accident occurring. Equestrian activities (including but not limited to recreational and therapeutic riding) can be inherently dangerous. I understand that horses can act in a sudden and unpredictable way, especially if frightened or hurt. Accidents can happen in equestrian activities which may result in injury or death to participants. I have voluntarily read and understand this warning and acknowledge and assume the risk in equestrian activities (including but not limited to recreational & therapeutic riding).note: Agreement to this does not affect people s rights under common law. I have read the Conditions of Entry and General Information and fully understand them. I agree to abide by the Conditions of Entry and rules and regulations as set down for the conduct of this event. Rider (if over 8) or Parent/Guardian Signature Date: Page of 7
3 NAME: RIDERS PROFILE FOR COMMENTARY Suggested information: - Age - When did you start riding - Interests outside of Equestrian activities - Who is your favourite sporting person? - The name of your coach - Is there anyone you would like to thank for supporting your riding? - What would you like to achieve with your riding? RIDER/GUARDIAN SIGNATURE Page 3 of 7
4 RIDERS ENTRY CHOICES RIDER NAME: HORSE NAME: DRESSAGE CHAMPIONSHIP RIDERS SECTION A, B, C GRADE a, b, II,III,IV Please tick the tests you will be entering Preliminary Test Championship Test Freestyle DRESSAGE INTRODUCTORY TEST RIDERS SECTION D GRADE a, b, II,III,IV Name of test GYMKHANA COMPETITORS Showjumping Led / Unled G F E D C B Le Trec Led / Unled Walk Trot Canter Prix Caprilli Led / Unled Walk Trot Canter ENTRY FEES: Dressage Championship per rider and horse $0.00 Dressage Introductory Test Full Gymkhana Gymkhana Single Event Dressage Champs & Full Gymkhana 06 Interstate Rider fee Test only at Dressage Championships Per rider and horse combination Showjumping, Prix Caprilli, TREC event only - specify event above Per horse and rider TOTAL $ Coach Declaration (RDA Centre / PCA(NSW Riders): I declare the rider has entered in the appropriate level of competition. The entry choices above are correct and training towards completing these events has commenced. Name: Sign: Unclassified Associate Rider Declaration: I declare this is an appropriate level of competition based on Open competition experience. Sign: Page 4 of 7
5 ACCOMMODATION Please note: Limited cabins are available and will be allocated on a first come first serve basis. Accommodation: (please circle days required) Cabins - twin share Specify nights Thurs, Fri, Sat, Sun $38.00 per night Wheelchair access essential Yes No $ *Camping Specify nights Thurs, Fri, Sat, Sun $.00 per night per site $ *Power Site for float / recharging scooters Specify nights Thurs, Fri, Sat Sun *SIEC charges PER Electrical lead plugged in. $ $.00 per night per site TOTAL $ CABINS FOR HIRE: Basic cabins with single beds, hanging wardrobe, table, chair and wall mounted strip heater. Must provide own linen and pillows. No cooking allowed access to Rider s retreat available. CARAVANS FOR HIRE: Parravans (0) , Potts Caravans (0) , Great Escape Caravan Hire (Castlereagh) , Great Western Caravan Rentals (Castle Hill) , Claron Caravans , Dolphin Caravan Hire (Londonderry) (0) Please make sure you obtain your site number and advise the caravan company before delivery of your van. RIDERS RETREAT: Will be available for all competitors throughout the competition. Full kitchen facilities are available including fridge and freezers, BBQ, Stove, Oven, Microwave and Toaster. It is an expectation that these facilities are kept clean and tidy at all times. Please bring all plates, glasses & cutlery, cooking utensils and equipment. Coffee Cart facilities will be available. Office use only Cabin number Camp area Power site Page 5 of 7
6 Name of Centre or owner of horse: HORSE ACCOMMODATION DETAILS HORSE NAME: SUBSTITUTE HORSE NAME (See Conditions of Entry No. 8) Stallion: YES NO Stallion: YES NO ALL HORSES STABLING OVERNIGHT Name of person staying overnight: MUST HAVE A COMPETENT HANDLER STAYING ON THE GROUNDS. PLEASE COMPLETE ACCOMODATION SECTION Contact Number: Please use one form per horse. If this horse has two competitors complete this page once only. Stabling & Day Stay (please circle days required) Bump In: Arrival no earlier than Thursday th August pm. Bump Out: Departure no later than Sunday 4 th August 4.30pm. (long distance horses may apply to arrive or depart outside of this timeframe) Stabling Specify nights: nights Thurs Fri Sat $3.00 per night Bedding Recommended 5 bales $.50/bale* = Day Stay for horses not requiring stables Specify days: Fri Sat Sun $.00 per horse per day TOTAL * - Cost of bedding is subject to change if done so by SIEC suppliers A separate cheque for bond is to be included. This will be returned/destroyed upon inspection if applicable. Do not include in total. Stabling bond (refundable - see $75.00 per stable Day Stay bond (refundable - see $30.00 per day Return / destroy please circle preference Bedding will be left in each stable unopened. Do not remove bales from other stables. When bales are opened the plastic wrap is to thrown into the waste bin not the manure bin. It is suggested that you or your centre bring a wheelbarrow, rake & broom. This will ensure that you get out early as SIEC can only lend out a certain amount of these items. All bedding must be picked up and placed in bins provided. Riders are responsible to ensure they leave stables clean and tidy. Your bond will be returned only if upon inspection the area is deemed acceptable by a SIEC representative and the Dressage Secretary. Horses may only be tied to floats connected to cars in the designated day parking area. TACK ROOM Only complete if a Private Tack room is required. Private Tack room Required by - Centre or name: Tack Room see $40.00 whole event Required Y / N Office use only Stable number Day Stay Nights required Tack Room Page 6 of 7
7 Summary Sheet Rider: Entry from Page 4 $ Horse Accommodation - Stables Horse $3 night $.50/bale Horse Accommodation Stables - $ Horse Accommodation - Day Stay Horse Day $/horse/day 3 4 Horse Accommodation Day Stay - $ Private Tack Room non refundable Number required Tack $40 each (whole event) Tack Room non refundable - $ Name Horse Accommodation $38/night $/night Power $/night Accommodation - $ Horse Accommodation Cleaning Bond - refundable Stable Bond $75 Day Stay Bond $30/day Horse Accommodation Bond Refundable - $ Grand : Circle: Direct Deposit: Date Money Order Cheque Cheque or money order made payable to RDA NSW Dressage (cash not accepted) Direct Deposit: Westpac BSB: A/C: Please use reference: Surname Dressage when direct depositing and stateoffice@rdansw.org.au to advise the date and amount. $ Horse Accommodation Cleaning Bond Refundable: If Bond is paid by direct deposit please provide return account details. Acct: BSB: Name: Cheque/Money order or Direct deposit Page 7 of 7
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