School Entry Form This form will become a TAX INVOICE & RECIEPT upon Payment St Joseph s School Millmerran ABN:
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1 St Joseph s Primary School Millmerran PO BOX 77, Millmerran QLD 4357 Phone: Fax: HORSE SPORTS DAY Hosted by Millmerran Pony Club Inc. Friday 23 rd June 2017 Millmerran Showground Pic QBMM0259 Start 9.00am Entries close: 26 th May 2017 $20 per rider Riders must be current financial Pony Club members Horse Sports Co-Ordinator Patrick Lunney PH: School Team Payment must accompany entry form & waiver/ indemnity form Payments to St Joseph s Primary School, Millmerran c/- V.LUNNEY PO Box 311 Millmerran QLD 4357 School March Past AGE GROUPS 6 & Under,7 & 8yrs, 9 &10yrs,11 & 12yrs,13 & 14yrs,15 & 16yrs, over 16yrs Age groups may be split depending on numbers. Sports Connect Group-Assisted (non competitive) Events: Boys & Girls compete together Best Presented Horse and Rider Rider Class All round Pony Club Mount Half Hitch Ben Bar Aft Figure of 8 Stockhorse Right Angle Bounce ScuddaHo Mug Race Drum & Peg Bawnduggie Bend Running T Wagon Wheel Champion and Reserve Champion for each age group Trophy for fastest Stockhorse Primary & Secondary Rider Trophy for Highest Points Scoring Primary & Secondary Rider Champion Primary and High school Stay on for the Millmerran Pony Club Inc. Campdraft and Dressage Day on Saturday 24th of June followed by Millmerran Pony Club Inc. Gymkhana Sunday the 25 th of June. Contact Patrick Lunney on or patrick.lunney@bigpond.com for programs.
2 School Entry Form This form will become a TAX INVOICE & RECIEPT upon Payment St Joseph s School Millmerran ABN: School: Competitors Name Age Student is turning in 2017 Date of Birth Pony Club Membership Number Number of Stables Total Total amount GST FREE Helper No. 1 Name: Helper No.2 Name: Principal Name: Team Managers Name: Signed by Principal: Team Manager:
3 Disclaimer Statement: Event: St Joseph s Primary School Millmerran Horse Sports Day, 23rd June 2017 herein after referred to as the Event. I knowledge and agree as a condition of participating that neither the school, organisers, sponsors, participants, officials, volunteers, medical personnel, any persons, owners and lessees of premises used to conduct the Event, shall be under any liability for my death or any bodily injury, loss or damage which may be sustained or incurred by me as a result of participation in or being present at the Event, except in regard to any rights I may have arising under the Trade Practices Act 1974 ( Commonwealth or Similar State legislation). I acknowledge that equestrian activities are dangerous and that accidents causing death, bodily injury, disability and property damage can and do occur. BY SIGNING HEREUNDER I CONFIRM HAVING READ AND UNDERSTOOD THE CONTENTS OF THIS DISCLAIMER. Name (Block Letters) Signature Date: PARENT/GUARDIAN CONSENT FOR PARTICIPANTS UNDER 18 YEARS. I being the Parent/ guardian of confirm that I have read the whole of this document and have taken all necessary actions to ensure that I am aware of the activity in which the above child will participate in and consent to him/her participating. In doing so, I acknowledge that equestrian activities are dangerous and that accidents causing death, bodily injury, disability and property damage can and do occur. I agree that neither the school organisers, sponsors, participants, officials, volunteers, medical personnel, any persons, owners and lessees of premises used to conduct the Event, shall be under any liability what so ever for the death or bodily injury which may be suffered or incurred by the above named or by me as a result of participation in or being present at the Event, except in regard to any rights the above named or I may have arising under the Trade Practices Act 1974 (Commonwealth or similar State Legislation). SCHOOLS PLEASE NOTE THIS INFORMATION IS MANDATORY AND MUST BE RECEIVED WITH ENTRY FORMS. PCAQ RULES AND REGULATIONS WILL APPLY ON THE DAY.
4 General Rules and Regulations All events are run under PCAQ rules and regulations Competitors must show proof of pony club membership. Horse Health Declarations to be completed and handed to secretaries box on arrival to the venue. Entry fee is $20 per rider, paid prior to the event. All riders must be competent and on suitable mounts for the duration of the day. Each school to provide a teacher and instructor where possible to help with gear check Each school to provide two helpers to assist Risk assessments or equivalent are to be completed by each school prior to competition. Competitors will compete as a school team There will be an unmounted presentation at the end of the day in full school uniform. Age groups are based on the age children are turning in 2017 not on the age they are on the day as in normal pony club competition. Schools may combine to compete Age groups can be separate or combined depending on numbers Girths must have 2 points or 1 girth point and a surcingle Helmets must be as per new Jan 2017 rulings. Team Managers Gear check at 8.30am, team manager to gear check. It is up to the team manager to ensure all riders are present at the gear check and are to be in correct uniform and saddlery. Team managers for each school are responsible for student s supervision and behaviour of students on the day of competition. All riders are to wear a PCAQ approved helmet when mounted One horse/ One rider Spectators, parents and coaches are not permitted on competitor s horses, or in the competition area. Champion school will be the school with the highest accumulated point score of their top 4 riders. The program may be altered at the organising committees discretion. A Project consent form should be completed by your school and handed in at secretaries box before competition. No stallions permitted Ribbons to 3rd place Provide medical forms for every competitor. Girths must have 2 girth points or 1 girth point and a surcingle Uniform Fawn jodhpurs or fawn stockman s cut trousers/ moleskins; approved pony club smooth soled boots, approved helmets must be AS/NZ38/38, EN1384, ASTMF 1163 or as new rulings Jan collared long sleeved shirts, school tie, school jumper or vest. No riding coats. Jeans of any colour are not permitted. School polo shirts may be worn in sporting events. Insurance St Joseph s Primary School Millmerran and the Toowoomba Catholic Schools Office will not be responsible for any injury, death or damage incurred. Students enrolled in a Department of Education and Training School enter at their own risk and shall hold St Joseph s Primary School Millmerran and the Toowoomba Catholic Schools Office blameless and indemnified against legal proceedings for injury or damage. Parents or team managers for Private School students must check their own Insurance with their Individual Principals to ensure their/child/,is/are adequately covered. This is to be the responsibility of the Team Manager.
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