Horseland. 30 th April - 1 May Horse Trials State Championships Pony Club Victoria Horseland Horse Trials State Championships 2016

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Horseland Horse Trials State Championships 2016 Hosted by Pony Club Victoria and HELD AT BACCHUS MARSH EQUESTRIAN CENTRE Balliang-Bacchus Marsh Road Bacchus Marsh 30 th April - 1 May 2016 Entries close: WED, 6 th APR 2016 STRICTLY NO DOGS ALLOWED 1 Linda Smith P: 03 9712 0330 0419005069 E: l.smithconvey@bigpond.com Lynne Brown: PO Box 32 Coldstream 3770 E:taminga16@yahoo.com.au

2 Table of Contents General Rules & Regulations... 3 Introduction... 3 Overview... 3 Location Bacchus Marsh Equestrian Centre... 3 Disclaimer... 4 Eligibility... 4 Qualifying criteria... 4 Entries... 5 Payments & Entry Fees Due: WED, 6 th APR 2016... 5 Refund Policy... 6 Competition Information... 6 Scoring... 6 Substitutions... 8 Competitor Numbers... 8 Lungeing... 8 Riding of Other Horses... 8 Queries and Protests... 8 Cross Country Course Closure... 9 Conduct of a PCAV Member or Team Manager... 9 Awards... 9 On-site Accommodation & Catering... 9 Stabling and Yards... 9 Camping... 10 Accommodation:... 10 Horse Feed, Hay, Straw... 10 Veterinarian... 10 Farrier... 11 Official Photographer... 11 Event Sponsors... 11 Individual Rider Entry Form Grade 1... 12 Individual Rider Entry Form Grade 2... 13 Club Team Entry Form... 14 Horse Health & Veterinary Form... 15 Off the Track Entry Form... 16 Evening Meal Order - Saturday... 17 Yard Booking Form... 18 Rider Profile... 19 Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

3 General Rules & Regulations Introduction Pony Club Victoria extends a warm welcome to everyone attending the 2016 Horseland Horse Trials State Championships. Due to ground renovations at Pony Club Victoria Equestrian Centre another venue had to be found. Barwon Zone was next on the roster to host State Horse Trials and Bacchus Marsh Pony Club had already been preparing for the event and has a well-established cross country course and grounds suitable to stage a State Championship. Pony Club Victoria is very appreciative of the hard work put in by Bacchus Marsh Pony Club members on short notice. We hope everybody enjoys the event and has a great time. In 1955 the first inter-branch competition was held by Mornington Peninsula Pony Club. The Pony Club Association of Victoria Horse Trials State Championships is conducted annually hosted by one of the 10 zones in the state, for qualified Grade 1 & Grade 2 combinations of horse and rider. The championships shall be held on the weekend containing the first Sunday in May. In 1977, the State Championships rotation began with North Eastern Zone conducting followed by the Zones in rotational order: Northern Metropolitan, Midland, West Gippsland, Wannon, Southern Metropolitan, Northern, Central, East Gippsland, Barwon and back to North Eastern. Commencing 2017 future Horse Trials State Championships will be held at Pony Club Victoria Equestrian Centre at Gladysdale where a new and exciting Ewan Kellett course is about to be built. Overview The PCAV Horse Trials State Championships are preceded by individual qualifying competitions. The Championships comprise three disciplines Dressage, Cross Country and Showjumping, which are conducted on the same weekend. Combinations compete in all three disciplines. All Dressage tests and the Cross Country will be ridden on Saturday. All Show Jumping will be on Sunday. Combinations of horse and rider must be qualified in Grade 1 or Grade 2 Horse Trials to be eligible to compete in the Championships. Any rider, who has been a pony club member for more than 2 years and is more than 14 years old, must have attained their C Certificate. A rider may compete in both Grade 1 and Grade 2 at the Horse Trials State Championships. The competition will be conducted on an individual basis. The Organising Committee will distribute riders from each Zone as evenly as possible throughout the sections. Club Teams: teams will consist of 3-4 riders comprised of one Grade 1 rider and one Grade 2 rider and one or two additional riders from either Grade. The best three scores will count. Location Bacchus Marsh Equestrian Centre Home of the Bacchus Marsh Pony Club Balliang- Bacchus Marsh Road, Bacchus Marsh. Melways Map Ref 333 B12 Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

4 The competitions are conducted in accordance with the current PCAV Rules for the year in which the Championship is conducted. PCAV Gear Rules PCAV Handbook of By-laws PCAV, Sun Smart, Smoke Free and Alcohol Policies PCAV Code of Conduct Disclaimer Neither the Organising Committee of this competition nor Pony Club Victoria or Bacchus Marsh Pony Club accepts any responsibility whatsoever for any accident, damage, injury or illness to horses, riders, ground spectators or any other person or property. Eligibility PCAV Club Member cards are not required to be presented at the state competition but they must be inspected thoroughly at qualifying competitions and by the Zone Representative who authorises the entry to ensure eligibility is in accordance with the current editions PCAV Handbook of By-laws and PCAV Horse Trials Rules. Each combination (horse and rider) may enter and compete in one grade. A rider may nominate multiple mounts for the event. These may be in Grade 1 and/or Grade 2. The Organising Committee reserves the right to ballot entries. Second nominated mounts will only be accepted subject to sufficient space being available after all first nominated mounts have been accommodated. Riders must nominate their first preferred mount on the entry form, in case the second mount cannot be accepted. Riders who have been in pony club for more than two years and are aged over 14 years must have attained their C Certificate in order to compete at the State Championships in accordance with criteria for state events in the PCAV Handbook of By-laws Qualifying criteria At the closing date for entries for the championships, ALL combinations of horse and rider must be qualified as per the rules, for the grade/s in which they wish to enter. D.6. Entries for State Championships (Qualifying Criteria) Any rider wishing to compete in the PCAV Horse Trials Championships must qualify according to these conditions: Grade 1 riders Riders who have been in pony club for more than two years and are aged over 14 years must have attained their C Certificate in order to compete at any state or national competition. Qualifications must be gained during the 12 months preceding the championships. The previous year's championship may not be used as a qualification. Event and Cross Country jumping penalties must be noted on the rider s membership card. Must complete two Horse Trials, one of which must be a PCAV Accredited Grade 1. An EA CNC* or FEI CIC*/CCI* may be used as one qualification. One qualification must have been gained in the calendar year of the championships. One qualification with no more than 20 jumping penalties in the cross country phase & one with zero jumping penalties in the cross country phase. Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

5 Grade 2 riders Entries Must complete three Horse Trials, two of which must be PCAV Accredited Grade 2 Events. An EA Pre Novice event or EVA 105 event may be used as a qualification. Two qualifications must have been gained in the calendar year of the championships. Two qualifications with no more than 20 jumping penalties in the cross country phase & one qualification with zero jumping penalties in the cross country phase. Entries Close WED 6th April 2016 All entries for the State Championships must be entered and paid for by WED, 6th April 2016. The declaration of qualification on the Entry Forms must be signed by the Club District Commissioner and then together with membership cards for each entrant must then be submitted to the Zone Representative, who shall verify the eligibility of the entrants, and sign the declaration. Membership cards are not required for inspection at State Championships No late entries will be accepted. Send Entries to Entry Secretary Lynne Brown These two steps must be followed 1. Send entry forms ONLY with correct payment via cheque Made out to Pony Club Association of Victoria in full or evidence of Direct Deposit to the PCAV Bank Account see below for Banking details to PO Box 32 Coldstream 3770 2. Orders for yards and dinners must be sent SEPARATELY to Yvonne McDonald at 709 Midland Highway Mt Rowan 3352. Payment for Yards and dinners must go to Bacchus Marsh Pony Club via cheque made out to Bacchus Marsh Pony Club or Direct Deposit to the Bacchus Marsh Pony Club Account Westpac BSB: 033 602 Acc #: 182295 Please quote State Horse Trials and the rider s name PLEASE DO NOT SEND YARD & DINNER BOOKING TO LYNNE BROWN Payments & Entry Fees Due: WED, 6 th APR 2016 Payments for Entries ONLY by Cheque, Money Order or Direct Deposit. If using Direct Deposit a printed form showing the deposit must be sent with the entry. PLEASE IDENTIFY PAYMENT WITH THE CODE HTSC & THE RIDER NAME Account: ANZ Pony Club Association of Victoria BSB: 013355 Account #: 260054734 Cheques must be made out to Pony Club Association of Victoria in full the Bank will not accept initials PCAV Competition Entry Fees: $95/Combination The correct fees must accompany all entries. Yards and meals have additional fees which must be paid at the time of entry. Yards and meals are to be booked on the attached form with Bacchus Marsh Pony Club direct. Merchandise to be purchased through PCAV website. Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

Official Dinner Saturday Night: $20/Person To be catered for by Bacchus Marsh Pony Club will include a Roast dinner comprising 3 meats, roast potatoes and pumpkin, peas and corn. There will be 3 choices for dessert and a can of soft drink. Special dietary needs indicated on order eg. vegetarian or special diet meals. Cost: $20/Person. Payment with Entry Forms on the Official Dinner Order form Orders Due: WED 6 th Apr 2016 Merchandise Available to be ordered direct online through PCAV via Latest News link. Orders due by TUESDAY MARCH 29 th 2016 for collection at the event. There will be a small number of garments available at the Event Refund Policy Entry refund requests for all State Level Events will be no more than 14 Days after the last day of the competition. Requests for a refund must be accompanied by a Medical Certificate or Veterinary Certificate. The organising committee may withhold an administration fee of up to 25% of the total entry fee. Competition Information 6 Gear Check Gear check required prior to each discipline Dressage Tests (Dressage on Saturday) Grade 1 HT2 Grade 2 HT1 Scoring Scoring - Individual Individual: The winner of each section will be based on the Horse Trials Rules Scoring The total score is reached by adding together the penalty marks incurred in each of the three tests. The winner is the competitor with the lowest total of penalty marks. In the case of an equality of points, refer to PCAV Handbook of By-laws. Handbook of Bylaws Separating equality of Scores Lowest cross-country penalties including faults at obstacles and time penalties Cross-country time closest to the allowed time without time penalties (this means only riders who come in at or under the allowed time) Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

Best score in the dressage test The higher dressage collective marks total If these figures are equal, the placing remains tied. 7 Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

Scoring - Teams Teams consist of 3 or 4 riders with the best three placing point scores to count for the team. Teams with less than 3 riders with placing point scores will be ineligible. Rider equalities will be separated within the section before placing points are awarded. 8 PCAV Points System: Once rankings have been determined for each competition, this points system is used to determine the final overall places for teams only. Every team member will score placing points according to their place against other team riders only in their section. Eg. Section 1 30 individual riders Riders 1 to 14 in draw belong to teams o 1 st place o 2 nd place o 3 rd place 15 points (14 points plus 1 bonus point) 13 points 12 points The number of teams entered at the commencement of the competition will determine the basis for points for team scoring. Eg 14 teams entered will have 1 st place = 15 points (14 points plus 1) In case of equality of placing points, the winning team is the one whose lowest classified competitor out of the three has the best points. If tied, use second rider, then first. If these figures remain equal, the placing remains tied. Eliminated Riders: A rider who has been eliminated will not count towards the team score. Teams must have at least three riders placing points to receive a team score. Substitutions If a combination that has been entered into the State Championships is subsequently unable to compete, another eligible combination may be substituted. However, the substitution must be: A combination that has qualified under the Zone qualifying selection criteria. Endorsed by the Zone Representative Notified by the Zone Representative, to the Organising Secretary, not later than one hour before the commencement of the first event of the State Competition. Competitor Numbers The Organising Committee will supply Body Numbers which must be worn in the jumping phases. Bridle or saddle cloth numbers can be used in the dressage and must be placed on both sides of the horse. Lungeing Lungeing is permitted in the designated yard only, as per PCAV rules Riding of Other Horses Over the weekend only horses entered into the competition are to be ridden on the grounds. Queries and Protests As per PCAV Handbook of By-laws Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

9 Cross Country Course Closure At the completion of the Cross Country Phase, the Cross Country Course is closed to all horses. Conduct of a PCAV Member or Team Manager PCAV Code of Conduct applies. Any conduct unbecoming of a Team Manager, parent and/or a competitor, including bad language, is a reportable incident and may lead to a Team or Individual disqualification on the day. Awards Presentations will be unmounted and full uniform must be worn. (Helmet optional) Individual Competitions: Each Section of Grade 1 and Grade 2 First Place: PCAV medallion, sash and Horseland sponsored rug. Second Sixth Place: Sashes Club Teams Competitions: Each member of the Club team First Place: PCAV Medallions, sash and Horseland sponsored rug and PCAV Perpetual Trophy (to be retained by PCAV office) Second Sixth Place: Sashes Presentations will be unmounted and full uniform must be worn. (Helmet optional) On-site Accommodation & Catering Catering at the Event There will be full catering at the grounds from Friday all day Saturday to Sunday. Meals can be arranged for Friday night if required by contacting Yvonne McDonald on 0407 883 321 Entertainment - To be advised Stabling and Yards Yards There are 100 yards available at a cost of $30/yard for the whole weekend. Yards will be allocated strictly in order of receipt of the booking. Riders may bring their secure steel yards. Yards should be of solid construction. The use of electrified tape, strings, ropes or chains, is not permitted at Pony Club Events Electric tape can be used as a top line or as a "standoff" on a steel or solid yard, but not as a standalone yard. Horses confined within temporary yards must not be left unattended overnight. At least one adult must remain on site with the horse. Yards are to be booked separately through Bacchus Marsh Pony Club the attached yard form can be emailed to YVONNE MCDONALD at Yvonne@balcacourt.com.au Payment must be made at time of booking either by cheque or direct deposit Westpac BSB 033 602 Acc # 182295 quoting State horse Trials and riders name.yards are to be left clean and tidy. Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

Camping Camping is permitted on-site No Power available Toilets are available. Limited showers at site. Condition of Camping Camp fires are permitted but must be in drums provided by the camper. Generators must not be run between 10pm and 7am Yards and Grounds are to be left clean and tidy Manure to be placed in designated areas. NO DOGS OR PETS ALLOWED PLEASE LEAVE THEM AT HOME Accommodation: Bacchus Marsh Caravan Park 26 Main Street BACCHUS MARSH P 03 5367 2775 10 Bacchus Marsh Avenue Motel 272 Main Street Bacchus Marsh 03 5367 3766 Sunnyside Villa on the Avenue 271 Main Street Bacchus Marsh P 0412 929 103 or info@sunnysidevilla.com.au Melton Motor Inn 344 High Street MELTON P 9743 5599 Tabcorp Park 2 Ferris Road Melton P 03 8746 0600 Horse Feed, Hay, Straw Bacchus Marsh Farm supplies. Bacchus Marsh Pet Supplies. Veterinarian Vet on the Grounds on Saturday Sunday on call - Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

Farrier On call to be advised Official Photographer Derek O Leary - www.derekoleary.com.au Event Sponsors HORSELAND Naming Rights Sponsors Horseland is the naming rights sponsor for all Pony Club Victoria State Championships. Prize Rugs for the winners in each section and gifts for each entrant are part of the sponsorship package. Pony Club Victoria and the Horseland Horse Trials State Championship Event Organising Committee thank them for their support. www.horseland.com.au 11 Linda Smith P 03 9712 0330/0419 005 069 E:l.smithconvey@bigpond.com Lynne Brown PO Box 32 Coldstream 3770

Pony Club Victoria Horseland Horse Trials State Championships 2016 Hosted by Pony Club Victoria at Bacchus Marsh Pony Club Individual Rider Entry Form Grade 1 The Medical & Horse/Veterinary Authority is a compulsory form and must be sent with your entry form. An Entry Form must be submitted for each horse. RIDER DETAILS: Name of Rider: Club: Address of Rider: Date of Birth: Zone: Town/Suburb: Phone (H): Postcode: Mobile: Email: Ambulance Cover NO YES Ambulance Number: Horse: QUALIFIED ENTRY DECLARATION: We the undersigned hereby certify that the above combinations of horse and rider entered in this grade to compete at the PCAV State Horse Trials Championships are eligible and qualified as per the current rules for this competition. District Commissioner:... Club:... Zone Representative:... Zone:... Club Colours:...... MEDICAL RESPONSE AUTHORITY Please complete the following section if rider is Under 18 years. Organisers suggest that all competitors complete this section. Parent/Guardian Name/Emergency Contact:...... Address:... Postcode:... Phone (h):... Mobile:... Email:...... I,.. being the parent/guardian named above or, if no person is named being the competitor aged 18 years or over, give permission for the competitor named above to receive FIRST AID and/or MEDICAL TREATMENT, and being transferred to hospital by ambulance should the need arise during the conduct of the State Championships. I give the President of the PCAV, or their appointed deputy, my consent to authorize such transfer and to make such emergency medical arrangements as may be deemed necessary by a qualified medical practitioner on my behalf. Before taking this action, the President of PCAV, or the appointed deputy, must be satisfied that every possible practical effort has been made to contact the accompanying parent/guardian/emergency Contact named above. I give authority in the full knowledge that I will be required to pay costs incurred if insurance held by the PCAV does not cover the ambulance transfer, medical treatment or any other costs involved. Rider s Parent/Guardian Signature/Emergency Contact Signature:...... Print Name:... Date:... Send entries to the Event Entry Secretary: ENTRIES CLOSE: WED, 6 th APRIL 2016 Lynne Brown PO Box 32, Coldstream 3770

Pony Club Victoria Horseland Horse Trials State Championships 2016 Hosted by Pony Club Victoria at Bacchus Marsh Pony Club Individual Rider Entry Form Grade 2 The Medical & Horse/Veterinary Authority is a compulsory form and must be sent with your entry form. An Entry Form must be submitted for each horse. RIDER DETAILS: Name of Rider: Club: Date of Birth: Zone: Address of Rider: Town/Suburb: Phone (H): Postcode: Mobile: Email: Ambulance Cover NO YES Ambulance Number: Horse: 13 QUALIFIED ENTRY DECLARATION: We the undersigned hereby certify that the above combinations of horse and rider entered in this grade to compete at the PCAV State Horse Trials Championships are eligible and qualified as per the current rules for this competition. District Commissioner:... Club:... Zone Representative:... Zone:... Club Colours:...... MEDICAL RESPONSE AUTHORITY Please complete the following section if rider is Under 18 years. Organisers suggest that all competitors complete this section. Parent/Guardian Name/Emergency Contact:...... Address:... Postcode:... Phone (h):... Mobile:... Email:...... I,.. being the parent/guardian named above or, if no person is named being the competitor aged 18 years or over, give permission for the competitor named above to receive FIRST AID and/or MEDICAL TREATMENT, and being transferred to hospital by ambulance should the need arise during the conduct of the State Championships. I give the President of the PCAV, or their appointed deputy, my consent to authorize such transfer and to make such emergency medical arrangements as may be deemed necessary by a qualified medical practitioner on my behalf. Before taking this action, the President of PCAV, or the appointed deputy, must be satisfied that every possible practical effort has been made to contact the accompanying parent/guardian/emergency Contact named above. I give authority in the full knowledge that I will be required to pay costs incurred if insurance held by the PCAV does not cover the ambulance transfer, medical treatment or any other costs involved. Rider s Parent/Guardian Signature/Emergency Contact Signature:...... Print Name:... Date:...

Pony Club Victoria Horseland Horse Trials State Championships 2016 Hosted by Pony Club Victoria at Bacchus Marsh Pony Club Club Team Entry Form Club Teams will consist of three or four riders comprised of One Grade 1 Rider and One Grade 2 Rider, and one or two additional riders from either Grade. The best 3 total scores to count. There is no entry fee for this section of the Horse Trials Championships. Please print out this form, complete it and email the scanned or photographed form to to be advised CLUB TEAM DETAILS: Club/Team Name: Zone: Team Manager: Mobile: Rider Name: Grade Horse 14 1. 2. 3. 4. I... being the District Commissioner of the above named Pony Club hereby verify that the above named competitors are officially entered as individual competitors in the 2016 State Horse Trials Championships and their entry has been approved by the Zone Representative. Signature:...

Pony Club Victoria Horseland Horse Trials State Championships 2016 Hosted by Pony Club Victoria at Bacchus Marsh Pony Club Horse Health & Veterinary Form The Medical & Horse/Veterinary Authority is a compulsory form and must be sent with your entry form. RIDER NAME: HORSE DETAILS: Registered name of horse and / or name as officially entered: Address of property from which the horse will be moved to the event Or PIC No: Address of property to where the horse will move after the event Or PIC No: 15 I, being the owner/lessee of the above named horse, hereby consent to the Official Veterinary Officer providing such treatment as is deemed necessary to this horse in the case of an accident at this State Championship. I agree to be fully responsible for all service or consultation fees charged as a result of such accident. In a case where it is deemed by the Official Veterinary Officer that on humanitarian grounds the above named horse should be destroyed because of illness, injury or accident, I hereby give the Official Veterinary Officer and the President of PCAV, or the appointed deputy, permission to act in accordance with the recommendation of the Official Veterinary Officer in this matter. Before taking this action the President of the PCAV, or the appointed deputy, must be satisfied that every possible practical effort has been made to contact the accompanying parent/guardian/carer named below. I list below any special conditions or instructions as to the disposal of the horse after such action by the Official Veterinary Officer. Health of Horse(s) I declare that the horse named above will be in good health, eating normally and not showing signs of respiratory disease during the last 3 days leading up to this event. I give my authorisation for the Event Secretary to call for veterinary inspection of the horse/(s) named above and in my care should they be showing signs of a respiratory illness at any time during the course of the event. I agree to pay any veterinary fees incurred as a result of this veterinary examination. Rider Signature:... Date: Rider s parent/guardian/carer Signature:... Date: Horse Event Declaration Waiver I understand that due to diseases such as equine influenza, the Victorian Department of Primary Industries, or other State or Commonwealth government body, may restrict or prevent the movement of horses, vehicles and personnel for a period of time ( Standstill ). I acknowledge and agree that a Standstill is a risk of competing at this event and I agree to pay all costs or expenses incurred for my horse by PCAV as a result of a Standstill. CONDITION OF ENTRY I hereby agree to abide by the conditions and rules as specified by the PCAV and the Organising Committee for this State Championship. Failure to comply with the conditions of entry may result in disqualifications Rider/Guardian Signature:... Date:

Pony Club Victoria Horseland Horse Trials State Championships 2016 Hosted by Pony Club Victoria at Bacchus Marsh Pony Club Zone: Off the Track Entry Form Entries to Off the Track should be sent with your the State Championship Event Entry Form Are you riding an Off the Track throughbred at the 2016- PCAV Horseland State Horse Trials Championship? If so we have some fantastic news for you; Racing Victoria s Off the Track Program are kindly donating a sash and a fabulous prize pack to the best performed Off the Track thoroughbred in each section. Just State your Horse s Racing Name below when you enter to be in the running for a sash and a fantastic prize pack kindly donated by Racing Victoria Off the Track www.racingvictoria.net.au/offthetrack Riders Name Club Grade 16 Horses Racing Name: Registration number Age Horses Current Name: Tell us about little about your horse and its racing history:.....................

Pony Club Victoria Horseland Horse Trials State Championships 2016 Hosted by Pony Club Victoria at Bacchus Marsh Pony Club Evening Meal Order - Saturday Dear Riders, Families and Friends Bacchus Marsh Pony Club invites you to join them on Saturday evening for a scrumptious meal. EVENING MEAL ORDER SATURDAY Saturday 30th April 2015, VENUE: Bacchus Marsh Pony Club COST: $20/head for all riders and non-competitors CLOSING DATE: WED, 6th April 2015 Competitor Full Name 17 Club Zone Team Discipline Contact number Number of Evening Meals - Saturday @ $20/head Total: $ Special Dietary Needs: Payments Payments by Cheque, Money Order or Direct Deposit TO Yvonne McDonald 709 Midland Highway Mt Rowan 3352 Email Yvonne@balcarcourt.com.au M:040788321 If using Direct Deposit a printed form showing the deposit must be sent with the entry. Account name: Westpac BSB 033 602 Acc# 182295 - Bacchus Marsh Pony Club

Pony Club Victoria Horseland Horse Trials State Championships 2016 Hosted by Pony Club Victoria at Bacchus Marsh Pony Club Yard Booking Form Booking & payment due WED 6 TH April 2015 Yards are available on a first booked basis. $30.00 for the weekend. All information must be provided as your Yard Booking form will be separated from your Entry Form Full name: Club: Zone: Full Address: Postcode: Mobile: Horse name: Alternative Contact name: Height: Mobile: YARD BOOKING DETAILS 18 Yard Requirements Number Cost/yard Total Number of yards $30 $ Payments Payments by Cheque, Money Order or Direct Deposit TO Yvonne McDonald 709 Midland Highway Mt Rowan 3352 Email Yvonne@balcarcourt.com.au M:040788321 If using Direct Deposit a printed form showing the deposit must be sent with the entry. Account name: Westpac BSB 033 602 Acc# 182295 - Bacchus Marsh Pony Club

Pony Club Victoria Horseland Horse Trials State Championships 2016 Hosted by Pony Club Victoria at Bacchus Marsh Pony Club Rider Profile Please provide a few details about you and your horse, so the announcer can share some fun facts with the spectators and other riders during the weekend. Rider Details Name of Rider: Club: Zone: Home Town: Years competing: Horse Details Horse Name: 19 Breed: Gender: Age: Combination Grade: Years riding this horse: Rider Other Interests & Goals Riders other interests: Goals:

Send entries to the Event Entry Secretary: ENTRIES CLOSE: WED, 6 th APRIL 2016 Lynne Brown PO Box 32, Coldstream 3770