BEALIBA PONY CLUB INC. A D

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BEALIBA PONY CLUB INC. A0039544D Will be holding a Four Day Camp on Friday 25 th, Saturday 26 th, Sunday 27 th & Monday 28 th September 2015. Join us as we travel Around the World in Four Days Throughout the four days riders will enjoy a variety of lessons with top class Instructors, each day we will celebrate a different country, learn about their top equestrians, sample the countries food and celebrate some of their traditions. We have AMAZING INSTRUCTORS Wonderful Meals Great Night-time Activities & Exellent facilities Participants are guaranteed to have lots of FUN!! Open to riders of ALL ages and abilities Four Show Jumping lessons with Allan Mitchell Allan has been instructing for many years, he is a very well known & sought after Show Jumping Instructor. Allan works with riders of all ages and abilities and makes sure that all riders leave the lesson feeling confident about jumping. Four Dressage lessons with Lynn MacIntyre Lynn is a NCAS EA Level 1 General Coach, RDA Level I Coach & also holds Certificate III in Sports Coaching Equestrian. Lynn instructs at Bealiba on a regular basis, she has a wealth of knowledge which she is happy to pass onto riders, Lynn works well with riders of all levels. One Cross-Country lesson with Simon Tainsh Simon is a 3* Event rider, his passion for Eventing began while he was in pony club. Over the years, Simon has represented Victoria at National Championships, was listed on State Squads and has competed at a number of International three day events. Tent Pegging with Merv Membrey Merv has held the position of President of the Australian Tent pegging Association for the past 2 years). Throughout his Tent pegging career he captained the Australian Team in 1996 at the first World Titles in South Africa. Merv has represented Australia on 3 occasions, he was also named the Australian Champion. Merv now spends his time judging games (A Grade) and also promotes the sport by instructing and holding clinics. COST: $280.00 per person includes all lessons, breakfast & tea OR $ 90.00 per day NUMBERS ARE LIMITED Preference will be given to riders booking in for the ENTIRE CAMP. All camp fees are to be paid IN FULL prior to the camp. Open riders must complete a Day Attendance Form and pay an additional $10 per day unless you are a financial member of EV/EA, AHS, SHCA, AERA, HRCAV, an Interstate Pony Club or you hold your own personal liability policy for equestrian activities ALL BOOKINGS MUST GO THROUGH THE DISTRICT COMMISSIONER Phone FAYE 0448000525 OR Email f.barnett4@bigpond.com

You MUST read the following rules and abide by them if you will be joining us for our Around the World in Four Days Camp. Horses must be fit if they are to cope with all lessons planned for the camp. You will need to commence a fitness program at least 6 weeks prior to the camp, your horse s feed will need to increase according to the amount of work that they are doing. If you make an effort to prepare your horse for the camp they will have no problem coping with what is asked of them. Horses that are too fat or unfit will be placed into a very low group or may not be able to participate in some of the more strenuous activities. Horses feet must be in good condition, either recently shod or have had their feet trimmed prior to the camp. To ensure that your horse is comfortable make sure that you clean out their feet prior to your first lesson. This will be checked at gear check. You must provide adequate high energy feed for your horse as well as good quality hay. Do not change your horses feed program at the camp. Introduce some high energy feed as their workload increases. Make sure that you bring lots of feed do not let your horse go hungry. Allow your horse to nibble at on a hay net throughout the day. Each horse requires a waterproof rug in case of bad weather and as protection from the jaws of nasty horses. Regular checks will be made to ensure that all horses are being well cared for. Horses must be offered fresh water throughout the day. Remember to bring your own feed and water buckets (large water containers that are not easily knocked over are more suitable than small plastic buckets) do not share with others, as this is a sure way to spread germs. Please remember to label your buckets. Riders are asked to hop off their horse s backs between lessons so that the horse may be rested prior to the next lesson. Loosen the horse s girth, put your stirrups up and throw a light rug over them so that they don t catch a chill. No one is allowed on the cross-country course while Cross-Country lessons are in progress. Horses are not to be tied to unattached floats. All horses are to be tied to string. Horses are not to be ridden during a FREE or LUNCH Break. If your horse is spending the night in a small yard please make sure that you rise early and take them for a walk around the oval to loosen them up. This should also be done prior to going to bed. If for some reason you are not camping overnight but your horse is please nominate someone to be responsible for looking after them. You MUST NOTIFY the DC, letting her know who is looking after your horse. An emergency phone number MUST also be left in case the horse becomes unwell overnight. Look after your friend And he will look after you!! PLEASE NOTE: Bealiba Pony Club have been running camps over the school holidays for 14 years. We are a small, hard working committee that endeavours to ensure that everyone has an enjoyable time. EVERY FAMILY with a rider at the clinic will be rostered to help in the following areas: - In the Canteen assist in preparing meals, wash/dry dishes, serve and clean up after meals. Around the Clubrooms clean toilets, empty rubbish bins, cut wood, sweep and generally tidy up around the clubrooms. On the grounds delivering drinks, setting up equipment, gear check, helping Instructors as requested.

RULES & CONDITIONS AROUND THE WORLD IN FOUR DAYS CAMP While Full Pony Club uniform is not required all riders are requested to wear suitable Pony Club attire (jodhpurs, polo shirt, windcheaters) approved riding helmet and fully soled riding boots. A daily Gear Check will be carried out prior to rider s first lesson. Only pony club regulation gear will be acceptable. (No sleeveless tops or jewellery) The Bealiba Pony Club District Commissioner may change a rider/s from a group if she feels that they have been incorrectly grouped. The District Commissioner may change the program of the clinic if necessary. No refunds will be given unless a Doctors or Veterinary Certificate is produced. Dogs must be kept under control and leashed at all times. Showers available. Bealiba Pony Club has 40 steel horse yards available for use at the camp. The rule is one yard per camp participant. If you are bringing more than one horse to the camp please bring suitable equipment to build another yard. The oval may be used for horses overnight. The horses must be caught and tied up prior to the first lesson the following day. Portable yards may also be built around the pony club grounds. Camping arrangements are as follows: The four-day camp will require lots of energy, so to ensure that everyone gets adequate sleep it may be a good idea to pitch a tent, bring a caravan or sleep in your horse float to ensure that when the lights go out you can get to sleep. Clinic participants may also bring a mattress & sleeping bag to throw down in our large clubrooms. There will be lights off curfew for riders but this will not guarantee that you will not be disturbed. Parents of small children are required to supervise them at bedtime. PLUS: We have a TELEVISION, VIDEO & DVD PLAYER You can sit back on the couch and relax while watching some of your favourite shows. Feel free to bring your own movies, please make sure that they are clearly marked with your name. Please be careful when around the above equipment as it is expensive and we don t want it damaged. MEALS Clinic participants are provided with Breakfast & Tea. Lunch is at your own cost. Note: Parents, relations and friends wishing to take advantage of the same meals as clinic participants may do so at a cost of $50.00 per person. All riders & pre-paid meal purchases will be given a wristband to wear over four days The Canteen will open for Lunch each day, offering a variety of meals for SALE. The Canteen will also sell drinks, lollies, cakes plus tea & coffee. If you would like to donate a cake, slice or biscuits to sell in the canteen it would be greatly appreciated. DRINK BOTTLES All participants will be given a named drink bottle filled with water to take to each lesson. These will be refilled to ensure that everyone is drinking enough throughout the busy daily program. Two parents from each group will be responsible for delivering drinks to each lesson. Please check roster. (The bottles remain the property of the Bealiba Pony Club) FREE SUNSCREEN Remember to SLAP ON some sunscreen throughout the day and don t forget to WEAR a hat!

Friday 25 th September ITALY We will dine on pizza & pasta, drink cappacino and sample gelato. In the evening camp participants will split into small groups to design An outfit suitable for the catwalk. Some interesting material will be used. Join us for the evening guaranteed to be lots of fun!! FRANCE - Start the morning eating crepes (pancakes) with a variety of toppings Saturday 26 h September ENGLAND Enjoy an evening meal of Roast Beef with Yorkshire Pudding followed by trifle or bread & butter pudding. After the meal a friendly game of cricket will be held. Names will be drawn out of a hat to select two teams Australia vs England Teams will play for the Mini Ashes. Sunday 27 th September AMERICA Today everything will ber upsized!! Enjoy burgers & chips followed by a Banana split or Sundae. You may even like to try a peanut butter & Jelly Sandwich. In the evening throw on your Halloween outfit and join us as we take part in Trick or Treat around the township of Bealiba. Monday 29 th September AUSTRALIA Enjoy a BBQ Lunch followed by Pavlova and Lamingtons. A special lunch-time activity will be the running of the Bealiba-Melbourne Cup. A special feature on past Melbourne Cups will be on display. A MESSAGE FROM OUR DISTRICT COMMISSIONER - FAYE BARNETT. I have held the position of DC of Bealiba Pony Club for the past 15 years; over this time I have watched many riders advance from being on a lead to competing at top level. I can honestly say that the regular camps and instructional clinics are a major reason why these riders have gained confidence, learnt new skills and been given the confidence to move forward. This four day camp is a wonderful opportunity to have consecutive lessons with our wonderful instructors. Four days of Dressage and Show Jumping lessons with Allan and Lynn will help you to become a better rider. As well as mounted lessons our program offers unmounted lessons, nighttime activities, wonderful facilities and meals (breakfast & tea), this is all included in the price of the camp. Throughout our camps many friendships are made, while riding is important so is the ability to socialize with people of various ages. Groups will be kept to 6/7 per group, with lessons running for 1 ¼ to 1 ½ hours. I am hoping that most riders will be able to book for the 4 days but do understand that sometimes this is not possible due to other commitments.. Please Note: All camp payments MUST be made prior to the camp; this can be done by direct deposit.

APPLICATION FORM Riders Name.. Age. Address.. Town..Postcode. Home Phone Number.Mobile Horses Name..Horses Height. Will applicant be staying overnight? Yes/No YOU MUST SUPPLY ADULT SUPERVISION Name of Parent/Guardian attending camp. I... (Parent/guardian) Herby consent to allow.. To attend the Four Day Pony Club Camp to be conducted by the Bealiba & District Pony Club Inc. on Friday 25 th, Saturday 26 th, Sunday 27 th & Monday 28 th September 2015 and enclose payment Being For: $..being Clinic entry Fee $...being for Day Insurance $10 per rider per day $...being for Camping with Power Access ($5 per night) $...being for Extra Meals @ ($50 per person) Method of payment $...: Total Fees Cheque/Money Order/Cash/Direct Deposit Signature. (Rider/parent/guardian, person over 18 years) Preferred Method of Payment; Direct Deposit: Bendigo Bank. BSB: 633-000 Account No: 112958616. Please add Surname & Clinic to transaction & email confirmation to bealibaponyclub@hotmail.com ALL CLINIC MONEY MUST BE PAID PRIOR TO THE CLINIC. Thank-you for your entry to our September Camp, we hope that you enjoy your time, improve your riding skills and make many new friendships. Committee of Bealiba Pony Club

LIABILITY DECLARATION FORM 2015-2016 EVERY DAY PARTICIPANT/OPEN RIDER MUST COMPLETE THIS FORM Event: Four day camp Date of Event: 25-28/9/15 Organising Body: Bealiba Pony Club Address of Event: Park Lane Bealiba PLEASE TICK THE APPROPRIATE BOX: I am a current member of an equine association, and/or I hold a current insurance policy, which provides me with 24/7 Public Liability insurance to the minimum limit of $10,000,000 per occurrence. The equine association I am a member of:... and My membership / policy number is:... I have provided my Membership Card / Insurance Policy / Certificate of Currency as proof of this insurance and if necessary* read, acknowledged & signed the Day Participant Waiver. Please tick if you are a member of: Equestrian Australia (please note you must be a direct member of your state branch and not just an affiliated club). Arabian Horse Society of Australia (please note you must be a financial member of the AHSA and not just an affiliated club). Pony Club Association of Victoria Interstate Pony Club Australian Endurance Riders Association Other (specify) HRCAV OR I hold my own personal liability policy for my equestrian activities. The insurance company is: and I attach my Certificate of Currency. I am not a member of any of the above and do not have a current Public Liability policy with a minimum of $10,000,000 cover so will complete the Registered Day Participant Waiver (below) and tender $10.00 per person per day (including GST) to cover the cost of participation with this Pony Club for each day of this event. I am aware that this is not Personal Liability Insurance so cover does not extend to cover travel to and from this event. I am also aware that no Personal Accident cover is provided. Full Name: Address: D.O.B: Postcode: Signed: (Guardian under 18) Contact Phone: DAY PARTICIPANT WAIVER 2015-2016 Participants in events organised by PCAV Clubs, who are not current financial members of a PCAV Club, or who do not have any other approved insurance in place, upon completion of this form are deemed to be Day Participants of the event. Protection is afforded to the Day Participant under the PCAV Public Liability policy, only whilst participating in activities organised and/or run by the PCAV Club at that event, where they are liable for causing bodily injury or property damage to others, excluding whilst travelling to and from such event. By signing this form, you agree to abide by the Rules & Conditions of the PCAV and any Rules of the event. For every Entrant who does NOT have a current and proven Public Liability insurance to the minimum of $10,000.00 a payment is due of $10.00 per person per day (including GST), to cover the cost of participation with this Pony Club for each day of this event. Horse Sports are a Dangerous Activity I, the undersigned, in consideration for being permitted to participate in any way in horse sport activities and in particular this event, acknowledge and accept that: Horse sports are a dangerous recreational activity and horses can act in a sudden and unpredictable way, especially if frightened or hurt. There is a significant risk that serious injury or death may result from horse sport activities and in particular this event and freely assume all such risks, even if arising from the negligence of PCAV and/or the event organiser / official. I voluntarily participate at my own risk and assume sole responsibility for any injury, death or property damage I may suffer that arises from my participation in horse sport activities. I understand and acknowledge the dangers associated with the consumption of alcohol or any mind altering drugs before and during the activity and I take full responsibility for any injury, loss or damage associated with their consumption. I agree to follow the directions of any event organiser or official and that any misconduct or refusal by me to follow any direction of any organiser or official can result in the cancellation of my participation in the event and my immediate removal from my horse no

matter where that may occur. I further agree to abide by the Rules and Conditions of this event and the official Rule Book of the Pony Club Association of Victoria. I understand that any such non-compliance may result in injury, death and/or permanent disability and I agree to indemnify PCAV against all claims made by any person as a result of my failure to comply. I agree to wear a helmet at all times whilst riding and agree that I am solely responsible for ensuring that I wear a suitable helmet at all times while riding and take sole responsibility for my actions. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin, hereby release and hold harmless and agree not to sue the proprietors of the Pony Club Association of Victoria and/or the event organiser, their officers, officials, volunteers, coaches, agents and/or employees, other participants, sponsoring agencies, sponsors, state bodies, affiliated clubs and if applicable, owners and lessors of premises used to conduct the activities (all of whom are referred to as Releasees ) with respect to any and all injury, disability, death, or loss or damage to person or property, whether caused by the negligence of the Releasees or otherwise. Effect of this Document - I have had sufficient opportunity to read this release of liability and assumption of risk agreement, fully understand its terms, understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without inducement of any kind. I understand that my signature to this document constitutes a complete and unconditional release of all liability of the Releasees, to the greatest extent allowed by law in the event of me and/or the children under my care, suffering injury or death. In consideration of your accepting my participation, I hereby undertake to indemnify the organising body against all claims, losses, suits and damages made against or suffered by the organising body by reason of any negligent act or omission on the part of any rider, driver, trainer or attendant whilst he/she is attending, riding, driving or otherwise handling any horse so entered or any other horse owned or entered by me, and I agree that any act or omission on the part of such rider, driver, handler or attendant found in any action against you to be negligent shall be deemed to have been negligent for the purpose of any claim under this indemnity. Further, I agree to abide by the Rules & Conditions and current Rule Book as laid down by the Pony Club Association of Victoria and/or contained in any official event schedule and I also agree to abide by all of the Event Venue rules regarding use of their centre and its facilities. Full Name: Address: D.O.B: Postcode: Signed: Contact Phone: For Participants of Minority Age (Under Age 18) This is to certify that I, as a parent/guardian with legal responsibility for this participant, acknowledge, understand and accept all of the above and consent and agree to his/her release as provided above of all the Releasees, and, for myself, my heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities arising from my minor child s involvement or participation in horse sport activities and in particular, this event, even if arising from the negligence of the Releasees. Full name of Rider: Address: Full Name of Guardian: D.O.B: Postcode: Contact Phone: Signed: Gow-Gates Insurance Brokers Pty Ltd, Level 8, 491 Kent Street, Sydney, NSW, 2000 P :(02) 8267 9999 F: (02) 8267 9998 E: equestrian@gowgates.com.au ABN 12 000 837 785 AFSL 245432