Fun Day Entry Form

Fun Day Date: Sunday 7th February 2021

Entries are open.

Entries close midnight Monday 25th January.

Fun Day dates and particulars To Be Confirmed depending on changes to Covid 19 guidelines

This Fun Day will be run under the current COVID-19 restrictions … we ask everyone to please co-operate with these requirements

-with keeping a social distance of 1.5m

-following all directional arrows and signage

-There will be no formal prize giving – come to the secretary individually to collect your prize

-the Final Scores will be emailed to all competitors at the end of the day

-There will be canteen with limited access to comply with Covid restrictions

-PLEASE if you are feeling unwell STAY AT HOME

Stay up to date with Public Health Guidelines on www.australia.gov.au

There may be spots available in some classes that are offered at the Fun Day after the closing date – please email Shibumi Equestrian Centre (equestriancentre@shibumi.net.au) directly to find out what classes may be available.

All riders/ parents/ guardians must read our Shibumi FUN DAY NOTICE before filling out the below entry form.

Risk Warning, Waiver & Indemnity Forms:

RWW – Adults NSW – Riders & Drivers

RWW – Children NSW – Riders and Drivers

Our bank details are:

Account Name: Shibumi Equestrian Centre Pty Ltd
BANK: ANZ
BSB: 012 013
Account number: 288 666 767

N.B. Organisers reserve the right to close classes if they become full before closing date. To avoid disappointment please enter early as places in each class are limited.
If entry fee does not accompany the entry – with name of rider as reference and a copy of the
transfer emailed thru – the entry will not be considered valid and the rider’s name will not appear on the draw.

$22 per CLASS + $5.50 ground levy for horses entering Shibumi

Please note that entries must be paid within 48 hours of entering. Failure to make payment within this time period may result in your entry being cancelled.
An invoice will not be automatically sent to you – if you require an invoice please email Sheryl on equestriancentre@shibumi.net.au

If you are human, leave this field blank.
February 2021 Fun Day Entry
Contact & Payment Details
Entries are not finalized until your payment has been made in full and confirmation (including receipt of payment) has been sent via email to equestriancentre@shibumi.net.au. This must be completed within 48 hours of entering. No Exceptions. Failure to make payment within this timeframe may result in your entry being cancelled.
First Name *
Surname *
Mobile No. *
Physical address of rider
*
Country
City
Zip code
Postal address of rider (only required if different to physical address)
Country
City
Zip code
Your email address *
Please select your method of payment *
IMPORTANT: As stated above entries will not be accepted until payment has been received. Please email receipt of payment to equestriancentre@shibumi.net.au with rider's name as reference.
*
I understand that payment must be made (and receipt of payment emailed) within 48 hours of entering or my entry may be cancelled.
*
I understand that entries that are NOT PAID at the time of the entry being submitted WILL NOT be included on the draw.
*
I understand No refunds after the closing date unless a vet or doctors certificate is presented and that an administration fee will be withheld
Important Information
Risk Warning,Waiver & Indemnity *
YES, I have read, accept and agree to adhere to the ‘Risk Warning,Waiver & Indemnity’ document, downloadable at the top of this page.
Photo Release *
By participating in equestrian activities at Shibumi Equestrian Centre you are consenting to you or your child/children being photographed or filmed. Shibumi Equestrian Centre may use these images for promotional use.
This promotional use includes but is not limited to the use of such images on the Shibumi website and any sponsors websites, marketing material and in all forms of media including social media. I understand photos in which I or my child/children appear may be passed to Shibumi Equestrian Centre sponsors who may also use these images for the purpose of promoting their products.
Junior Riders
Parent/Guardian's name (If under 18 yrs)
Parent/Guardian's Mobile #
Age Rider 1 (if under 18 yrs)
Age Rider 2 (if under 18 yrs)
Emergency Contact Details
Name of Next of Kin (In case of emergency) *
Next of Kin - Phone # (mobile preferred) *
Entry details for rider and/or horse 1
$22 per class + $5.50 Ground Levy for horses entering Shibumi Please note that you may enter more than one rider or horse by using the below fields. If you are entering more than 2 horses or riders you will have to fill out another form.
Rider Name (Rider 1) *
Horse Name (Horse 1) *
Registered Name of Horse (Horse 1) *
Owners Name (Horse 1) *
1st CLASS (1) *
2nd CLASS (1)
3rd CLASS (1)
4th CLASS (1)
Please specify Test here if you chose 'D4 - Select your own Test' for any of your tests above
Please specify your tests here (so that we can prepare tests for judges and class draw)
Entry details for rider and/or horse 2
$22 per class + $5.50 Ground Levy for horses entering Shibumi
Ride Name (Rider 2)
Horse Name (Horse 2)
Registered Name of Horse (Horse 2)
Owners Name (Horse 2)
1st CLASS (2)
2nd CLASS (2)
3rd CLASS (2)
4th CLASS (2)
Please specify Test here if you chose 'D4 - Select your own Test' for any of your tests above
Please specify your tests here (so that we can prepare tests for judges and class draw)
Biosecurity Details (Horse 1)
PIC Number (Horse 1)
A property identification code or PIC is a unique identifier for land used for keeping livestock. PICs are assigned to individual properties and allocated by Livestock Health and Pest Authorities (LHPA).
Microchip number (Horse 1)
Microchip number or other unique identifier
Name of person usually in charge of horse (if different to rider) (Horse 1)
Persons Phone Number (Horse 1)
Physical address of horse if different from riders address (Horse 1)
Physical address where horse is usually kept i.e. agistment property
Biosecurity Section (Horse 2)
PIC Number (Horse 2)
A property identification code or PIC is a unique identifier for land used for keeping livestock. PICs are assigned to individual properties and allocated by Livestock Health and Pest Authorities (LHPA).
Microchip number (Horse 2)
Microchip number or other unique identifier
Name of person usually in charge of horse (if different to rider) (Horse 2)
Physical address where horse is usually kept i.e. agistment property
Persons Phone Number (Horse 2)
Physical address of horse if different from riders address (Horse 2)
Physical address where horse is usually kept i.e. agistment property
Other Information
Are you leading a child at the Fun Day?
Please write name of child you are leading. (so that we can allow sufficient time in the draw for you to lead and ride)
How did you hear about us? *
Facebook
Friend/Family
Search Engine like \'Google\' or \'Yahoo\'
Other
Are you a member of a club?
Please list here, e.g EFA, Moss Vale Pony Club, Bowral Dressage etc
Do you have any special dietary requests?
e.g gluten free lunch

Fun Day Date: Sunday 7th February 2021

Entries are open.

Entries close midnight Monday 25th January.

**Fun Day dates and particulars To Be Confirmed depending on changes to Covid 19 guidelines**

This Fun Day will be run under the current COVID-19 restrictions … we ask everyone to please co-operate with these requirements

-with keeping a social distance of 1.5m

-following all directional arrows and signage

-There will be no formal prize giving – come to the secretary individually to collect your prize

-the Final Scores will be emailed to all competitors at the end of the day

-There will be canteen with limited access to comply with Covid restrictions

-PLEASE if you are feeling unwell STAY AT HOME

Stay up to date with Public Health Guidelines on www.australia.gov.au

There may be spots available in some classes that are offered at the Fun Day after the closing date – please email Shibumi Equestrian Centre (equestriancentre@shibumi.net.au) directly to find out what classes may be available.

All riders/ parents/ guardians must read our Shibumi FUN DAY NOTICE before filling out the below entry form.

Please note that entries must be paid within 48 hours of entering. Failure to make payment within this time period may result in your entry being cancelled.An invoice will not be automatically sent to you – if you require an invoice please email Sheryl on equestriancentre@shibumi.net.au

February 2021 Fun Day Entry

Contact & Payment Details

Important Information

Junior Riders

Emergency Contact Details

Entry details for rider and/or horse 1

Entry details for rider and/or horse 2

Biosecurity Details (Horse 1)

Biosecurity Section (Horse 2)

Other Information

2019 Upcoming Events

Fun Day dates and particulars To Be Confirmed depending on changes to Covid 19 guidelines

Please note that entries must be paid within 48 hours of entering. Failure to make payment within this time period may result in your entry being cancelled.
An invoice will not be automatically sent to you – if you require an invoice please email Sheryl on equestriancentre@shibumi.net.au