Fun Day Entry Form

Fun Day Date: Sunday 20th July.

Entries are open. Entries close midnight Monday 7th July

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

RWW – Affinity

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.

$30 per CLASS + $9.00 ground levy for horses entering Shibumi

Please note that entries must be paid immediately upon entering.
Failure to make payment 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.

July 2025 Fun Day Entry

Riders Contact Details

First Name *

Surname *

Mobile No. *

Physical address of rider
*

CountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabwe

City

Zip code

Postal address of rider (only required if different to physical address)

CountryUnited States (US)United Kingdom (UK)CanadaAustralia---AfghanistanÅland IslandsAlbaniaAlgeriaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAmerican SamoaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelauBelizeBeninBermudaBhutanBoliviaBonaire, Saint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBritish Virgin IslandsBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos (Keeling) IslandsColombiaComorosCongo (Brazzaville)Congo (Kinshasa)Cook IslandsCosta RicaCroatiaCubaCuraÇaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqRepublic of IrelandIsle of ManIsraelItalyIvory CoastJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacao S.A.R., ChinaMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNetherlands AntillesNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorwayOmanPakistanPalestinian TerritoryPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalQatarReunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint Martin (French part)Saint Martin (Dutch part)Saint Pierre and MiquelonSaint Vincent and the GrenadinesSan MarinoSão Tomé and PríncipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia/Sandwich IslandsSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUruguayUzbekistanVanuatuVaticanVenezuelaVietnamWallis and FutunaWestern SaharaWestern SamoaYemenZambiaZimbabwe

City

Zip code

Your email address *

Payment Method & Details

Please note that 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 will result in your entry being cancelled.

*

I understand that payments MUST be made at time of entry to Shibumi Equestrian Centre Pty Ltd, BSB 012 013, Account number 288 666 767

*

I understand if payment is not made within a maximum of 48 hours my entry will not be included on the draw

*

I understand that NO Refunds after the closing date will be given unless a vet or doctors certificate is presented and that regardless of cicumstance an administration fee will be charged.

*

I understand any scratchings or cancellations received after the draws have been sent out are not eligible for a refund regardless of a medical or vet certificate being produced.

*

I understand that an invoice will not be sent for my entry

Important Information

Risk Warning,Waiver & Indemnity *

I confirm that I have read and signed the Risk Waiver form found here.

The Risk Waiver form must be read and signed. I understand that it is my decision to sign the document electronically, maunally or by other means, However by ticking the confirmation box above I confirm that I have signed the linked form and this has the same force and effect as an original signature on the linked form.

Medical Assistance *

I acknowledge that equestrian pursuits are inherently dangerous and accept that Shibumi Equestrian Centre will NOT have full time paramedics on site at the Fun Day, but that there will be HLTAID011 accredited senior first aiders in attendance.

Photo Release *

By participating in the Fun Day at Shibumi Equestrian Centre you are consenting to you or your child/ children or family being photographed or filmed. Shibumi Equestrian Centre and their sponsors may use the images on social media and websites.

Junior Riders

Parent/Guardian's name (If rider is under 18 yrs)

Parent/Guardian's Mobile #

Emergency Contact Details

Name of Next of Kin (In case of emergency) *

Next of Kin - Phone # (mobile preferred) *

Next of Kin - email address *

Entry details for rider and/or horse 1

$30 per class ($22 -fancy dress) + $9.00 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) *

Age of Rider 1 (if under 18 yrs)

Horse Name (Horse 1) *

Registered Name of Horse (Horse 1) *

Owners Name (Horse 1) *

1st CLASS (1) *

NOT ENTERING ANY MORE CLASSESJ 25J 45J 60J 75J 85J 95J 105D1 - PREPARATORY 2 (2023)D2 - PRELIMINARY 1.2 (2023)D3 - NOVICE 2.1 (2023)D4 - Choose Your own TestFancy Dress

2nd CLASS (1)

NOT ENTERING ANY MORE CLASSESJ 25J 45J 60J75J 85J 95J 105D1 - PREPARATORY 2 (2023)D2 - PRELIMINARY 1.2 (2023)D3 - NOVICE 2.1 (2023)D4 - Choose Your own TestFancy Dress

3rd CLASS (1)

NOT ENTERING ANY MORE CLASSESJ 25J 45J 60J 75J 85J 95J 105D1 - PREPARATORY 2 (2023)D2 - PRELIMINARY 1.2 (2023)D3 - NOVICE 2.1 (2023)D4 - Choose Your own TestFancy Dress

4th CLASS (1)

NOT ENTERING ANY MORE CLASSESJ 25J 45J 60J 75J 85J 95J 105D1 - PREPARATORY 2 (2023)D2 - PRELIMINARY 1.2 (2023)D3 - NOVICE 2.1 (2023)D4 - Choose Your own TestFancy Dress

Please specify Test here if you chose 'D4 - Choose 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

$30 per class ($22 fancy dress) + $9.00 Ground Levy for horses entering Shibumi.

Rider Name (Rider 2)

Age of Rider 2 (if under 18 yrs)

Horse Name (Horse 2)

Registered Name of Horse (Horse 2)

Owners Name (Horse 2)

1st CLASS (2)

NOT ENTERING ANY MORE CLASSESJ 25J 45J 60J 75J 85J 95J 105D1 - PREPARATORY 2 (2023)D2 - PRELIMINARY 1.2 (2023)D3 - NOVICE 2.1 (2023)D4 - Choose your own TestFancy Dress

2nd CLASS (2)

NOT ENTERING ANY MORE CLASSESJ 25J 45J 60J 75J 85J 95J 105D1 - PREPARATORY 2 (2023)D2 - PRELIMINARY 1.2 (2023)D3 - NOVICE 2.1 (2023)D4 - Choose your own TestFancy Dress

3rd CLASS (2)

NOT ENTERING ANY MORE CLASSESJ 25J 45J 60J 75J 85J 95J 105D1 - PREPARATORY 2 (2023)D2 - PRELIMINARY 1.2 (2023)D3 - NOVICE 2.1 (2023)D4 - Choose your own TestFancy Dress

4th CLASS (2)

NOT ENTERING ANY MORE CLASSESJ 25J 45J 60J 75J 85J 95J 105D1 - PREPARATORY 2 (2023)D2 - PRELIMINARY 1.2 (2023)D3 - NOVICE 2.1 (2023)D4 - Choose your own TestFancy Dress

Please specify Test here if you chose 'D4 - Choose 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)

Other Important 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 our Fun Days? *

Facebook

Friend/Family

Search Engine like \'Google\' or \'Yahoo\'

Other

Are you a member of a club?

Please list here, e.g EA, Moss Vale Pony Club, Bowral Dressage etc

Do you have any special dietary requests?

e.g gluten free lunch

Do you have any other special requests?

Where is your pony/ horse generally kept

At your home.
Agisted at a property (please provide contact details)
Agisted at an agistment centre (please provide contact details)

SUBMIT