Woodchop Entry Form

ABN: 65 861 621 504
Office Use Only
Woodchop Entry Form
Paid
Served by ………….………
To the Secretary,
Subject to the Rules, By-Laws, Regulations of the above Society, I wish to make
the following entries for the forthcoming Show.
Exh No
Office Use
Only
Sect
No
Class
No
Carded 
Receipt No. ………….………
Data Input by ………….……
Description of Exhibit
Entry
Fee
Total Entry Fees Payable
Exhibitor Details
Mr/Mrs/Miss/Ms
Full Name ……….……………………………………..………..……….
2-day Exhibitors Passes will be
issued to competitors only.
Postal address …………………………………….…………….….……
…………………………………………………….…………………….….
Family members may purchase
either pre-sold gate passes or buy
passes on Show days.
Town…………………………...... State…….……. Postcode…..….…
Phone No…………………….…… Mob …..……………………………
Email ………..…………………….………………………………………
I hereby certify that I have read the Show Rules and the Conditions of Entry and agree to be bound thereby.
Signature……………………………..…………………………...……
Date……………………………………...………
Please turn over & sign Dangerous Activity Acknowledgement
Telephone (07) 4091 4260
Email: athertonshow@westnet.com.au
Web: www.athertonshow.com.au
Dangerous Activity Acknowledgement
Participant Details
Mr/Mrs/Miss/Ms
Full Name ……….…………………………………….………..…………………………………..
If under 18 years
Guardian's Full Name ...…………………………….....………..………………………………..
Postal address …………………………………….…………….….…………………………………………………..…...…
……………………………………………………………………………………………………………………...…...….…….
Town…………………………………………..…….………... State…….……………….. Postcode…….……..…........
Phone No…………………………………………….…....….…… Mob …..………………………………...………………
Email …………………………………………………………….…………………….………………………..………………
In consideration for being permitted to participate in any way in wood-chopping activities, I, the undersigned,
understand, acknowledge and accept:
•
That wood-chopping is a dangerous activity and that the use of axes and chainsaws can result in sudden and
unpredictable (changeable) consequences.
•
•
That there is a significant risk that serious injury or death may result from wood-chopping activities.
The dangers associated with the consumption of alcohol or any mind altering drugs and agree not to drink
alcohol or take drugs prohibited by law before or during any wood-chopping activities.
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 activities
and my immediate removal from the Arena or the Showgrounds no matter where that may occur.
I agree to take all appropriate safety measures at all times whilst participating in the activities.
I agree to indemnify the Atherton Tableland Agricultural Society Inc, against Liability for any accident, damage,
loss or illness caused to anyone, including but not limited to myself or my property, or a member of the public
during any part of the event, including but not limited to preparation, competition, judging, performing or
displaying.
I have had sufficient opportunity to read this Dangerous Activity Acknowledgement and fully understand its
terms and sign it freely and voluntarily.
Signature of participant …………………..……………………………………… Date………………………………...……
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 my minor child's involvement or participation
in wood-chopping activities.
Signature of guardian ………………..……………………………………… Date……………………………………...……
Telephone (07) 4091 4260
Email: athertonshow@westnet.com.au
Web: www.athertonshow.com.au