Maryborough Active Riders Club Inc RUTH WHITE CLINICS

Maryborough Active Riders Club Inc
RUTH WHITE CLINICS - RIDER BOOKING FORM
FEES FOR LESSONS (Inc. facility fee and travel costs for
PRIVATE LESSONS
instructor)
Bookings Close: Monday 13th April 2015
SHARED LESSONS
$84.00 FOR MARC MEMBERS
$88.00 FOR EFA MEMBERS
$52.50 FOR MARC MEMBERS
$56.00 FOR EFA MEMBERS
MONEY MUST ACCOMPANY BOOKINGS or it will not be accepted – MARC members have priority, clinic is
also open to EFA members who are NON - MARC members
PERSONAL INFORMATION
NAME
ADDRESS
E-MAIL
TELEPHONE
MARYBOROUGH ACTIVE RIDERS MEMBER
EFA MEMBER NUMBER
Please PRINT your name in the table below next to the preferred time and place a tick in the preferred day of the lessons.
Organiser will endeavour to accommodate preferred day and times where possible. If you have 2 horses then place H1 or H2
next to your name
If you are unable to attend the lesson you have booked you will need to find a replacement rider or have a Vet certificate to
obtain refunds.
VENUE: FRIDAY - COVERED ARENA AND SATURDAY- LEANDRA’S ARENA
DATE: 17- 18 APRIL 2015
Time
Name
8.00
8.45
9.30
10.15
10.30
11.15
12.00
1.30
2.15
3.00
3.45
4.00
4.45
Friday
Saturday
Morning Tea
Lunch
Afternoon Tea
PAYMENT
POST BOOKING FORM WITH CHEQUE OR POSTAL MONEY ORDER TO:
Leandra Hulst, 135 Old Coach Rd, Torbanlea Q 4662
Make Cheques payable to MARC Inc.
TOTAL NUMBER OF PRIVATE LESSONS X
$84.00 MARC MEMBER OR $88.00 EFA
DIRECT DEPOSIT PAYMENTS MAY E-MAIL THEIR BOOKING FORM TO:
thulst@bigpond.net.au
TOTAL NUMBER OF SHARED LESSONS X
$52.50 MARC MEMBER OR $56.00 EFA
MEMBER- MAXIMUM 2 RIDERS
FOR DIRECT DEPOSIT
MARYBOROUGH ACTIVE RIDERS CLUB INC
ALL STABLES ARE NOW LOCKED,
BOOKINGS FOR STABLES AND CAMPING ARE
TO BE MADE THROUGH NOMINATE.COM, IF
Commonwealth Bank, BSB 064 421, Account no. 00906677
DIRECT DEPOSITORS – PLEASE ATTACH YOUR RECEIPT
MEMBER
YOU HAVE ANY PROBLEMS CONTACT
PH: 0427773760 (THEA)
OR 41223584 (JULIE)
TOTAL
INDEMNITY
I understand and acknowledge that horse sports are a dangerous activity and that horses can suddenly act in an unpredictable manner, especially if
frightened or hurt.
I understand and acknowledge that serious injury or death may result from horse sport activities, including this event.
I agree that I participate at my own risk
I agree not to drink alcohol or take drugs prohibited by law before or during this event.
I understand that my signature to this document constitutes a complete and unconditional release of all liability to Equestrian Australia (EA),
Maryborough Active Riders Club Inc., and including all of its state bodies, coaches and affiliated clubs, to the greatest extend allowed by the law in the
even of me / or the children under my care suffering injury or death.
Signature of:
Rider / Guardian………………………………………………………………Dated……………………………………….