2015 Royal Show Entry, Indemnity & Banking Form

Transcription

2015 Royal Show Entry, Indemnity & Banking Form
2015 ROYAL AGRICULTURAL SHOW, SHOWING SECTION ENTRY FORM
Please refer to details in the Schedule concerning the entry fees, levies and rules pertaining to each particular event.
Send together with your deposit slip, clearly marked, when making entries. Please remember to put Rider’s surname in the reference box when making a
direct deposit or bank transfer (not the name of your horse). If you are doing a deposit for another rider please include their surname as well. PLEASE
INDICATE ON THE ENTRY FORM IF JUNIOR,ADULT OR PONY RIDER.
ENTRIES CLOSE 12 May 2014 (NO LATE OR TELEPHONIC ENTRIES WILL BE ACCEPTED)
BANKING DETAILS: Royal Riding Club, FNB, Midlands Mall, Branch code: 257355 - Account Number: 62 412 865 084
Fax to: 086 516 8100/033 330 8234
Email to: TheRoyalRidingClub.2013@gmail.com
CLASS
HORSE
Height
RIDER/HANDLER
Adult/Jnr
Or PR
ENTRY
FEE
OWNER
Stabling…..nights @R120 per horse/pony per night x…...horses.
SASA Horse Reg. No.:
SASA Temporary Membership Fee (Not applicable to breed,inhand and young children’s classes)@ R30
SASA Rider Reg. No.:
R50, Admin levy per horse.
Programme R25
AHS 1
Showing Number R10
Date: …………….. Batch No: ……………………
AHS 2
Date ……………… Batch No …………………….
TOTAL
Flu Vac
Date……………….. Batch No: …………………….
Name……………………………………………………………………………………………………………………… Address …………………………………………………………………...
Tel No (day) ……………………………………………….. Cell No ……………………………..……………… Email: (please print clearly)……………………………………………………………….…
LIABILITY: I the undersigned agree to be bound by the rules as set out in the show schedule & Indemnity set out below.
Signature …………………………………………………………………………………………………… Date ………………………………………………………………. 2015
INDEMNITY FORM
CONFIRMATION BY Provincial Secretary
INDEMNITY
In the Event of the exhibiter being under the age of 18 years, the Parent/Guardian must
complete Indemnity.
1. I declare that the particulars on this entry form are true. I am aware of, and agree to be
bound by the General Regulations of the Society and by the conditions governing the
Horse Section.
2. I understand:
 That the Society’s Public Liability Insurance Policy does not cover exhibitors or their
animals and it is in my interests, therefore, to obtain my own Public Liability cover
for the Show.
 The Society’s Rule relating to vehicles parked within the grounds and hereby
authorise the Society to tow away my vehicle (or the vehicle I have hired/loaned), at
my expense, should same be parked in contravention of the Rules.
Name: …………….……………………… Signature: …………………………………..Date: ………………………2015
Out of Province Entries :
On behalf of the ……………………………………….…
Horse Society, I hereby certify that the above
entries are correct in every respect as at the
closing date of entry
Name: …………………………………………………………….
Signature: ………………………………………….……………
Date: …………………………………………………………..….
PLEASE STATE IF YOUNG RIDER:
Name: ……………………………………. Date of Birth………………………….………..Age …………..……………
Account Name:
EXHIBITORS BANKING DETAILS TO ALLOW FOR ELECTRONIC TRANSFER OF WINNINGS IF NOT PAID AT THE SHOW FOR ANY REASON.
Bank:
Account Number:
(Parent or Guardian if Exhibitor/Rider under 18 yrs)
Branch & Number: