Royal Agricultural Society of Western Australia HORSES IN ACTION CARRIAGE DRIVING
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- Beverley Jefferson
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1 Royal Agricultural Society of Western Australia HORSES IN ACTION CARRIAGE DRIVING APPLICATION FOR ENTRY (Please read the schedule thoroughly before filling in this entry form and signing the acknowledgement below) Entries close 4.00pm FRIDAY 20 JULY ENTRIES RECEIVED AFTER THIS DATE AND TIME WILL NOT BE ACCEPTED. Please forward entry forms to: horses@raswa.org.au OR Horses Competition and Event Coordinator, PO Box 135, Claremont WA 6910 PLEASE ENSURE THAT ENTRY FORMS ARE COMPLETED CORRECTLY AND THAT ALL REQUIRED PAPERWORK IS INCLUDED. IF YOU FAIL TO DO SO YOUR ENTRY WILL BE RETURNED. PERSONAL DETAILS Are you a current RASWA Member? Yes No Membership No:... Are you a first time exhibitor? Yes No Exhibitor Name: (This will be printed in the Catalogue and on Prize Certificates) Company Name: (This will be printed on Tax Invoices and Receipts - only if registered for GST) Contact Name: Title (Dr, Mr, Ms etc) First Name: Surname: Postal Address: Suburb: State: Postcode: *A mobile number and address are mandatory and must be provided below: Telephone:... *Mobile:... * ... PAYMENT OF ENTRY FEES Method of Payment for entry fees: Cheque for... to be made payable to the Royal Agricultural Society of WA. (Office use only - cheque number ) Please debit my Mastercard Visa for the amount of... Card Number: / / / Expiry Date: / Name on Card:...Signature... CONDITIONS OF ENTRY 1. I/We certify that the particulars as shown on this entry form are correct and I have read and agreed to the terms and conditions of entry as detailed in the 2018 Horses in Action Schedule, including the liability and indemnity provisions. 2. I/We agree to be bound by the Society s General Show Regulations (refer to the RASWA website or alternatively a copy is available upon request). 3. Permission is hereby granted to the publication of photographs relating to participation in the Competition. SIGNATURE OF EXHIBITOR:... DATE: / / (If the Exhibitor is under 18 years, this must be signed by the Exhibitor s Parent or Legal Guardian) PRIVACY ACT STATEMENT The information provided by the Exhibitor in the application for entry is collected and used by the Royal Agricultural Society of Western Australia (RASWA) to organise and conduct Competitions at the 2018 IGA Perth Royal Show. We may publish details such as your name, address and exhibit details in any RASWA publication or communication. Such information may also be made available to, and published by, the media. We will not disclose your information without your consent for any other purpose unless required or authorised by law. You may request access to your personal information and, if necessary, request that our records of that information be corrected by writing to the Chief Executive Officer at the Royal Agricultural Society of Western Australia, PO Box 135, Claremont WA PAGE 1 OF 4
2 ACCOUNT DETAILS RASWA has a policy whereby all prize money is paid by EFT (Electronic Funds Transfer). Your banking details will be kept secure and can only be used by RASWA to credit your bank account. Please complete your account details even if you have provided them previously. In accordance with the rules of the competition, failure to provide your bank details will mean that any prize money you earn will be forfeited and retained by RASWA. Please complete the following: Account Name. Print clearly the account name as shown on your account records. Do not write the account type (for example savings, cheque or mortgage offset). Include spaces between each word and between initials in the account name. Bank. This is the bank name (for example NAB, ANZ, Commonwealth Bank, etc). BSB No. This six digit number identifies the financial institution. Do not include spaces, dashes or hyphens in the number. Account No. You cannot use an account number with more than nine characters. Do not include spaces in the account number. Prize money cannot be paid via electronic funds transfer (EFT) if the nominated account has restrictions on EFT deposits, is a credit card, or an overseas account. THIS SECTION MUST BE COMPLETED. ACCOUNT NAME: Royal Agricultural Society of WA PRIZE MONEY PAYMENT DETAILS BANK: BSB NO: ACCOUNT NO: GST MANAGEMENT RASWA requires the following information from all Competitors in order to make appropriate payments to those Competitors who win a prize. 1. Is what you are supplying to RASWA done as a private recreational pursuit or hobby? Y N 2. If No to Question 1, what is your ABN? 3. Are you registered for GST? Y N NOTE: It is a condition of entry that this information be forwarded to the Royal Agricultural Society of WA. If you do not complete this section of the form we may be required to withhold 47% of your prize payment. Office Use Only Please tick Please tick Account Details Entered: Date: / / PAGE 2 OF 4
3 CURRENT REGISTRATION CERTIFICATES ARE REQUIRED FOR ALL HORSES NAME OF HORSE: REGISTRATION NO: COLOUR: HEIGHT: STALLION MARE GELDING DAY CLASS NO. NAME OF DRIVER ACDS NO. D.O.B ENTRY FEE NAME OF HORSE: REGISTRATION NO: COLOUR: HEIGHT: STALLION MARE GELDING DAY CLASS NO. NAME OF DRIVER ACDS NO. D.O.B ENTRY FEE CATALOGUES: Catalogues cost 5.50 and may be ordered and paid for with the entries. Catlaogues will be available for collection from the Armband Office on arrival at the Showground. A limited number of Catalogues will be available for sale during the Show. MEDICATION CONTROL WARNING: Owners of horses/ponies are warned that many medical preparations and tonics whose, ingredients and quantities analysis are not specifically known, may contain prohibited substances. An offence may result in severe penalties and costs may be awarded in relation to the determination of any proceedings. CLASS FEES STABLE FEES LOCKER FEES CATALOGUE PARKING TOTAL CARRIAGE DRIVING QUALIFICATION: Both the horse/pony and driver must have competed in at least two (2) recognised Carriage Driving Shows between the 6 July 2017 and 20 July 2018, one of which may include the 2017 IGA Perth Royal Show. NAME OF HORSE: DRIVER 1ST CARRIAGE DRIVING SHOW DATE 2ND CARRIAGE DRIVING SHOW DATE NAME OF HORSE: DRIVER 1ST CARRIAGE DRIVING SHOW DATE 2ND CARRIAGE DRIVING SHOW DATE PAGE 3 OF 4
4 Royal Agricultural Society of Western Australia 2018 IGA PERTH ROYAL SHOW - HORSE SECTIONS DISCLAIMER STATEMENT NOTE: A SEPARATE DISCLAIMER STATEMENT IS REQUIRED FOR EACH PERSON. Before signing this Disclaimer, refer to the Section Conditions in the Society s Horse Schedules relating to the Parent/Guardian Responsibility, Safety Helmets, General Show Regulation 17 and the Animal/Livestock Owners/Exhibitors Public Liability Insurance. Exhibitor Name: Exhibit Name: ALL ADULT EXHIBITORS, RIDERS, DRIVERS, PASSENGERS, GROOMS, ATTENDANTS and ANY OTHER PARTICIPANTS 18 YEARS OF AGE and OVER I acknowledge and agree as a condition of participating at the 2018 IGA Perth Royal Show that neither the Royal Agricultural Society of Western Australia, its directors, officers, employees, members and agents, participants, officials, volunteers, medical personnel, any persons, promoters, sponsors, providers of equipment, advertisers, nor Owners or Lessees of premises used to conduct the EVENT(S) shall be under any liability whatsoever for either the death of or for any injury, loss or damage which may be sustained or any claim, demand or costs arising therefrom and incurred by myself or any rider, driver, passenger, attendant or any other participant for whom I am responsible, as a result of participation in or being present at the EVENT(S). I acknowledge that equestrian activities are dangerous and that accidents causing death, injury, disability and property damage, can, and do occur. By signing hereunder I confirm I have read and understood the contents of this Disclaimer together with the Society s Section Conditions, General Show Regulation 17 and the Animal/Livestock Owners/Exhibitors Public Liability Insurance by which I agree to abide. Name (Print): Signature: Dated this: day of PARENT/LEGAL GUARDIAN CONSENT for EXHIBITORS, RIDERS, DRIVERS, PASSENGERS, GROOMS, ATTENDANTS and ANY OTHER PARTICIPANTS 17 YEARS OF AGE and UNDER I,, being the parent/legal guardian of Name: Address: Date of Birth: confirm that I have read the whole of this document and have taken all necessary actions to ensure I am aware of the activity in which the above named will participate at the 2018 IGA Perth Royal Show and consent to him/her participating. In doing so, I acknowledge that equestrian activities are dangerous and that accidents causing death, injury, disability and property damage can and do occur. I acknowledge and agree that neither the Royal Agricultural Society of Western Australia, its directors, officers, employees, members and agents, participants, officials, volunteers, medical personnel, any persons, promoters, sponsors, providers of equipment, advertisers nor Owners or Lessees of premises used to conduct the EVENT(S) shall be under any liability whatsoever for either the death of or for any injury, loss or damage which may be sustained or any claim, demand or costs arising therefrom and incurred by the abovenamed or by any other person for whom I am responsible as a result of participation in or being present at the EVENT(S). By signing hereunder I confirm I have read and understood the contents of this Disclaimer together with the Society s Section Conditions, General Show Regulation 17 and the Animal/Livestock Owners/Exhibitors Public Liability Insurance by which I agree to abide. Name (Print): Signature: Dated this: day of 2018 PAGE 4 OF 4
5 HORSES IN ACTION ENTRIES ONLY 2018 IGA PERTH ROYAL SHOW STABLE, LOCKER AND BED APPLICATION FORM Applications for stables, lockers and beds will only be accepted on this form, and must be accompanied by the appropriate fee. Name of Exhibitor (Use separate form for each Exhibitor): Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Stable Application 20-Sep 21-Sep 22-Sep 23-Sep 24-Sep 25-Sep 26-Sep 27-Sep 28-Sep 29-Sep Name of Horse/Pony Sex (C/S/F/M/G) Height DAY NIGHT DAY NIGHT DAY NIGHT DAY NIGHT DAY NIGHT DAY NIGHT DAY NIGHT DAY NIGHT DAY NIGHT DAY NIGHT Overnight stables will not be available to incoming horses/ponies until after 6.00pm on the evening prior to judging. Stable fee is per horse/pony per day (including overnight). TOTAL EXHIBITORS PLEASE NOTE: STABLES CAN ONLY BE BOOKED FOR THE NIGHT PREVIOUS AND THE DAY OF COMPETITION Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Locker Application 20-Sep 21-Sep 22-Sep 23-Sep 24-Sep 25-Sep 26-Sep 27-Sep 28-Sep 29-Sep X... days Locker fee is per locker per day TOTAL Bed Application Thu Fri Sat Sun Mon Tue Wed Thu Fri Sat Name of person Age M/F 20-Sep 21-Sep 22-Sep 23-Sep 24-Sep 25-Sep 26-Sep 27-Sep 28-Sep 29-Sep Accommodation will not be provided for Exhibitors residing within an 100km radius, as shown on the map over page. Due to the limited number of bunks available, country Exhibitors will have preference in the allocation. A maximum of two beds will be available per every one exhibit. Signature of Exhibitor / Parent / Guardian Date
6 TERMS AND CONDITIONS THE AREAS IN THE DIAGRAM BELOW ARE CONSIDERED WITHIN THE 100KM RADIUS OF THE SHOWGROUND. 1. No Exhibitor shall be deemed to have any right, whether of occupation or otherwise, to any bed, locker, stable or any portion of the Showground allocated to him/her from time to time by the Society. He/she shall forthwith vacate same upon being requested to do so by any authorised Official of the Society. 2. Any horse found in a stable not allocated to such a horse shall if so required by the Chief Executive Officer, be immediately removed from the Showground except with the written consent of the Chief Executive Officer. 3. Any person found in possession of a locker not allocated to him/her shall if so required by the Chief Executive Officer be immediately removed from the Showground except with the written consent of the Chief Executive Officer. 4. Any person found in a bed not allocated to him/her shall if so required by the Chief Executive Officer, be immediately removed from the Showground except with the written consent of the Chief Executive Officer. 5. Any person found parked in the Private Road facility without the allocated Parking Permit attached to the windscreen of the vehicle shall if so required by the Chief Executive Officer be immediately removed from the Showground except with the written consent of the Chief Executive Officer. PLEASE NOTE: ACCOMMODATION WILL NOT BE PROVIDED FOR EXHIBITORS RESIDING WITHIN AN 100KM RADIUS AS SHOWN ON THIS MAP. ALTHOUGH EVERY ATTEMPT WILL BE MADE TO MEET THE ACCOMMODATION REQUIREMENTS FOR THOSE EXHIBITORS OUTSIDE THIS AREA, THIS WILL NOT BE GUARANTEED. PRIORITY OF ALLOCATION WILL BE GIVEN TO EXHIBITORS RESIDING IN AREAS FURTHER FROM THE SHOWGROUND.
7 2018 IGA PERTH ROYAL SHOW IRWIN BARRACKS PARKING FORM Livestock and Walk Through WA Vehicles EXHIBITOR NAME:... ADDRESS:... CONTACT NAME: MOBILE NO:... VEHICLE REGISTRATION NUMBER:.. FLOAT / TRAILER REGISTRATION NUMBER:... VEHICLE MAKE, MODEL AND COLOUR (including details of float if used): SHOW SECTION: (Please Tick) Horses Breed Horses In Action Showjumping Beef Cattle Dairy Cattle Trade Cattle Alpacas Walk Through WA Sheep Goats (Dairy) Dogs PARKING REQUIRED: (Tick Box) WED THUR FRI SAT SUN MON TUE WED THUR FRI SAT SUN 19/09/18 20/09/18 21/09/18 22/09/18 23/09/18 24/09/18 25/09/18 26/09/18 27/09/18 28/09/18 29/09/18 30/09/18 RASWA ADMINISTRATION AND SHUTTLE BUS FEE: 6.00 PER DAY I HAVE INCLUDED THE FEE OF... OR, PAYMENT HAS BEEN INCLUDE WITH ENTRY FEES PAYMENT DETAILS Cheque for is enclosed (To be made payable to the Royal Agricultural Society of WA) Visa MasterCard for the amount of Card Number Card Expiry Date / Card Holder Name Signature of Cardholder Conditions No camping or sleeping at the Barracks. Parking is available from: Wednesday 19 September pm to 6.00pm Thursday 20 September to Sunday 30 September am to 8.00pm No personnel permitted at the Barracks after these times. Drivers will require an Irwin Barracks parking pass which will be posted to you. The parking pass will need to be fixed to the driver s side of the windscreen of the vehicle that has been registered. Vehicles without parking passes will not be admitted into the Barracks. Drivers must ensure that on arrival at the Barracks that they have a valid photo ID (Driver's License) to present to gate staff. To enable adequate parking space to be allocated and to facilitate the preparation of security arrangements and passes, persons considering taking advantage of these parking arrangements must complete this form and return by WEDNESDAY 29 AUGUST 2018 to the Royal Agricultural Society of WA, PO Box 135, CLAREMONT WA Release and indemnify the Commonwealth As a condition of parking you must agree to release and indemnify the Commonwealth, its officers, employees or agents from and against all claims, actions, proceedings, demands, costs and expenses whatsoever and howsoever arising relating to any loss, damage or injury (including death) to any person (including Commonwealth officers and employees) or property (including Commonwealth equipment and stores) caused by or arising out of the provision of the assistance, whether or not such loss, damage or injury (including death) was caused by, or arose out of, any act or omission by the Commonwealth, its officers, employees or agents. I HAVE READ, UNDERSTAND AND AGREE TO THE ABOVE CONDITIONS Signature Date
8 HORSES IN ACTION ENTRY CHECKLIST I have completed the Exhibitor details, signed the entry form and included the entry fees. I have enclosed the Stabling/Locker application form for my Horses in Action entries and all application fees. I have enclosed my bunk room application (if applicable). I have ed/enclosed a copy of the horse/pony Registration papers and a current Height Certificate. I have completed and enclosed the Qualification form. I have enclosed a copy of my Birth Certificate, Passport or Driver s Licence, as proof of age, which is required for all Leading Rein, Kindergarten Rider, Rider and Driver Exhibitors. As the Exhibitor I have enclosed with this entry a signed Disclaimer Statement for myself and one for every person that will handle or ride this exhibit at the IGA Perth Royal Show. If you are going to handle or ride more than one exhibit, a Disclaimer Statement needs to be lodged with every entry. You will need to sign a Disclaimer Statement for every Exhibitor on whose entry your name appears. I have entered the Leslie Jones Memorial class and have supplied the registered Thoroughbred name and enclosed a copy of the Thoroughbred registration papers or document booklet. I have retained a copy of my entry form as a record of my entry (recommended). To enable prompt processing of your entry, you will need to make sure that all your documentation has been checked against this list and that photocopied documents have been supplied with your entry as required.
9 Your shoes must cover the upper part of the foot. Shoes that DO NOT cover the upper part of the foot will NOT be allowed. requirements Also, State badges, pins or emblems will not be allowed to be worn on hacking jackets. These are only to be worn when competing for your State at a National Competition.
10 MULTI ENTRY PASSES Exhibitors will be issued passes for admission to the grounds on the following ratio: 1 or 2 Horses/Ponies stabled per day 2 passes 3 or 4 Horses/Ponies stabled per day 3 passes 5 or more Horses/Ponies per day 1 pass per exhibit The allocation of tickets is not based on the number of Horse/Ponies entered, riders or handlers, but on the number of stables booked per day. All persons entering the Showground before 9.00am must hold a valid Exhibitor, Competitor or Staff pass. Any Exhibitors requiring extra passes must purchase these prior to Friday 3 September (Please see over for application form) Requests for passes after this time will not be processed. Please contact me if you have any queries: Horses Competition and Event Coordinator Phone: horses@raswa.org.au
11 APPLICATION FOR ADDITIONAL ROYAL SHOW ADMISSION PASSES PLEASE COMPLETE AND RETURN THIS FORM WITH THE APPROPRIATE PAYMENT TO: HORSES COMPETITION AND EVENT COORDINATOR ROYAL AGRICULTURAL SOCIETY OF WA PO BOX 135, CLAREMONT WA 6910 Requests for tickets after 3 September 2018 will not be processed. When completing this form please complete all the below details. NAME:... ADDRESS: POST CODE:... MOBILE NO: Section entered: Horses Breed Horses in Action Showjumping Show Days entry is required: Sep Total Admission Days/Tickets per ticket per day:.. Total Payment Included:... All persons wishing to enter the Showground before 9.00am must hold a valid Exhibitor, Competitor or Staff pass. Any person who does not hold one of the aforementioned passes, will need to complete this application form. Payment may be Cash/Cheque/Credit Card (Cheques to be made payable to the Royal Agricultural Society of WA) CREDIT CARD AUTHORISATION Please debit my: MASTER CARD VISA CARD Card Number / / / Cardholder s Name: Expiry Date: / For the amount of:... Signature:... Date:...
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