ORANGEGROVEADULT RIDERSINC
JOIN UP
2018
PLEASE TAKE THE TIME TO CAREFULLY READ ALL THE FORMS WITHIN THIS PACKBEFORE SIGNING
JOIN UP DAY 28 JANUARY 2018
WELCOME OLD AND NEW MEMEBERS
COME ENJOY A FANTASTIC YEAR HERE WITH US AT
KARINYAEQUESTRIANPARK
GRANT STREET ORANGE GROVE
ORANGEGROVE
ADULT RIDERSINC.
Website:
Email:
MEMBERSHIP
ENROLMENT FORMFOR2018
NAME:ADDRESS:POSTCODE:
HOME PHONE: MOBILE: Date of Birth:
EMAIL:
MOUNT’SNAME
MOUNT’SAGE
MOUNT’SHEIGHT
MEMBERSHIPFEESFOR 2018- MUSTBEPAIDINFULLBY MARCHRALLY
$200.00PERADULTRIDINGMEMBER
RALLY FEES ARE NOT INCLUDED IN MEMBERSHIPFEES.
**THEYARE, $30.00FOR ONE LESSON PER RALLYOR $55.00IF YOU WOULDLIKE TO DO TWOLESSONS.PAYABLEINADVANCE OR YOUR POSITION WILL NOT BE CONFIRMED. IF YOU DONOTADVISE THAT YOU CAN NOT MAKEYOUR LESSON OR LESSONS BEFORE THE THURSDAYYOUR FEESARENOT REFUNDABLE OR TRANSFERABLE.UNLESS YOUHAVEAVET OR DOCTOR CERTIFICATE.AS WE HAVE TOPAYTHE INSTRUCTOR FOR YOUR POSITION.
**OrangeGroveAdult RidersInc.doesnotprovidePersonal InsurancecoverageforAdult Rider members. Insuranceisthe responsibilityoftheMember.
Please Indicate if you are a member of EWA
JOININGAGREEMENT OF ORANGEGROVEADULT RIDERSCLUB INC.
1. Enrolment signifiesacceptanceoftherulesandconstitution.
2. Allridingmembers arerequiredtoassistat OrangeGroveARInc. runevents, whichwill consistof
Either:pencilling,marshalling, gearchecking, canteen, settingupfor theeventsorpackingawayafter theeventsoranyassistance withtheactual organizationon theday.
3. Bysigning thisformyoualsogiveconsentandauthorisationfor themembersontheenrolmentform
to bephotographedat theOrangeGroveARInc.groundsandwhen representing theclubat eventsheldatothervenues.
4. Itiscompulsorytoassistwithsettingupandpackingawayateachrallythatyouattend. Failuretodo sowill resultinnot beingeligibleforany clubtrophiesat theendoftheyearorasuspensionof membership.
5. To abide by the Karinya Management rules. All manure must be removed from yards after use and spread over the adjoin grounds. Strictly no lunging in the sand arenas. Only members are allowed to ride at the grounds at any time. And No Dogs on grounds.
BySigninghereunder,Iconfirmhavingreadandunderstoodandagree tothecontentsofthis enrolment form.
NameSignatureDate
Canyoupleaseensuretocompletein full theMembershippack,thisassiststhecoordinatorplace you in thecorrectclassforyourleveloryourhorses level.
ORANGEGROVEADULT RIDERSINC
SECTION A–MEDICALANDCONSENT FORM-CONFIDENTIAL
NameofParticipant...... DateofBirth: ...... Address...... Telephone No:…......
Thisform istobecompleted by therider thatis attendingactivities ofthe Orange GroveARCInc. Theinformationcontainedhereinmayberequired byamedical practitioner intheevent ofarider requiringemergencytreatment.Theinformationgiven here isnotintendedtostoparider participatingintheactivity.Itis importantfor thewellbeing oftheRider thatthisformbecompleted fullyand accurately.
CONTACT: (Incase of emergency) ………...…...... …… TELEPHONE: Home ...... …...Work………...……...... …...Mobile………...……... Relationship too participant ...... ……...... ARE YOU INA MEDICAL INSURANCE FUND? YES/NO-WHICH FUND: ......
DOESTHE ABOVENAMED PARTICIPANTSUFFER FROMANY OFTHE PROBLEMS LISTED BELOW? Ifso pleasecircle. If‘yes’ please provide details.
(A)HeartProblems Yes/No
(B)Respiratory ProblemsYes/No (i)Asthma Yes/No (ii)Other Yes/No
(C)Allergies Yes/No (i)FoodYes/No (ii)Drugs Yes/No (iii)Ointment Yes/No (iv)Other Yes/No
(D)DiabetesYes/No
(E)Blood PressureYes/No
(F)Recent OperationsYes/No
(G)Recent IllnessYes/No
(H) Past Injuries Yes/No
Iconsentfor the above namedparticipanttobe allowed emergencymedical/dental attention,ifnecessary, during theparticipation in anyactivity.
(Please circle) YES / NO
Iunderstandthatno liabilitycan be accepted bythe Association orCentreconcernedinthe event ofaninjury oraccidentoccurring.
IunderstandthatOrangeGrove ARC Inc. reserves therighttorefuseanyperson accesstoOrange Grove
ARC Inc.activities ifit isreasonablybelieved that participationmaybe detrimentaltothe person’shealth.
Inthe easeofemergencyand Icannot be contacted, Igive permissionfortheabove namedparticipant to be transportedbyprivatecar, ambulanceorwhateverother meansisappropriate, and agreeto coverthe costof such transport.
Inthe easeofemergencyand Icannotbe contacted, Igive permissionforan OrangeGrove ARC Inc.Official to allowtreatment of theparticipantas deemednecessaryand agreeto coverthe cost ofsuchtransport.
Ihave disclosed all information,tothe bestof myknowledge, required bythisform.The above named
participant isclearedbytheirregisteredMedical Practitionerto undertakeall OGARC Activities.Inthe case that a Medical restrictionhasbeen imposed oncertain activities,I have listed thesehere:
Iagreeto all of the above.
Ihave readandfullyunderstoodthecontent ofthisMedical and ConsentForm.
Signature...... Date.…...... ….
SELF ASSESMENTFOR YEAR2018
Name: ………………………………………………………………………………………………………………………………………….
Horse’s name: ……………………………………………………………………………………………………………………………...
Horses experience: ……………………………………………………………………………………………………………………..
Currently competing at: ……………………………………………………………………………………………………...level.
How often: ……………………………………………………………………………………………………………………………...….
Training Currently: ………………….……………………………………………………………………………...Times/week.
Typical training sessions incorporates: ……………………………………………………………...……………………...
…………………………………………………………………………………………………………………………………..…………………
…………………………………………………………………………………………………………………………………..………………..
This year I would like to achieve: …………………………………………………………………………….……………….
……………………………………………………………………………………………………………………………………….…………..
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Why have you chosen to join Orange Grove Adult Riders? …………………………………………………..…….
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Would you like to compete at the ARCA Challenge’s throughout the year? ………………………..…..
If so what discipline? …………………………………………………………………………………………………………………
If not how can we help you to join in and compete? ………………………………………………………..……..
…………………………………………………………………………………………………………………………………………..…….
If you don’t want to compete would you like to be a part of our support team for ourmembers
Competing? …………………………………………………………………………………………………………………………….