PONY CLUB ASSOCIATION of TASMANIA Inc

11.1.1

PONY CLUB ASSOCIATION OF TASMANIA Inc.

NOMINATION FORM

The following positions fall vacant at the Annual General Meeting at the end of November every year so either the present office bearers or new nominations need to be furnished.

The...... Pony Club, signed by the ......

District Commissioner of the above Club wish to nominate these people for the following position/s:

PATRON...... ………….... / Signature of Nominee...... …...
PRESIDENT...... ……… / Signature of Nominee...... …...
VICE PRESIDENT...... / Signature of Nominee...... …...
SECRETARY ...... ….. / Signature of Nominee...... …...
TREASURER ...... …….... / Signature of Nominee...... …...
INSURANCE REPRESENTATIVE...... ……. / Signature of Nominee...... …...
EFA REPRESENTATIVE ...... / Signature of Nominee...... …...
WEBSITE MANAGER ...... / Signature of Nominee...... …...
NEWSLETTER EDITOR...... / Signature of Nominee...... …...
STATE TEST COORDINATOR...... / Signature of Nominee...... …...

The signature of the nominee verifies that they are willing to accept nomination for that position.

Please note – The nominee must be a Life or a Financial member of a member club.

Please return to the State Secretary

At least 42 days before the date of the meeting.

11.1.2

PONY CLUB ASSOCIATION OF TASMANIA Inc.

LEASE

Please type or print.

THIS AGREEMENT made theday of20

Between the following person(s) hereinafter called the LESSOR(S)

SURNAME

/ GIVEN NAMES / RESIDENTIAL ADDRESS
1. Mr /Mrs
/ Miss
2. Mr /Mrs
/ Miss

AND the following person(s) hereinafter called the LESSEE(S)

SURNAME

/ GIVEN NAMES / RESIDENTIAL ADDRESS
1. Mr /Mrs
/ Miss
2. Mr /Mrs
/ Miss

Where the Lessor agrees to lease and the Lessee agrees to take on lease from the Lessor, the horse described below for a term commencing on 20___ and expiring on 20___

SPECIAL CLAUSES (to be initialled by all parties)

______

SIGNATURE(S) OF LESSOR(S)

1.______(Lessor) 2______(Lessor)

SIGNATURE(S) OF LESSEE(S)

1.______(Lessee) 2______(Lessee)

REGISTERED (if so) NAME OF HORSE______

COLOUR______SEX ______AGE ______

SIRE DAM______EFA No______

SIGNATURE OF CLUBD.C.

11.1.3

MEMBERSHIP REGISTRATION FORM (club members, Judges and Instructors to complete –

Club officials to update or enter information into MYclub, or forward to State Secretary )

Member’s Personal Details______

Pony Club: ………………………………………………………………………………………………………….

Mr/Mrs/Miss/Ms/Other: ……Full Name….……………………………….……D.O.B.…./……/……Age…....

Address: ………………………………………….....Surburb/Town: ………….………………Postcode: ……….

Phone (H): ……………….. Phone (W): ………………..(M)………………………….....(fax)………………....

Email: ……………………………………..………………………Occupation:………………..…………………

Ever attended a Pony Club other than the one listed above  Yes  No If Yes , which club…………………...…

What year did you join Pony Club……… D

Certificates held: (please insert year passed)D D* C K

C* B H A

PCAT HandbookDecember 2008

Membership Type

Riding Member (please specify)

Age taken at 1st January

 Junior (Under 17years)

 Associate (17-25years)

 Adult Riding Member

 Non-Riding Member

 Club Instructor

 Volunteer

Life

Instructor Details

PC O Level date ………………………

Preliminary Coach date ………………………

PC Level 1 date……………………….

EFA Qualification date…………………….…

Judging Details

Dressage…………………what grade………….

Show jumping……………P/C EFA (please circle)

Technical Delegate…………………………..

Course Designers SJ  XC 

PCAT HandbookDecember 2008

FIRST AID Qualification

First Aid Certificate Level…………….………………Providers Name………………………………….…….Number……………

First Aid Expiry Date:…………………………

We live horses too!

11.1.4

Membership Registration Formpage 2

Member Declaration (to be signed by new members)

I ...... agree to abide by the rules, code of conduct regulations, policies, procedures and directives as stipulated by Pony Club Association of Tasmania Competition rules and affiliated bodies.

I acknowledge that horse sport is dangerous and that accidents causing death, bodily injury, disability and property damage can, and do happen.

I acknowledge and agree that neither PCAT nor “the organizers” shall be under any liability for death, or bodily injury, loss or damage which may be sustained or incurred by the applicant, as a result of participation in or being present at PCAT endorsed events, except in regard to any rights I may have arising under the Trade Practices Act 1974.

I acknowledge that I have read and understood the information provided in this membership form regarding codes of conduct and privacy.

Signed:...... Date:......

Member’s Parent/Guardian Declaration

Must be signed for all members under the age of 18 years

I/We consent to our above named child becoming a member of the Pony Club Association of Tasmania as a member of the………………………………………………Pony Club.

I/We have read and accept the Member Declaration on behalf of our child.

Signed…………………………………………………………………Date……………………….

Release of Coaches/Judges Details

I consent to being listed on the PCAT Registered Coaches/Judges List, which will be made available to Club Personnel only. Personal details will include First Name, Second Name, Contact details including postal address, phone numbers (home and mobile), email and Coaching Qualifications

Signed……………………………………………………...Date…………….

I do/ I donot(please delete whichever is inapplicable)consent to my personal details being advertised to the public verbally, in printed or electronic mediums. Personal details will include First Name, Second Name, Coaching Qualifications and Contact Number.

Signed……………………….. ……………..Date………….

We live horses too!

11.1.5

Membership Registration Formpage 3

Voluntary Workers Personal Details– to be completed by volunteer workers, new member’s parents or siblings and Club officials to update MyClub or forward to State Secretary.

Judges and Coaches to complete Member Registration Form 11.1.3 and bottom portion of 11.1 .4 only.

Pony Club: ......

Mr / Mrs / Miss / Ms/ Other: Full Name: ......

Address: ......

Surburb/Town: ...... Postcode: ......

Phone (H): …………………… Phone (W): ...... …………..…Phone (M):

Email: ...... ……………….Fax………………………………

Pony Club: ......

Mr / Mrs / Miss / Ms/ Other: Full Name: ......

Address: ......

Surburb/Town: ...... Postcode: ......

Phone (H): …………………… Phone (W): ...... …………..…Phone (M):

Email: ...... ……………….Fax………………………………

Pony Club: ......

Mr / Mrs / Miss / Ms/ Other: Full Name: ......

Address: ......

Surburb/Town: ...... Postcode: ......

Phone (H): …………………… Phone (W): ...... …………..…Phone (M):

Email: ...... ……………….Fax………………………………

We live horses too!

PCAT HandbookDecember 2008