File - Lake Albert Pony Club

Registration Form
Please complete for each child
The Lake Albert Pony Club Camp 2015 is to be held at the Lake Albert Pony Club Grounds
commencing Saturday 11 April and finish Monday 13 April 2015
Entries close Friday 3 April. Due to large numbers of entries previously, numbers will be capped
at 80 riders on a first in basis. NB Camping welcome (unpowered sites only), ample horse yards
available. No phone entries accepted.
Pony club uniform not required for the fun gymkhana on Monday.
Talent quest / pizza night on Saturday night.
Each family must nominate a volunteer to assist for the weekend.
Each club must nominate an instructor for the weekend.
Entries and payments online EFT (bank details below)
Cost: $ 80.00 1st child in each family
$ 70.00 2nd child in each family includes morning/afternoon tea, lunch daily and instruction
$ 60.00 3rd child in each family
$10.00 per family camping fee (whole of camp)
$ 5.00 per horse yard fee (whole of camp)
Surname……………………………………………………………………………………………………..
Given Name………………………………………………………………..…………………...……………..
DOB……………………………………..…..Age……………………………………...…….Male / Female
Parents/Guardians Full Name……………………………………………………………………………….
Postal Address……………………………………………………………...…………………………………
Home Phone……………………………………Mobile Contact……………………………………………
Email Contact………………………………………………………………………………………………….
Pony Club…………………………..…..………….M/No(if not LAPC member)……………….…………
PIC Number…………………………...Showjumping Grade (if any) ………………………………..
Horses’s Name………………………...…………………………Age …………………………………..
Brief description of rider ability (i.e led, able to canter confidently etc.
…………………………………………………………………………………………………………………
…………………………………………………………………………………………………………………
…...……………………………………………………………………………………………………………
Medical
Should your child require medical treatment it would assist us if you supply the following:• Is he/she normally in good health
Yes / No
• Does he/she have any chronic illness or special needs
Yes / No
If yes, please give specific details…………………………………………………………………………..
• Asthma or allergies
Yes / No
Skin Conditions
Yes / No
• Diabetes
Yes / No
Epilepsy Fits
Yes / No
• Peanut Allergies
Yes / No
Reaction to drugs Yes / No
If yes to any of above, please give full details and treatment course
……………………………………………………………………………………………….………………….
Doctor’s Name ………………………………………..… Surgery Ph No………..……………………….
Medicare No……………………………………………Health Fund…………………No…………………
Ambulance Cover: Yes / No
Lake Albert Pony Club Incorporated
PO Box 601
Wagga Wagga, NSW, 2650
ABN: 30 889 529 038
http://www.lakealbertponyclub.weebly.com
Page 1
Dietary Requirements:
………………………………………………………………………………………………………………..
………………………………………………………………………………………………………………..
Urgent Medical Consent Form
I ……………………………………give permission for any urgent medical treatment that my child
…………………………………….…………………may need.
Urgent Veterinary Consent Form
I………………………….……………………………give permission for any urgent veterinary
treatment that may be needed. I also authorize the service of a farrier, the repair or replacement of
any faulty saddlery or gear at MY expense. I accept full responsibility for my horse/pony whilst
yarded at Lake Albert Pony Club Grounds for the duration of the Pony Club Camp 2015.
Signature of Parent/Guardian………………………………………………………………………………..
Print Name……………………………………………………………………………………………………..
A helper from every rider entered MUST be nominated to assist with one job each day.
Parents/helpers
Please print name/s: __________________________________________________________________
WORKING WITH CHILDREN’S CHECK CLEARANCE NUMBER ______________________________
AND DATE OF BIRTH FOR ONLINE VERIFICATION
Day’s you can assist (please circle):
Saturday
Sunday
Monday
Preferred jobs (no guarantee you will be allocated your preferred task)
Kitchen
Group Leaders
Cleaning
Morning/afternoon teas
Lunches
Other jobs as req
Contact Mobile No: ___________________________________________________________________
Please check roster at registration time. A roster will also be placed in the kitchen. If you can fill
in a blank space please do so. If you cannot make it please arrange someone to take your place.
The committee expects every family member or friend to do at least one job a day!!!!
Due to the huge number of other equine events being held over the 3 days, and to provide
maximum benefit and diversity to riders attending our camp, LAPC would be grateful for
assistance from any instructors who may be attending with their children. Please nominate at
least one instructor from your club below and the LAPC Senior Instructor will contact you to
discuss.
Thank you.
Instructors
Please print name/s: ____________________________________________________________________________
Day’s you can assist:___________________________________________________________________________
Time/s: _______________________________________________________________________________________
Field / Activity prefer to coach in: _________________________________________________________________
______________________________________________________________________________________________
Contact Mobile No: _____________________________________________________________________________
Lake Albert Pony Club Incorporated
PO Box 601
Wagga Wagga, NSW, 2650
ABN: 30 889 529 038
http://www.lakealbertponyclub.weebly.com
Page 2
IMPORTANT INFORMATION
Applicants must be financial members of Pony Club NSW.
NO DOGS WILL BE ALLOWED ON THE GROUND
All camp attendees will be responsible for the care of their own horse/pony. This applies
particularly to the yard area. There will be yard helpers for those children needing help.
Appropriate footwear must be worn at all times – enclosed footwear ie: riding or working boots,
this includes parents and helpers. Helmets to be worn whenever riders handling horses – this
includes saddling, brushing and leading.
Horse requirements
• Horses must be hard fed for at least 2 weeks prior to camp(hay, chaff) to reduce the chance of
colic
• Horse feed for 3 days- plenty of chaff and hay
• Horse rug/s – the nights can be getting quite cool
• Bridle, saddle, headstall, lead and at least 2 saddlecloths
• Tack box with brushes (hard, soft, tail), hoof pick, sponge, towel and bucket
• Yard cleaning rake and barrow (or chaff bag)
• 20 litre bucket NB: No smaller bucket will be permitted
• Feed bucket, extra buckets for carrying feed and water
• Cleaning gear for boots and saddle
• Horses feet must be well cared, either shod or trimmed
Attendees Requirements
• Adequate changes of riding clothes, raincoat, work or rubber boots
• Riding boots, brush and polish, PC approved riding helmet, correctly sized stirrups
• Sunscreen, lip balm
Check in to Camp – Saturday 11 April
Gear Check will take place before activities start. Children need to mount and proceed to gear
checker. You will then be put into your troop. A list of troops/daily schedule will be posted outside
the camp office. If you have any queries about the troop allocated for your child, please speak to
Camp/LAPC Senior Instructor Lisa Boatwright, who will be on the grounds.
Disciplines that will be included during the camp may include: showjumping, dressage, team
penning/cattle work, sporting and novelties, cross country, show riding, polocrosse, long
rein/harness driving, endurance and trail riding. It is anticipated there will be a dentist and vet
joining us during the camp and several other specialist instructors will cover horsemanship and
saddlery. We will be holding a mini gymkhana on Monday 14th April for camp participants. Gear
check will be first thing daily, with riding to begin around 9.30am and go until 4pm.
Check out of Camp – Monday 13th April.
Camp attendees are required to leave the LAPC grounds as they found them, so that means all
litter must be picked up, yards cleaned out and everything left in an orderly manner. You will not
be able to leave this to your parents or camp organisers.
CANTEEN/Camp Office
The canteen/camp office will be open daily from 9am to 4pm. There will be a variety of
additional meals, snacks, tea/coffee, and soft drinks for purchase during the camp or just
call in for a chat!
Lake Albert Pony Club Incorporated
PO Box 601
Wagga Wagga, NSW, 2650
ABN: 30 889 529 038
http://www.lakealbertponyclub.weebly.com
Page 3
PAYMENT FORM
- Complete only 1 per family and return with Registration form
1st child @ 80.00
=
$
2nd child @ 70.00
=
$
3rd child @ 60.00
=
$
Camping fee $10.00 per family =
$
Yard fee $5.00 per horse
=
$
______________
Total Payment Attached
=
______________
If paying by EFT, details are:
Account Name: Lake Albert Pony Club Inc.
BSB: 805-022
Account Number: 38701049
Please put “<rider’s surname> Camp” as the reference
Please advise [email protected] of payments
(NOT the usual [email protected] – this is a specific address for Events)
If you wish to pay by cheque, please post to:
Lake Albert Pony Club
PO Box 601
WAGGA WAGGA NSW 2650
Further enquiries please phone 0429 434 488 / 69266598 a.h or
[email protected]
We look forward to seeing you at the LAPC Camp
Lake Albert Pony Club Incorporated
PO Box 601
Wagga Wagga, NSW, 2650
ABN: 30 889 529 038
http://www.lakealbertponyclub.weebly.com
Page 4