Equestrian Club
Telephone 03 5964 4493
________________________________________________________________________
APPLICATION FOR MEMBERSHIP 2008
(PLEASE
PRINT IN BLOCK LETTERS)
Applicant Details
Mr / Mrs / Ms/
Miss Surname: ____________________ First Name: _________________
Residential Address:
_______________________________________________________________
____________________________________________
Post Code: _________
Postal Address: _______________________________________________________________
____________________________________________
Post Code: _________
Telephone: Home: ________________________ Work:
______________________
E-mail Address: __________________________________________________________
All members of the Glenbrae Equestrian Club must be financial members
of either the EFA, HRCAV, AQHA or PCAV. Evidence of membership must be shown below.
AQHA membership number:
______________________________
EFA membership number:
______________________________
HRCAV membership number: __________________________
PCAV Club: ______________________________
Membership Fees
Cost of membership to the Glenbrae Equestrian Club is $20 in 2008. Membership Fees should be included with
Application for Membership. Cheques
should be made payable to Glenbrae Equestrian Club.
Declaration
I apply for membership to the Glenbrae Equestrian Club and certify that
I am currently a financial member of either the AQHA,
EFA, HRCAV or PCAV. I agree to abide by
the rules and regulations of the Glenbrae Equestrian Club.
Print name: _____________________ Signature: _________________________
Date: ___ / ___ / _____
Membership is effective immediately on payment of the membership
fee.
The 'Waiver' printed on the reverse of
this form must also be completed and signed.
WAIVER, RIDING AGREEMENT and EXCLUSION OF CERTAIN
RIGHTS TO SUE
WARNING:
Under the provisions of the Fair
Trading Act 1999 (Vic) several conditions are implied into contracts for the
supply of certain goods and services.
These conditions mean that the Centre named on this form is required to
ensure that the recreational services it supplies to you are:
·
rendered with due
care and skill; and
·
as fit for
the purpose for which they are commonly bought as it is reasonable to expect in
the circumstances; and
·
reasonably fit for
any particular purpose or might reasonably be expected to achieve any result
you have made known
to the Centre.
Under section 32N of the Fair Trading Act 1999, the
Centre is entitled to ask you to agree that these conditions do not apply to
you. If you sign this form, you will be
agreeing that your rights to sue the Centre under the Fair Trading Act 1999 if
you are killed or injured because the services were not rendered with due care
and skill or they were not reasonably fit for their purpose, are excluded,
restricted or modified in the way set out in this form
NOTE: The change to your rights, as set
out in this form, does not apply if your death or injury is due to gross
negligence on the Centres part.
"Gross negligence" is defined in the Fair Trading
(Recreational Services) Regulations 2004.
ACKNOWLEDGMENTS
1. Horse riding involves a significant
degree of physical exertion and physical risk and is undertaken for the purpose
of recreation, enjoyment and leisure.
2. I engage in horse riding entirely at my own
risk and accept that horse riding is a dangerous activity with many inherent
risks.
3. I accept that I am responsible for my own
actions and the actions of those people in my care and control.
4. A reference to the Centre in this contract
includes Glenbrae Equestrian Centre, the operating company Jacques R. Pty Ltd
and the property owners B. and S. J.
Hodgson and C. J. Le Bas de Plumetot, directors, officers, employees, agents,
successors and assigns.
5. The services provided by the Centre are
recreational services for the purposes of the Fair Trading Act 1999
(Vic) and Trade Practices Act 1974 (Cwth).
6. The Centre does not make any warranty
concerning the nature, habits and disposition of any horse supplied by it.
7. This riding
agreement contract is for the calendar year in which it is signed.
TERMS AND
CONDITIONS OF RIDING
8. I will
waive my rights
I will not
bring any claim, demand, action or suit against the Centre in relation to
personal injury or death, and also any loss, injury or damage I sustain as a
direct or indirect result of horse riding organised by the Centre. This waiver applies irrespective of any
liability, fault or negligence of the Centre.
9. I will indemnify the Centre
I will
indemnify the Centre against any claim, demand, action or suit brought by third
parties (including a child for whom I have responsibility) in relation to any
personal injury or death, and also any loss, injury or damage which is a direct
or indirect result of horse riding pursuant to this agreement. This indemnity applies irrespective of any
liability, fault or negligence of the Centre.
10. I will ride safely
I will only ride the horse in a safe and
controlled manner. I will wear an
Australian Standard Approved helmet and the correct footwear at all times.
11. I will read and follow instructions
I will read and follow all signs on the
Centres property and follow all the Centres instructions.
12.
I will accept and pay for assistance
I consent to being evacuated and to the
provision of first aid and medical treatment if I am injured or become ill. I agree to pay for any such evacuation or
provision of first aid or medical treatment.
I acknowledge and agree that I will pay any costs or expenses incurred
by any person or organisation for or on behalf of my horse or as a result of an
equine influenza standstill.
13. The
Centre may cancel my ride
The Centre may cancel my ride without refunding any
fee if I do not comply with any of these terms and conditions.
14. I will disclose any pre-existing medical or other condition that may affect or risk other persons
or myself (please circle)
Asthma, Diabetes, Epilepsy /
Fits, Fainting
/ Dizziness, Blackouts / Migraines, Disability,
Heart / Blood Condition, Allergic Reactions, Pregnancy, Uneven
Pupils, Recent
Injuries, Medications, Other
.
AGREEMENTS: By signing this agreement I understand that I
and my dependants waive our rights to sue.
The
riders agreement
I have
read, understood and agree to the acknowledgements, terms and conditions.
Full Name:
.
Age
(Under 18):
..
Address:
.
Riding Experience:
Signature:
.Date:
..
...
...
Ph:
The parent or guardians
agreement
I am the riders parent or
guardian and I have read and understood the acknowledgements, terms and
conditions.
I agree to them. I agree for the rider to be bound by
them.
Full Name:
Signature: