COASTAL EQUESTRIAN CLUB ONLINE DRESSAGE EXTRAVAGANZA
SPONSORED BY TRAILRACE SADDLERY
RIDER DETAILS
Rider Name
First Name
Last Name
Address (please ensure it is correct for mailing purposes)
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Mobile or phone number
Email
example@example.com
Judging Conflict
Type judges name you have a conflict with - must be according to HRCAV/EA rules
MEMBERSHIP DETAILS
You must be a EA or HRCAV member or pay the event insurance fee
EA member number
HRCAV member number
Are you riding a pony?
YES
HORSE DETAILS
Horse's Name
Back
Next
I AGREE TO THE TERMS AND CONDITIONS
*
YES
I AGREE THAT MY VIDEO MAY BE USED FOR PROMOTIONAL PURPOSES OR UPLOADED TO THE WEBSITE IF I PLACE
*
YES
NO
TESTS & PAYMENT
My Products
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( X )
EVENT INSURANCE FEE (FOR NON EA OR HRCAV MEMBERS)
$20.00 AUD
$
20.00
AUD
EA PRELIM 1A
$35.00 AUD
$
35.00
AUD
EA PRELIM 1B
$35.00 AUD
$
35.00
AUD
EA NOVICE 2A
$35.00 AUD
$
35.00
AUD
EA NOVICE 2B
$35.00 AUD
$
35.00
AUD
EA ELEM 3A
$35.00 AUD
$
35.00
AUD
EA ELEM 3B
$35.00 AUD
$
35.00
AUD
EA MEDIUM 4A
$35.00 AUD
$
35.00
AUD
EA MEDIUM 4B
$35.00 AUD
$
35.00
AUD
EA ADVANCED 5A
$35.00 AUD
$
35.00
AUD
EA ADVANCED 5B
$35.00 AUD
$
35.00
AUD
EA FEI PSG
$35.00 AUD
$
35.00
AUD
EA FEI INTER 1
$35.00 AUD
$
35.00
AUD
EA FEI INTER 2
$35.00 AUD
$
35.00
AUD
EA FEI GRAND PRIX
$35.00 AUD
$
35.00
AUD
PARA EQUESTRIAN
$35.00 AUD
$
35.00
AUD
Enter coupon
Apply
Total
$0.00 AUD
$
0.00
AUD
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Expiration Month
January
February
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June
July
August
September
October
November
December
Expiration Month
Expiration Year
2026
2027
2028
2029
2030
2031
2032
2033
2034
2035
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2040
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2045
Expiration Year
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