Five Manes NZCCA Cowboy Challenge Entry Form

1
Name* This field is required.RIDERS NAME
First Name
Last Name
2
NZCCA membership numberIf you are not a member please leave blank
3
Email* This field is required.
example@example.com
4
Phone Number* This field is required.Riders
Area Code
Phone Number
5
Emergency Contact Name* This field is required. Emergency contact name
First Name
Last Name
6
Emergency Contact Number* This field is required. Emergency contact number
Area Code
Phone Number
7
Horse and Class selection
Horse Name
Class
Class
Youth
Rookie
Intermediate
Open
Class
Horse Name
Class
Class
Youth
Rookie
Intermediate
Open
Class
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Entry Fees* This field is required. Please scroll and choose from the options below. If you are a NZCCA member apply coupon code "MEMBER" for the $10 discount. Payment to FMH account 38-9004-0487486-08 with your name as the reference please.
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Entry Summary
Total costNZD
Camping FeePrice is per night
$FreeNZDEdit
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Nights
Youth Class
$50.00NZDEdit
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Rookie Class
$60.00NZDEdit
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Intermediate Class
$60.00NZDEdit
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Open Class
$60.00NZDEdit
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Enter Coupon
Total cost $0.00NZD
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Terms and Conditions* This field is required.1. Release and Indemnity of Owners and Occupiers of the Land This event is made possible by kind permission of the owners and occupiers of farmland and/or suitable area, allowing us to use their land. I accept they have given their permission on condition that I release and indemnify them, and I hereby release and indemnify them from any and all liability, claims, losses, and damages and expenses whatsoever including any liability under the Health and Safety in Employment Act. 2. General I am capable of looking after my horse/s. I accept that the organisers/judges reserve the right to check on my horse/s, and not allow the start or continuation of the competition if my horse/s is deemed unfit for any reason. I understand that my horse/s must be at an acceptable level of fitness and ability. I will follow the instructions and accept the decisions made by the organisers and/or judges. If I do not follow instructions and/or abuse my horse I accept that I may be asked to leave the premises by the organiser/s or judges. 3. Personal Safety I understand that the participation in the Cowboy Challenge involves risk of injury or death. In entering the Cowboy Challenge, I confirm I am physically fit enough, suffer no medical condition, disability or lack of skill which would render me unsuitable for this event. 4. Safety of Property I acknowledge that I have sole responsibility for my horse/s, equipment and other possessions during the period of the event. I further agree at all times to take reasonable care with regard to farmland, property, stock, and crops. I accept that no firearms or littering are allowed. I understand that dogs must be secure at all times, or if stated on the entry that there is to be no dogs on the property, that I abide by this. 5. Liability By participating in the event, I expressly accept all risks personally and release the organisers, their servants and agents, owners and occupiers of the land, sponsors and all other persons involved in the event from any liability, claims, losses, damages or expenses caused by the event including, but not limited to, any personal injury or death, any emotional or nervous disorder, any medical condition or suffering, any property loss or damage. 6. Medical Treatment I consent to receive medical treatment in case of injury, illness or suffering during the event and agree to indemnify the organisers, their servants and agents from any liability or claims in respect of that treatment. 7. Cancellations The organisers and/or judges reserve the absolute right to cancel or down-grade the Cowboy Challenge as a result of adverse weather conditions, correctness of the course or any other unforeseen circumstances. I accept that refunds for any cancellations or no-shows will be made only with a medical or vet certificate or at the discretion of the organisers.
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