YOUTH DEVELOPMENT WEEKEND

YOUTH DEVELOPMENT WEEKEND

21-22 JUNE 2025
NAME*

First NameLast Name
PLEASE ADVISE WHAT YOU WOULD LIKE TO ENTER AS*
Youth Develpment Weekend Rider (ages 6-21 years) OR Dressage Youth Scholarship Rider (ages 8-21 years & Dressage Card Holders)
PLEASE CONFIRM THE RIDERS AGE*
WHAT IS YOUR REGULAR DISCIPLINE?*
WHAT OTHER ESA DISPLINE/S DO YOU REGULARILY COMPETE IN

DRESSAGEEVENTINGSHOWHORSEINTERSCHOOLPARASHOWJUMPINGOTHER
ESA MEMBERSHIP NUMBER*
HORSE BRIDLE NUMBER (DRESSAGE)
(IF Applicable)
PARENT/CARE GIVERS NAME (if under 18)

First NameLast Name
IF Rider is under 18 lease enter the following contact information with the parent or care giver's details.
PHONE NUMBER*
Please enter a valid phone number.
EMAIL*
example@example.com
COMPETITON LEVEL (DRESSAGE EQIVILANT) *
BIO OF COMBINATION*
IDEAS: How long have you been together, key results, ambitions etc
PLEASE UPLOAD A PICTURE OF THE COMBINATION*

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DO YOU HAVE ANY DIETARY REQUIREMENTS?*

YESNO
IF ‘YES’ Please advise*
T-SHIRT SIZING*

KidsAdult
SIZE*
KIDS (S to XXL) ADULT (6-20)
SIGNATURE OF RIDER OR PARENT/CAREGIVERS NAME GIVER*

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$250pp

Private Lesson with Jason Dins

Protocol Session/s

2x Lunches

Expert seminars

Please transfer funds to;

Dressage SA

BSB: 015 650

Acct: 318 284 293
PLEASE UPLOAD SCREENSHOT OF PAYMENT *

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