• HCEXCA Membership Registration Form

    Please fill out the details below to become a member.
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  • Format: (000) 000-0000.
  • Date of Birth*
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  • Membership Type*
  • MEMBERSHIP OPTION*
  • Please Note -

    PRO RATA (PR) fees are only applicable for NEW joining members and will be available from 1/1 to 30/6

  • PLEASE MAKE PAYMENT

    HIGH COUNTRY EXCA INC

    BSB    083 755

    ACC    88 218 1789

    PAYMENT REF : YOUR ENITIALS & YEAR

    EG :  JS 2025

  • EXTREME COWBOY RACING IS A BROAD COMBINATION OF DISCIPLINES, ARE THERE ANY PARTICULAR AREAS OF INTEREST THAT YOU WOULD PARTICIPATE IN IF CLINICS OR LESSONS WERE AVAILABLE ?
  • Do you have a working with children check*
  • Are you a current member of any other equestrian club or association ?
  • PARTICIPANT ACKNOWLEDGEMENT
    Release of liability of the EXTREME COWBOY ASSOCIATION and HIGH COUNTRY EXCA, et al, indemnity agreement of observers and participants, and waiver of compensation for video and/or recording and photography.

    Horse riding and participation in horse related activities is/are dangerous recreational activities and horses and cattle can act in a sudden and unpredictable (changeable) way, especially if frightened or injured.

    I acting individually and on behalf of all minor children accompanying me, as consideration for the privilege of observing and/or participating in all activities of the EXTREME COWBOY ASSOCIATION and HIGH COUNTRY EXCA, including all events on the premises, DO HEARBY AGREE TO RELEASE AND HOLD HARMLESS THE EXTREME COWBOY ASSOCIATION AND HIGH COUNTRY EXCA, and their respective owners, officers, agents, sponsors, representatives, employees and volunteers, from liability for negligent and grossly negligent acts of hazardous conditions including the uncontrolled acts of other guests, participants, and livestock.

    I acknowledge and fully understand there are known and unknown risks, hazards and dangers associated with equine events, natural hazards, and other hazardous activities being conducted on the premises, and I HEARBY EXPRESSLY ASSUME ALL RISKS AND HEARBY KNOWINGLY RELEASE THE EXTREME COWBOY ASSOCIATION AND HIGH COUNTRY EXCA, AND THIER RESPECTIVE OWNERS, OFFICERS, AGENTS, SPONSORS, REPRESENTATIVES, EMPLOYEES AND VOLUNTEERS, FROM ANY AND ALL CLAIMS OF NEGLIGENCE AND GROSS NEGLIGENCE.

    I agree to indemnify and hold harmless THE EXTREME COWBOY ASSOCIATION and HIGH COUNTRY EXCA , and their respective owners, officers, agents, sponsors, representatives, employees and volunteers, from any and all claims, demands, causing of action and damages, wether or not caused by their negligence and gross negligence.

    I HEARBY EXPRESSLY ASSUME ALL RISK OF HARM, to which I, and those minors accompanying me, may be exposed while observing on the premises and/or participating in HIGH COUNTRY EXCA cowboy events.
    Finally, I agree to the taking of photographs, videotaping and audio recording of myself and those minors under my control; and, to the uncompensated use by the EXTREME COWBOY ASSOCIATION and their assigns.

    EXECUTED THIS DAY OF SIGNING

    To be affective until the end of this club membership year June 30, 2026

  • Risk Warning and Waiver of Liability With Affinity Insurance

    PROVIDER
    High Country Extreme Cowboys Inc
    6574 Maroondah hwy, Yarck Victoria  3719


    The following pages affect your legal rights and obligations. Please read these carefully and only sign if you fully understand their contents. For Participants under 18 years of age, these documents must be completed by a parent or legal guardian.

    Description of Activities2:

    Horse Riding and handling

    Risk Warning

    I am aware that by my participation in any activities arranged by the Provider, certain risks or dangers may occur which could include:

      Physical, bodily or psychological injury or death.
      Physical exertion to which I am not accustomed.
      Failure of equipment or use of inadequate equipment.
      There may be no or inadequate facilities for treatment or transport to treatment if I am injured.
      The conditions in which the activities are conducted may vary without warning.
      I may cause injury to other persons and/or other persons may cause injury to me.
      I may be injured or die due to the negligence, breach of contract or breach of statutory duty or guarantee of the provider.

    I acknowledge that the activities are being undertaken for the purposes of recreation, enjoyment or leisure, and involve a significant degree of risk of physical harm.

    I acknowledge that the Activity may be undertaken with one or more other persons as part of a group and that the Provider is not liable for the actions of other participants in the group activity.

    By signing below, I acknowledge, agree and understand that the risks associated with the Activities and/or recreational services have been explained to me. I undertake any such risk voluntarily and at my own risk.

    I acknowledge that the risk warning above constitutes a “risk warning” in accordance with the Civil Liability Act 2002 (NSW) and the Civil Liability Act 2002 (WA).

    1 Provider includes the officers, employees, agents, contractors, franchisees and assigns of the Provider.
    2 Activities includes all activities and services ancillary to or associated with the named Activity, both before and after the Activity, including transportation to and from the location of the Activity whether provided by the Provider or not, briefings, inductions, training, and the provision of information in all manuals, safety guidelines and other documentation provided to or made available to the Participant with respect to the Activity, familarisation with clothing or equipment and methods of operation of equipment and the wearing and removal of any clothing or equipment associated with the Activity. Unless otherwise specified, a reference to an Activity is a reference to a recreational service or a recreational activity as defined in relevant legislation referred to herein.


    Participant’s Warranties
    I agree to abide by any of the Provider’s rules, and any direction or instruction given to me by the Provider during the course of the Activities. I agree to use and/or wear any equipment given to me by the Provider.

    I declare that I am medically and physically fit and able to participate in the Activities. I acknowledge that I must, and agree that I will, disclose any pre-existing medical or other condition, injury or concern that may affect the risk that either I or any other person will suffer injury, loss or damage during the course of the Activities and notify the Provider of any injuries, illness or concerns that may arise during the Activity. I will not engage in any reckless, negligent or foolish behaviour or any other behaviour that is likely to cause injury to me, any other participant or person.

    I agree that if I suffer any injury or illness, the Provider may provide evacuation, first aid and/or medical treatment at my expense and that my acceptance of these terms and conditions constitutes my consent to such evacuation, first aid and/or medical treatment.

    I declare that I have not consumed any alcohol or mind altering substance, or medication that may impact my judgement or physical capacity, before or at the time of engaging in the Activities.

    Exclusion of liability

    I agree to and unconditionally release, waive, discharge and forever hold harmless, the Provider or any of its employees, agents, directors or officers, from any claims as a result of any personal injury sustained, whether caused by the Provider’s negligent act or wilful act or omission, breach of contract, breach of statutory duty, error, or otherwise in connection with or arising out of the Activities.

    I agree that the Provider will not be liable for any claims for personal injury that may be brought against it as a result of or in connection with any act, omission, default, failure or error on the part of the Provider, and agree to indemnify and keep indemnified the Provider in respect of any such claims.

    Waiver

    It is possible for a supplier of recreational services to ask you to agree that the statutory guarantees under the Australian Consumer Law (which is schedule 2 to the Competition and Consumer Act 2010 (Cth)) do not apply to you. If you sign this form, you will be agreeing that your rights (or the rights of a person for whom or on whose behalf you are acquiring the services) to sue the Provider in relation to the Provider’s services or the activities that you undertake because the services or activities provided were not in accordance with the guarantees are excluded, restricted or modified as set out below.

    For Queensland, New South Wales, Western Australia, Tasmania, Northern Territory and Australian Capital Territory and Commonwealth

    By signing this form, you agree that the liability of the Provider in relation to the activities (as defined by the Competition and Consumer Act 2010 (Cth), the Consumer Affairs and Fair Trading Act (NT) and the Australian Consumer Law) and recreational activities (as defined by the Civil Liability Act 2002 (NSW) and the Civil Liability Act 2002 (WA)) for any:

    (a)  Deaths;
    (b)  Physical or mental injuries (including the aggravation, acceleration or recurrence of such an injury);
    (c)  The contraction, aggravation or acceleration of a disease;
    (d)  The coming into existence, the aggravation, acceleration or recurrence of any other condition, circumstance, occurrence, activity, form of behaviour, course of conduct or state of affairs in relation to an individual:

    (i)  That is or may be harmful or disadvantageous to you or the community; or
    (ii)  That may result in harm or disadvantage to you or community;
    That may be suffered by you (or a person for whom or on whose behalf you are acquiring the services) resulting from the supply of the recreational services or recreational activities is excluded.


    You acknowledge and agree that the above provision operates to exclude the liability of the Provider as a result of a breach of an express or implied warranty that the recreational services will be rendered with reasonable care and skill in accordance with section 5J of the Civil Liability Act 2002 (WA) and section 5N of the Civil Liability Act 2002 (NSW).

    For South Australia

    Exclusion, restriction or modification of rights under the Australian Consumer Law (SA)

    Your rights:

    Under sections 60 and 61 of the Australian Consumer Law (SA), if a person in trade or commerce supplies you with services (including recreational services3), there is—

      A statutory guarantee that those services will be rendered with due care and skill; and
      A statutory guarantee that those services, and any product resulting from those services, will be reasonably fit for the purpose for which the services are being acquired (as long as that purpose is made known to the supplier); and
      A statutory guarantee that those services, and any product resulting from those services, will be of such a nature, and quality, state or condition, that they might reasonably be expected to achieve the result that the consumer wishes to achieve (as long as that wish is made known to the supplier or a person with whom negotiations have been conducted in relation to the acquisition of the services).

    Excluding, restricting or modifying your rights:

    Under section 42 of the Fair Trading Act 1987, the supplier of recreational services is entitled to ask you to agree to exclude, restrict or modify his or her liability for any personal injury suffered by you or another person for whom or on whose behalf you are acquiring the services (a third party consumer).

    If you sign this form, you will be agreeing to exclude, restrict or modify the supplier's liability with the result that compensation may not be payable if you or the third party consumer suffer personal injury.4

    Important

    You do not have to agree to exclude, restrict or modify your rights by signing this form. The supplier may refuse to provide you with the services if you do not agree to exclude, restrict or modify your rights by signing this form. Even if you sign this form, you may still have further legal rights against the supplier.

    A child under the age of 18 cannot legally agree to exclude, restrict or modify his or her rights. A parent or guardian of a child who acquires recreational services for the child cannot legally agree to exclude, restrict or modify the child's rights.

    Agreement to exclude, restrict or modify your rights:

    I agree that the liability of ...HIGH COUNTRY EXTREME COWBOYS... [the Provider] for any personal injury that may result from the supply of the recreational services that may be suffered by me (or a person for whom or on whose behalf I am acquiring the services) is excluded.

    Further information:
    Further information about your rights can be found at www.ocba.sa.gov.au

    3 Recreational services are services that consist of participation in— a sporting activity or similar leisure-time pursuit; or any other activity that involves a significant degree of physical exertion or risk and is undertaken for the purposes of recreation, enjoyment or leisure.
    4 Personal injury is bodily injury and includes mental and nervous shock and death.


    For Victoria
    Warning under the Australian Consumer Law And Fair Trading Act 2012 (Vic)

    Under the Australian Consumer Law (Victoria), several statutory guarantees apply to the supply of certain goods and services. These guarantees mean that the supplier named on this form is required to ensure that the recreational services it supplies to you—

      Are rendered with due care and skill; and
      Are reasonably fit for any purpose which you, either expressly or by implication, make known to the supplier; and
      Might reasonably be expected to achieve any result you have made known to the supplier.

    Under section 22 of the Australian Consumer Law and Fair Trading Act 2012, the supplier is entitled to ask you to agree that these statutory guarantees do not apply to you. If you sign this form, you will be agreeing that your rights to sue the supplier under the Australian Consumer Law and Fair Trading Act 2012 if you are killed or injured because the services provided were not in accordance with these guarantees, 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 supplier's part. Gross negligence, in relation to an act or omission, means doing the act or omitting to do an act with reckless disregard, with or without consciousness, for the consequences of the act or omission. See regulation 5 of the Australian Consumer Law and Fair Trading Regulations 2012 and section 22(3)(b) of the Australian Consumer Law and Fair Trading Act 2012.

    Agreement to exclude, restrict or modify your rights:

    I agree that the liability of the Provider for any personal injury that may result from the supply of the recreational services that may be suffered by me (or a person for whom or on whose behalf I am acquiring the services) is excluded.

    Declaration and Signature

    I have read carefully and understand this risk warning and waiver of liability and sign it feely and voluntarily without inducement of any kind.

    For Participants under age 18

    This is to certify that I, as a parent/guardian with legal responsibility for the Participant, acknowledge, understand and accept all of the above and consent to his/her release as provided above. I release and agree to indemnify and hold harmless the Provider from any and all liabilities arising from my minor child’s involvement or participation in the Activities and/or recreational services, even if arising from the negligence of the Provider.

  • WORKING WITH CHILDRENS CHECKS

    Introduction

    Creating safe sporting environments for children and young people requires a commitment from everyone involved in sport. Providing safe sporting environments for children and young people in Victoria is not optional, it is required by law under the Child Wellbeing and Safety Act 2005. New Child Safe Standards came into effect on 1 July 2022 to closely align with the National Principles for Child Safe Organisations.

    All organisations, associations and clubs in Victoria that provide services or facilities for children are required to comply with Child Safe Standards. This ensures that the safety of children is promoted, child abuse is prevented, and allegations of child abuse are properly responded to.

    The minimum compulsory standards for all organisations that interact with children and young people are outlined in the 11 Child Safe Standards available on theCommission for Children and Young People website.

    The Standards aim to prevent abuse through cultural change and creating positive environments where children feel safe to speak up about issues that affect them.

    VicSport is the peak body for sport and active recreation in Victoria and work closely with the Victorian Government to promote:

    - participation

    - industry development


    - advocacy and

    -safe, fair and inclusive sport.

    What does this mean for High Country Extreme Cowboy Association (HCEXCA)?

    All sports and recreations where participants are under 18 years of age have now all legislative requirements, this includes Equestrian Australia and its respected states. HCEXCA is slightly unique as our association is American based, however, is a Victorian based club which has regular participants under 18 years of age. HCEXCA committee have made the decision to adopt all legislative requirements as solidarity to the protection of children and promoting our sport in a safe and encouraging environment.

    The committee are busy working through all requirements to be proficient in the Child Safety Standards. One of the elements, requires the addition of Working with Children’s Checks to be submitted to the club.

    Who needs to provide a Working with Children’s Check?


    As you sign up your membership form you will also need to include your Working with Children’s Check (WWCC) number and expiry date. Please also include your name on the card if it’s different to your membership. Teachers cards are also accepted but note they expire yearly and will need to be updated.

    In line with the National Standards, all the following will have needed to provide their credentials:

    1. All Executive Committee members

    2. Judges/Scribes/Instructors/Timers/Course reset teams

    3. Anyone who walks the course or enters an arena AT ANY TIME, when participants under 18 years are on course. This includes parent/s/guardians of the under 18 years of age

    What happens when a non-member is asked or wants to participate?

    Registering for an event, there will be a requirement for non-members to enter their WWCC checks, or a reminder will go out to send in or provide on the day.

    Will I need to provide my WWCC each time?


    No, as members, the yearly WWCC in the form is enough and we will store only with the same form. Non-members will only have to provide once also, as we will keep this on record. It will be the responsibility of the individual to ensure new WWCC numbers are provided if close or at expiry.

    I’ve got some questions or wanting to help, who can I ask?

    We are in the early stages of setting all documentation and website to be functioning readily with all the information. Providing WWCC numbers is just one small area which the committee are working to ensure compliance.

    Please email any queries to the HCEXCA inbox and we will answer them as soon as possible. If you’re interested in assisting HCEXCA to establish, implement and maintain the Child Safety Standards, we would love to hear from you.

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