2026 Harts Range Gymkhana Nomination Form

Gymkhana Registration

Run By the Red Centre Campdraft & Rodeo Association
Event Timing: Saturday 1st August 9am

Event Location: Harts Range Campdraft Arena

Nominations Close: Wednesday 29th July 5pm

Payment can be made on the day, or before the event to

Harts Range Amateur Race Club

BSB: 085 995 ACC: 560 798 276

or use Pay ID: treasurer.hrarc1@gmail.com

Reference: Gymkhana (Competitors Name)

Please send nominations and payment receipt to noms.hrarc1@gmail.com

ONE FORM PER COMPETITOR

Events Included in nomination

Bending
Flags
Barrel race
Keyhole
Name

First NameLast Name
Email address
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Date Of Birth

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Age Group
NCA Day Membership
First Name* Last Name*
(In this acknowledgement, "I" refers to myself, "my child" refers to the junior participant on whose behalf I am signing this acknowledgement and indemnity, and "Participant" means either myself or my child, as applicable.)
I agree and declare that:
I acknowledge that the Participant takes part in the Harts Range Amateur Race Club Inc. Rodeo & Gymkhana ("the Event") at their own risk. I further acknowledge that the Harts Range Amateur Race Club Inc., Mt Riddock Pastoral Pty Ltd, the Harts Range Amateur Race Club Inc. members, officials, stock handlers, fellow participants and employees are not liable for any personal injury, death, loss or damage suffered by the Participant in connection with the Event, or for any loss of or damage to the Participant's property or possessions, whether such liability arises from any express or implied term relating to participation in the Event, at common law or otherwise.
I agree to immediately report any injury sustained by the Participant, or by any animal provided for the Participant's use during the Event, to the Event organiser, together with the circumstances in which the injury occurred.
I acknowledge that it is my responsibility to ensure that I and/or my child have appropriate ambulance cover for the Event.
I hereby consent to the collection of photographs and video recordings of the Participant. I acknowledge that these images may be used in social media, websites, newsletters and other publications. I further acknowledge that the Participant's image may be used by the Harts Range Amateur Race Club Inc. and the Northern Cowboys Association Inc. (NCA) to promote future NCA rodeos and related events.
I understand that I may withdraw this consent at any time by providing written notice to ncasecretary@hotmail.com or noms.hrarc1@gmail.com.

Signature* Date*
Should be Empty:

Gymkhana Registration