NOMINATION FORM

Rider name: (required)

Rider AERA number:(required)

Rider FEI number: (required)

Division: (required)
YouthOpen

Horse name:(required)

Horse AERA number:(required)

Horse FEI number:(required)

Rides Entered (required)

1*80km-$150: yesno

2*120km-$400: yesno

3*160km-$500: yesno

Email for Confirmation: (required)

Anticipated arrival date at venue (required) 
Tuesday, 15 AugustWednesday, 16 AugustThursday, 17AugustFriday, 18 August

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Payment Information

Please note, nominations will only be accepted on receipt of proof of payment.  Please email your bank payment receipt to Kim Moir at kktkmoir@bigpond.com to ensure your nomination is completed.
BSB 034001
A/C 405400

Nominations close 11 August

The committee reserves the right to retain part of the nomination fee for cancellations after 11 August.

Requirements:

Horse HeV Certificate to be available at arrival and at nomination.