EmailMe Form - Keysborough Equestrian Club Membership 2020-2021

First Name *

Surname *

Address *

Street Address City State / Province / Region Postal / Zip Code

Contact Number (1) *

Contact Number (2)

Date of Birth (Required) *

Email *

Type of Membership *

Membership of Keysborough Equestrian Club Inc begins on 1st November annually. A separate fee for rally attendance is charged per rally. Members receive a monthly club newsletter via email.

Fundraising Levy *

Agree

NOTE: DUE TO COVID-19 FUNDRAISING LEVY IS WAIVED FOR 2020/2021 FINANCIAL YEAR.
Club members are required to help at fundraising events & rallies.

KEC Membership *

HRCAV No. (if applicable or write N/A) *

Is KEC your 1st or 2nd Club? *

First Club

Second Club

Name of other Club (if applicable)

Emergency Contact (1) *

First Last

Relationship *

Contact Number (1) *

Contact Number (2)

Emergency Contact (2) *

First Last

Relationship *

Contact Number (1) *

Contact No. 2

Please list health conditions eg asthma, diabetes, epilepsy, allergies (or write NONE) *

Please list medications

Doctors' name and contact details

First Aid - Please tick if you are trained in first aid.

Yes

Ambulance Cover *

I have Ambulance Cover

I do NOT have Ambulance Cover

Name of Private Health Insurer (if applicable)

Equine Interests *

Assessed Level or Grading (if applicable)

Riding Level *

Horse's Name *

Horse's Age

Horse's height *

Branding *

Colour *

Address where horse is kept *

Vehicle Registration No.

Float Registration No.

Veterinarian (1) Name and Contact Details *

Veterinarian (2) Name and Contact Details

Membership Level *

Senior ($150)

Junior ($105)

Second Club ($60)

Joining Fee ($60) new members or members renewing after 1 Jan each year

NOTE: $50 LEVY IS WAIVED FOR 20/21 FIN YEAR DUE TO COVID-19. A $50.00 Levy is included in Membership Fee. Club members are required to help at fundraising events & rallies. Levy will be refunded or rolled over at Membership Renewal if fundraising attendance is met.

Would you like to add the HRCAV Chaff Chat to your Subscription?
Subscription will run for 12 Months from date ordered. *

Yes

No

Magazine Version $70.00

On-line Version $30

Keysborough Equestrian Club Conditions of Membership

I have read and understand the KEC Conditions of Membership as set out below:

In becoming a member of Keysborough Equestrian Club Inc I agree to
• Purchase the club uniform
• Wear the uniform when attend rallies and representing the club at official events
• Attend as many rallies as possible (at least three rallies per year – as a spectator or rider)
• Neatly present myself and my horse at rallies, ensuring my horse is clean and that my riding gear is in good order
• Support club activities
• Be considerate and courteous to members, instructors and spectators at all times
• Work at least two fund raising functions each year – if I do not, I agree to forego the refund or rollover of $50 levy paid with my membership renewal.
• Work at one working bee each year
• Adhere to Silverdene rules which are:
o Strictly no dogs allowed
o Cars and floats must be parked in the car park opposite outdoor arena
o Members are restricted to areas designated for club use only (not in stables or wandering on foot other than the car park and driveway)
o Members must not ride anywhere at Silverdene other than the Indoor arena and Outdoor arena. If you warm up on the outdoor, DISMOUNT before you head to the indoor
o Riders MUST NOT ride their horse in the driveway
o Entering and leaving the indoor arena:
- Riders MUST NOT enter the arena mounted
- Ensure horse’s feet are picked out BEFORE entering
- Call “door free” before entering and leaving
- Pick out horse’s feet upon leaving and sweep up sand
o Give way to those performing lateral (side-ways) movements
o Ride on the inside track if walking and others are trotting or cantering
o A KEC/Silverdene waiver must be signed at beginning of each Membership year
o A safety helmet and appropriate riding boots will be worn at all times when mounted
o Clean up all horse manure, rubbish and hay
• Return any perpetual trophies that I may receive during the course of my membership in the condition in which I received them on or before the date requested for the following year or return trophies within seven days of my membership ceasing. Damaged trophies must be repaired or replaced to the satisfaction of the committee.
• As a KEC member I have an obligation to read the KEC Member Responsibilities and Code of Conduct available on the KEC website www.kecriders.com.au

Dlsclaimers *

I have been given a copy of the KEC Conditions of Membership which I agree to abide by. I also will abide the HRCAV rules. I acknowledge that my membership may be cancelled if I do not abide by the KEC and HRCAV rules.

I acknowledge & understand that neither KEC nor the facility which we hold our rally/s accepts any responsibility for any accident or incident causing damage to property, livestock, other people or myself while attending KEC functions

I understand my membership can be refused, suspended or cancelled if I disregard these rules, at the discretion of the committee.

Payment Options *

Bank Receipt No:

Amount Paid & Date of Payment: *