Mataura Rodeo Trek 2018 Rego Form

Venlaw Station, Wyndham
Mataura Rodeo
Horse & Pony Trek; 17th November 2018
Location: - Starting and finishing at Venlaw Station. 267 Venlaw Road, Wyndham.
The trek will start and finish at the property of David & Diane Story’s property.
Camp will be based around the woolshed area for the day.
Timetable: - Full day ride on Saturday

You are welcome to arrive Friday night, and be ready for Saturday mornings start.
Saturday: - 8.30am ride out, return to camp 4.30ish followed by a complimentary beverage and
evening meal.
Saturdays ride will take you through some of Venlaw Stations property with great views across the
East Coast area. Easy enjoyable riding for all.
Horse Accommodation: - paddocks and electric fences

Riders Accommodation: - Horse trucks. Floats and tents SELF PROVIDED
Meals: - BBQ will be available for you to use on Friday night.

Mataura rodeo will supply your Saturday evening meal ONLY.
Please bring your own cutlery/plates/ cups/ tea towel/etc and food for the all other meals. BYO
refreshments/ alcohol.
Points from our Trail Boss:

1.All horses must be fit and able to maintain a reasonable pace.
2.No stallions or rigs are allowed
3.Junior riders [10-15yrs] must be accompanied by a parent or guardian and must wear a safety
helmet.
4.Horses need to be shod for this trek.
5. All horses are to be ridden with a bridle.
NO SMOKING ON TREK, OR IN WOOLSHED
Remember that all riders are under the control of the Trail Boss and riders must take notice of
instructions about hazards etc.
NO DOGS NO FIREWORKS NO FIREARMS
REGISTRATION: - Registrations close Sunday 11th November 2018.

Each person must register on a separate form.
Post to: - Mataura Rodeo Club
c/o Alyce Perkins
62 Frazer Road
RD4
Gore 9774
Email: - [email protected]
Enquiries to: - Olivia Ross 0278017868 or Alyce Perkins 027 482 8981
Mataura Rodeo - Horse & Pony Trek Registration
Registration Form: [Please return this page & H&S form]
NAME:- .................................................................................................................
Names of Riders if more than one under same family. (please add age if under 18).
Rider: ………………………………………………………………………………………………………………
Rider: ………………………………………………………………………………………………………………
Rider: ………………………………………………………………………………………………………………
Rider: ………………………………………………………………………………………………………………
Rider: ………………………………………………………………………………………………………………
ADDRESS:-............................................................................................................
………………………………………………............................................................................
POST CODE...................................PHONE……………………………………......................
EMAIL...................................................................................................................
Registration fee:
Adults: $ 60.00
Riders under 15 years: $30.00
Make cheque Payable to: - Mataura Rodeo Club
Send all forms & cheques to: - Alyce Perkins
Or make payment online: - Bank A/C 03 1355 0691837 00

PLEASE use your full name reference with payment and Trek
If you pay by direct credit, please ensure your registration form is sent at the same time
Paid by:
- Cheque
- Online
- Cash
Many thanks for your support and we are looking forward to see you on the 17th November.
Mataura Rodeo Horse & Pony Trek Health and Safety Declaration: -
To cover the requirements of OSH you will have to read and understand the Safety form and sign
at the bottom of this page, saying you have read and understood the Safety Form and will
comply with all responsibilities indicated on that form.
The Mataura Rodeo Club has organised this Horse & Pony Trek'. As a condition of your entry you are
required to read and sign the following terms and conditions:
Release and Indemnity of Owners and Occupiers of Land

This event has been made possible by the kind permission of owners and occupiers of farmland allowing us
to use their land. I accept they have given their permission on condition that I release and indemnify them,
and I hereby release and indemnify them, from any labiality, claims, losses and damage and expenses
whatsoever including any liability under the Health and Safety in Employment Act 1992. I further agree at
all times to take care with regard to farmland and property, stock and crops.
Personal Safety
I understand that participation in the Horse Trek involves a level of personal responsibility. In entering in
the Horse Trek I confirm that I am physically fit, suffer no medical condition, disability or lack of skill which
render me unsuitable for the event. I understand that, as a rider, I might not be covered by insurance if I
choose not to wear a helmet.
Safety of property
I acknowledge that I have sole responsibility for my horse, equipment and other possessions during the
period of the event.
Liability
By participating in the event I expressly accept all risks personally and release the organisers, owners and
occupiers of land, sponsors and other persons involved in the event from any liability, claims, losses,
damages or expenses caused by any event including but not limited to:
any personal injury or death
any emotional or nervous disorder
any medical condition or suffering
any property loss or damage
Medical Treatment
I consent to receive medical treatment in the event of any injury, illness or suffering during the activity and
agree to indemnify the organisers, their helpers and agents from any liability or claims in respect of that
treatment.
Refunds
I agree I will be only entitled to refunds on the descression of the Organisers.
Cancellations
The Organisers reserve the absolute right to cancel the Horse Trek as a result of adverse conditions or other
unforeseen events or circumstances. I accept that refunds for any cancellation will be made entirely at the
discretion of the Organisers.
Mataura Rodeo Horse & Pony Trek: Agreement to terms and conditions:
CONFIRMATION OF RESPONSIBILITIES
I confirm that I have read and understand the Safety Form. I will abide by the terms and conditions agreed
to at the time of registration and all further instructions from the Horse Trek co-ordinator and the Trial Boss
with respect to this Horse Trek.
…............................................................. ........................ ………………………………………..….....................

Signature of participant Date Full Name [please print]
NEXT OF KIN Name...........................................................................................................
Address........................................................................................................
Phone...........................................................................................................
…............................................................. ........................ ………………………………………..….....................

NEXT OF KIN Name...........................................................................................................
Address........................................................................................................
Phone...........................................................................................................
…............................................................. ........................ ………………………………………..….....................

NEXT OF KIN Name...........................................................................................................
Address........................................................................................................
Phone...........................................................................................................
If participant is less than 18 years, the signature of parent or guardian:
…......................................................... Rider Name

…......................................................... ….............. …...........................................................
Signature of parent or Guardian Date Full name [ please print]
NEXT OF KIN Name...........................................................................................................
Address........................................................................................................
Phone...........................................................................................................
…......................................................... Rider Name

…......................................................... ….............. …...........................................................
NEXT OF KIN Name...........................................................................................................
Address........................................................................................................
Phone...........................................................................................................
…......................................................... Rider Name

…......................................................... ….............. …...........................................................
NEXT OF KIN Name...........................................................................................................
Address........................................................................................................
Phone...........................................................................................................

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Venlaw Station, Wyndham

Timetable: - Full day ride on Saturday

Horse Accommodation: - paddocks and electric fences

Meals: - BBQ will be available for you to use on Friday night.

Points from our Trail Boss:

NO SMOKING ON TREK, OR IN WOOLSHED

REGISTRATION: - Registrations close Sunday 11th November 2018.

Registration Form: [Please return this page & H&S form]

Send all forms & cheques to: - Alyce Perkins

Or make payment online: - Bank A/C 03 1355 0691837 00

Release and Indemnity of Owners and Occupiers of Land

…............................................................. ........................ ………………………………………..….....................

…............................................................. ........................ ………………………………………..….....................

…............................................................. ........................ ………………………………………..….....................

If participant is less than 18 years, the signature of parent or guardian:

…......................................................... Rider Name

…......................................................... Rider Name

…......................................................... Rider Name

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