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2016 PCA NATIONAL JUNIOR GAMES

CHAMPIONSHIPS

ENTRY PACKFOR RIDERS, TEAM

MANAGERS & COACHES

PROUDLY HOSTED BY

PONY CLUB AUSTRALIA2016 NATIONAL JUNIOR GAMES CHAMPIONSHIPS PROUDLY HOSTED BY PONY CLUB WESTERN AUSTRALIA INC

WELCOME

The Active Riding subcommittee of Pony Club Association of Western Australia is pleased to invite our fellow Pony Club members and their families from around the country to Western Australia to compete at the 2016 Pony Club Australia Inc Junior Mounted Games Championships.

The competition will be held on the last Saturday of the 2016 Perth Royal Show, highlights will include taking part in the Grand Parade, the competition, dinner at the show and the closing fireworks. On the Friday evening before the event we will host an official dinner which will take place on a three-hour river cruise through the city and to Fremantle.

We look forward to you joining with us in September at this PCA 2016 National Championship to celebrate everything Pony Club.

Marc FraserChair PCAWA Active Riding

Pony Club Western Australia Inc303 Cathedral Ave, Brigadoon WA 6069

E: [email protected] | P: 08 92961500 | www.pcawa.comPage 2

http://www.pcawa.com/


THE EVENT DETAILS

EVENT DATE: 29th September – 2nd October 2016

ENTRIES CLOSE: Friday August 26th, 2016

VENUE: Claremont Showgrounds, 1 Graylands Rd, Claremont WA 6010

REFUND POLICY

Requests for a refund after close of entries must be accompanied by a Medical Certificate. Refunds will not be processed if request is forwarded more than 7 days post the Championships. The Organising Committee may withhold an administration fee of up to 25% of the total entry fee.

ABOUT THE VENUE

The Perth Royal Show is held at the showgrounds in Claremont is a suburb close to the centre of the city, it is easily accessible by bus, train and car. We will transport our teams there by bus and details will be made available closer to the event. For more information regarding the Perth Royal Show go to their website - www. perthroyalshow .com.au .

VENUE RULES

1. Approved Safety Helmets must be worn at all times when riding.

2. Riding of horses bareback is prohibited.

3. Riding of rugged and/or unbridled horses is prohibited.

4. Designated horse areas are clearly defined and riders will be given the opportunity to “try” horses in those areas.

5. Please observe all signs at the venue.

6. Ambulance officers will be in attendance throughout the Championship.

7. As per the PCAWA Health Policy the stables areas are SMOKE FREE VENUE.

8. The consumption of alcohol is prohibited for all riding members, coaches & chaperones irrespective of any age, who are representing Pony Club in competition at any level.

9. Athletes, Managers and supporters are to obey any directions as issued by the Organising Committee, Stable Manager or any member of the RAS Staff.




http://www.perthroyalshow.com.au/


ACCOMMODATION

Accommodation will be at Camp Leschenaultia whose details can be viewed on their web page http://www.camplesch.com.au/), the facilities include:

Accommodation in dormitories. Large recreation hall for indoor games. In the cool of winter stay warm near the wood combustion stove. Separate accommodation for group leaders. Communal dining with fully equipped kitchen, clean and well maintained Volleyball area, sporting oval and table games. Shops, tennis courts, football and cricket oval nearby.

Each team member, coach and chaperone will be required to bring:

All your own bedding, (pillow, fitted sheet, sleeping bag, blanket or quilt.) Bath towel, Soap, shampoo, and toiletries etc. Clothes (of course), especially a jumper for night walks. Bathers and towel - if your group is planning to walk to the lake and have a

swim/paddle. Shoes suitable for outdoor games and walking in the bush. A torch, a hat, insect repellent, sunscreen

Breakfast will be provided at the camp.

Thursday dinner will be in the form of a Welcome Dinner at the camp. Riders who arrive earlier or later will be provided with meals as necessary.




http://www.camplesch.com.au/


GENERAL TIMETABLE

Date and Day Activity Comments

29th September Thursday

Arrive in Perth - It would be appreciated if teams could arrive around lunch time.

Teams will be met at the Perth airport by volunteers from the Active Riding Subcommittee with a 20 seater coaster bus and transported to their accommodation.

Welcome Dinner Welcome Dinner with meet and greet and some evening icebreaker activities at accommodation.

30th September Friday

Morning activities with BBQ lunch and equipment inspection and Team Managers Meeting.

Morning activities such as Laser Tag will be organised at the camp. BBQ lunch will be provided at nearby Lake Leschenaultia where you can swim and canoes will be available for teams to use. The games trailer will be bought to Lake Leschenaultia for teams to view games equipment. A Team Managers meeting will also be held in the afternoon.

Official dinner - River cruise with dinner

Pick up by bus and transported to Barrack St Jetty – River Cruise and then pick up and take back to accommodation.

1st October Saturday

Royal Show day and National Junior Games Championships

Pick up by bus from accommodation at 9.30am and transported to Claremont Showgrounds. Free time in the morning to look around the Show. Teams to purchase own lunch at Royal Show. Take part dismounted in Grand Parade at 1.30pm in riding uniform. Loan horses will be ridden in Grand Parade by PCAWA horse lenders in full club uniform. Meet horse handlers and their horses in the stable area at approximately 2.15pm. Safety check and horse tryout followed by commencement of competition at approximately 3.00pm. Presentations at end of competition followed by free time at show and dinner supplied at showgrounds for teams and supporters near stable area. Fireworks display and then teams picked up at 9.00pm and transported by bus back to competition for wind down and socialising with their new friends.

2nd October Sunday Depart Perth

Transport back to airport by 20 seater coaster. There will be one bus trip down to airport in the morning and one in the afternoon – fly home.





GENERAL RULES & GAMES SETS

Rules are as PCA Mounted Games rules and the following are the sets of games to be ridden:Please note some games have been changed from initial information sent out.

GAMES:Set 1BendingBall and BucketTack Shop

Set 2Canadian Fishing5 Cone

Set 3 Stepping Stones3 MugLitter

Set 4HiloTyre9 Ring

Set 5SwordHurdleWindsor Castle

Set 6BottleQuoits and ConePony Club

Set 7PyramidPony Club Pole5 Flag

Spares2 Flag5 Mug





WELCOME DINNER – THURSDAY 29TH SEPTEMBERA welcome Dinner for all teams and officials will be held at 5.00pm at Camp Leschenaultia. Parents and team supporters are welcome to join us at a cost of $10 per person.

FORMAL DINNER – FRIDAY 30TH SEPTEMBERThe Formal Dinner will be included in the form of a Swan River cruise. Athletes will be transported to and from the venue. If you have any dietary requirements, please ensure that you provide them on your entry form. Additional tickets may be pre-ordered on your entry form for $90 per person.

PARENTS & SUPPORTERSAdditional tickets to the Formal Dinner and Welcome Dinner can be purchased in a package for $100 per head. ($90 for River Cruise & $10 for Dinner). There is no extra accommodation for parents and supporters at Camp Leschenaultia.

MERCHANDISESouvenir shirts maybe available for purchase details to follow.

MEALS & CATERINGRiders, Team Managers and Coaches as part of their entry are provided with all breakfasts and dinners during the event along with Thursday lunch. On site at the Showgrounds, there are many food vendors where Saturday lunch may be purchased. Saturday dinner will be supplied at the showgrounds for all riders, team managers and officials as well as horse handlers.

UNIFORMPlease bring your State saddle blankets. All other dress will be according to individual state rules. State polo shirts should be worn when not riding whenever possible.

CLIMATESeptember and October in Perth can be warm (22– 27deg) and cool at night. Occasional showers may occur. Ensure you bring some warm water proof clothing as well as sunscreen.





RIDER - PERSONAL DETAILS, CONTACT & EMERGENCY DETAILSAll information on the Rider, Manager & Coach Contact & Emergency Details and Medical Statement is confidential. Access to this form is limited to the Team Manager, Coach and Medical staff.

RIDER PERSONAL DETAILSFull Name

Pony Club State

Home Address Postcode

DOB Age

Height Weight

Date “C” Certificate Achieved

PRIVATE DOCTOR DETAILSDoctor’s Name

Emergency Contact No 1 No 2

HEALTH COVER & INSURANCE DETAILSPrivate Health Fund Private Health No

Medicare No Ambulance No





EMERGENCY CONTACT DETAILSRiders Name

PARENT/GUARDIAN DETAILSName of Parent/Guardian

Relationship to Rider


ALTERNATIVE CONTACT DETAILSAlternative Contact Name

Relationship to Rider

Alternative Contact No 1 No 2





RIDER - MEDICAL STATEMENTRiders Name

MEDICAL CONDITION YES NO MANAGEMENT PLAN*

Allergic reactions (Anaphylaxis)

Asthma

Diabetes

Eating problems

Epilepsy

Hay Fever

Migraine

Previous Injury

Other (Please specify):

* Please attach management plans if required for any medical conditions and ensure you brief the Team Manager & Coach on the Management Plan

INJURIES/CONDITIONS YES NO DETAILSDo you have any pre-existing injuries/conditions?Are you currently being treated for a pre-existing injury/condition?Do you have a current injury/condition?Are you currently being treated for a current injury/condition?





MEDICATIONS

Riders Name

Please list any current medications:

Team members are not permitted to carry any prescribed medications that have not been notified to the team manager. The manager will carry an adequate First Aid kit. Team members are asked not to bring with them additional herbal preparations/ pills/ drops/ lotions unless previously notified and discussed with the Team Manager.

OTHER MEDICAL ISSUESDate of last tetanus injection

SPECIAL DIETARY REQUIREMENTS

EMERGENCY MANAGEMENT DECLARATIONIn the event of (rider name) requiring emergency medicalor dental treatment whilst taking part in the National Championships, I hereby authorise the Team Manager (or in his/her absence the Coach) following consultation with a medical or dental practitioner, to allow emergency care to be given to myself/my child. This authority extends to all medical and dental treatment including the giving of an anesthetic where necessary. I will not hold the Pony Club Association of Victoria Inc, its Officers or team officials responsible for any accident or sickness suffered during the period of my/my child’s team selection.

Rider Name

Signature Date

Parent/Guardian (if rider is under 18)

Signature Date





RIDER PROFILE About You

Full Name

Pony Club State

Age Years in Pony Club

About Your TeamState

Team

Discipline

About Your Pony Club LifeMost memorable Pony Club moment:

Most exciting Pony Club achievement:

Your favorite thing about being a Pony Club member:

Most admired sportsperson:

Other past times. What do you like to do when you are not riding?:

INFORMATION RELEASE AUTHORITY

I understand the information I have provided on this form will be used in the program and may be used on electronic media. I give my permission for this information to be published in the Event Program, on the PCA/PCAWA Website and in the PCA/PCAWA Magazine.

Signature Date

Parent/Guardian (if rider is under 18) Date





MEDIA/PUBLISHING CONSENT FORM

All professional photographers must seek approval from PCAWA as stated in the PCAWA Photography Policy.

For promotional purposes, photographs may be taken on the day of your competition, activity, event, meeting or workshop. To assist Pony Club Association of WA to promote, advertise or report on these activities photographs and results will be published from time to time on both print and electronic media. We ask that you give your permission for your pictures, name and results to be included in any promotional material.

I (Please print name)

Mark X in chosen box Give my permission Do not give my permission

To be photographed/videoed by Pony Club Association of WA or media agents engaged by the Pony Club Association of Victoria during the event/activity I am participating in. I understand the images/film taken will remain the property of Pony Club Association of WA and/or the media agent engaged by Pony Club Association of WA and may be used to promote Pony Club Association of WA in both printed and/or electronic media.

Signature Date

Media Consent Form (under 18 years)




To my child to be photographed/videoed by Pony Club Association of WA or media agents engaged by the Pony Club Association of WA during the event/activity my child is participating in. I understand the images/film taken will remain the property of Pony Club Association of WA and/or the media agent engaged by Pony Club Association of WA and may be used to promote





Pony Club Association of WA in both printed and/or electronic media.

Parent/Guardian (if rider is under 18) Date

TEAM MANAGER PERSONAL DETAILSFull Name DOB

Email Address

Pony Club State

Home Address

Postcode

Are you Coach or Team Manager? Mark X in chosen box Coach Team Manager









TEAM MANAGER STATEMENTName



Asthma

Diabetes

Eating problems

Epilepsy

Hay Fever

Migraine

Previous Injury








MEDICATIONSName





EMERGENCY MANAGEMENT DECLARATIONIn the event of (Team Manager/Coach name) requiring emergency medical or dental treatment whilst taking part in the National Championships, I hereby authorise the Team Manager (or in his/her absence the Coach) following consultation with a medical or dental practitioner, to allow emergency care to be given to myself/my child. This authority extends to all medical and dental treatment including the giving of an anesthetic where necessary. I will not hold the Pony Club Association of Victoria Inc, its Officers or team officials responsible for any accident or sickness suffered during the period of my/my child’s team selection.

Team Manager/Coach name

Signature Date





TEAM MANAGER / COACH PROFILE

About YouFull Name

Pony Club State



Team

Discipline





Other past times:



Signature Date











Team Coach/Manager Signature Date





COACH PERSONAL DETAILSFull Name DOB

Email Address

Pony Club State

Home Address

Postcode

Are you Coach or Team Manager? Mark X in chosen box Coach Team Manager









COACH MEDICAL STATEMENTName



Asthma

Diabetes

Eating problems

Epilepsy

Hay Fever

Migraine

Previous Injury








MEDICATIONSName





EMERGENCY MANAGEMENT DECLARATIONIn the event of (Team Manager/Coach name) requiring emergency medical or dental treatment whilst taking part in the National Championships, I hereby authorise the Team Manager (or in his/her absence the Coach) following consultation with a medical or dental practitioner, to allow emergency care to be given to myself/my child. This authority extends to all medical and dental treatment including the giving of an anesthetic where necessary. I will not hold the Pony Club Association of Victoria Inc, its Officers or team officials responsible for any accident or sickness suffered during the period of my/my child’s team selection.

Team Manager/Coach name

Signature Date





TEAM MANAGER / COACH PROFILE

About YouFull Name

Pony Club State



Team

Discipline





Other past times:



Signature Date











Team Coach/Manager Signature Date









FORMAL DINNER & WELCOME DINNER EXTRA TICKETS ORDER FORM

Rider (Full Name)

Address

Suburb/Town Postcode

Phone 1 Phone 2

Email

GUEST LIST PLEASE NOTE THAT THERE ARE LIMITED SPACES AVAILABLE

Name

Total Extra Guests

Total Payment @ $100/ticket

Formal Dinner will be a three course meal concluding with a cheese platter tea and coffee and the Welcome meal will be a relaxed Dinner at Camp Leschenaultia.

Please note there will be no alcohol served or allowed at these events.

Please make payment to your State/Territory Organisation.




STATE PAYMENT FORM

State

Payment Item Cost Quantity Total

Team Entry National Mounted Games $500 per person (Inc GST) x $

Formal Dinner & Welcome Dinner Extra Tickets $100 ea (inc GST) x $

Total Entry Fee $

Entries must be return in word format via email to [email protected] Payments must be made via EFT bank details are below

Bank: Bendigo BankAccount Name: Pony Club Association of Western Australia Inc.BSB: 633 000 A/C: 147906960 Reference: State NJGC





CHECKLIST

Please make sure you have included the following items with your entry and forward them to your State/Territory Office – payment to be made to your State/Territory Association

Form Please Tick

Rider - Emergency contact details

Rider profile including photo

Medical Statement

Media Publishing Consent

Manager - Emergency contact details

Manager profile including photo

Medical Statement


Coach - Emergency contact details

Coach profile including photo

Medical Statement


Formal Dinner Extra Tickets

State Payment Form

Pony Club Association of Western Australia303 Cathedral Ave, Brigadoon. WA. 6069

E: [email protected] | P: 08 92961500 | | www.pcawa.com Page 27


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