Participant nomination application

This form can be used for the following purposes:

to add participants to your booking ( a maximum of 3 is permitted, which does not include immediate family members)
remove existing Nominated Participants

Booking Client Details

First Name *

Last Name *

Email Address *

Are you wishing to *

ADD Nominated ParticipantREMOVE Existing Participant

You can choose multiple options if so desired

A Client with a stable booking must nominate all Participants (including family members) who have access to their horse for the purpose of engaging in any equine activity including handling, riding and horse care.
A separate nomination form is required for adding each Participant.
This form can only be completed by the Booking Client.
The Client must ensure that this form is lodged prior to the nominated person below engaging in equine activities with their horse.

New Participant Details

First Name (Participant 1) *

Last Name (Participant 1) *

Date of birth (Participant 1) *

Mobile Number (Participant 1) *Please enter the Participants mobile number (10 digits)

Email (Participant 1) *

This partcipants email will be included in the CPEC General Mail List, should you NOT wish to be included please tick this box.

Frequency of riding or participating in equine activity with your horse *

As per the Code of Conduct minors (under 16 years) must be supervised by a responsible parent or guardian 18 years or older (who is listed as a Participant at CPEC) whilst at CPEC and the Equestrian Grounds.

Documentation required

All prerequisite documents for this Nominated Participant must be uploaded with this lodgement as follows:

Proof of EA Membership or Personal Riding Accident & Public Liability insurance policy with $20,000,000 limit. *

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Acceptable file formats: jpg, jpeg, gif, bmp, png, doc, docx, svg, tif, heif, tiff, pdf, heic, hevc

Photo (clear headshot) – similar to a driver’s licence photo *

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Acceptable file formats: jpg, jpeg, gif, bmp, png, doc, docx, svg, tif, heif, tiff, pdf, heic, hevc

Once this nomination has been assessed by CPEC Management, you will receive confirmation of acceptance or non-acceptance, please ensure that the nominated person does not handle or ride your horse until you receive our response.

Participant Removal Details

All Clients with a stable booking are responsible for notifying the CPEC office of all Participants related to their booking.
This form can only be completed by the booking client.

Participant Name 1 *Please enter the name of the person you wish to remove

Participant Name 2

Signature of Client with stable booking *

Clear

Date signed *

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