Horse Entry Form


Please fill in the online form, make your payment, and forward your signed Horse Waiver form(s) and Horse Tracing form(s). 

Sign, scan and email to the horse secretary (at the address below), and we will contact you by email.

If you have any questions, please contact
Angela Flowers
(03) 5345 4000

 

Paying Online

When paying your fees by bank transfer, please add your name and invoice number (found on the online form) for your reference.  Thank you.
Fee:  $4 per Class

Our Bendigo Bank Details:
Clunes and District Agricultural Society
BSB 633000
Account:  155108533


ENTRY FORM

Invoice
7292
Your Name*
Your Email Address*
Address
Town*
Contact Phone*

NOTE:  We will email your entry confirmation & exhibit number to you.

Please complete the following on this form: Name of Handler and/or rider, Name of Horse, and Reg. No (if applicable) for each entry.

ENTRY 1
Class No Entry 1*
Name of Handler and/or Rider Entry 1*
Name of Horse Entry 1*
REG. No Entry 1
ENTRY 2
Class No Entry 2
Name of Handler and/or Rider Entry 2
Name of Horse Entry 2
REG. No Entry 2
ENTRY 3
Class No Entry 3
Name of Handler and/or Rider Entry 3
Name of Horse Entry 3
REG. No Entry 3
ENTRY 4
Class No Entry 4
Name of Handler and/or Rider Entry 4
Name of Horse Entry 4
REG. No Entry 4
ENTRY 5
Class No Entry 5
Name of Handler and/or Rider Entry 5
Name of Horse Entry 5
REG. No Entry 5
ENTRY 6
Class No Entry 6
Name of Handler and/or Rider Entry 6
Name of Horse Entry 6
REG. No Entry 6
ENTRY 7
Class No Entry 7
Name of Handler and/or Rider Entry 7
Name of Horse Entry 7
REG No Entry 7
ENTRY 8
Class No Entry 8
Name of Handler and/or Rider Entry 8
Name of Horse Entry 8
REG No Entry 8
ENTRY 9
Class No Entry 9
Name of Handler and/or Rider Entry 9
Name of Horse Entry 9
REG No Entry 9
ENTRY 10
Class No Entry 10
Name of Handler and/or Rider Entry 10
Name of Horse Entry 10
REG No Entry 10
ENTRY 11
Class No Entry 11
Name of Handler and/or Rider Entry 11
Name of Horse Entry 11
REG No Entry 11
ENTRY 12
Class No Entry 12
Name of Handler and/or Rider Entry 12
Name of Horse Entry 12
REG No Entry 12
ENTRY 13
Class No Entry 13
Name of Handler and/or Rider Entry 13
Name of Horse Entry 13
REG No Entry 13
ENTRY 14
Class No Entry 14
Name of Handler and/or Rider Entry 14
Name of Horse Entry 14
REG No Entry 14
ENTRY 15
Class No Entry 15
Name of Handler and/or Rider Entry 15
Name of Horse Entry 15
REG No Entry 15

I agree to abide by the Rules and Regulations of the EFA and abide by the Disciplinary Actions and Penalties of the EFA Disciplinary Committee.  Please tick the box below if you agree.

EFA Rules
 

Horse Sports Waiver

Please open and read the horse sports waiver.  A signed copy to be forwarded.
Horse Waiver
 

Horse Tracing Details

Please open and read the Horse Tracing Details.  A signed copy to be forwarded.

Section - Fee

Horse fee $4

I will make payment by bank transfer of $*
Bank Transfer Receipt No.
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