2024 Herefords Australia National Youth Expo Cootamundra NSW

Please click here to read full conditions of entry prior to completing this form

PARTICIPANT DETAILS

First Name *

Last Name *

Date of Birth (must be 6-25 years of age as of 1st July 2024) * +

Address *

Address Line 2

City *

State *

Postcode *

Phone Number *

Email Address *

Level of Participant's Experience *

Vest Size (VEST SIZING CHART BELOW) *

I have read, understood and agree to abide by the Conditions of Entry. I acknowledge that if I am not already a member of Herefords Australia Youth, a membership will now be created for me at a cost of $37.50 and will be added at checkout and conclusion of this application. I agree to abide by the constitution and regulations of Herefords Australia. (Must be signed by parent or guardian if participant is under 18 years of age). *

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24 Hour Emergency Contact

Name *

Relationship to Participant *

Phone Number *

Alternative Phone Number

Parent or Guardian Information & Consent (required if Participant is under 18 years of age)

First Name

Last Name

Address

Address Line 2

City

State

Postcode

Phone Number

Email Address

Parent or Guardian Signature

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Camp Guardian Details - All competitors aged 12 and under must be accompanied by a parent or guardian or identified camp guardian for the duration of the Expo.

Camp Guardian Name

Camp Guardian Phone Number

MEDICAL INFORMATION

Is the participant subject to any of the following health conditions?

Does the participant have any other condition that may affect safety or ability to fully participate during the event? (please describe below)

Do you have an injury or condition which is likely to be aggravated by the event? *

Yes

No

List/describe health conditions/injuries if applicable including any recent illness

Does the participant have any known allergies *

Yes

No

If yes, please list allergy and known reaction

Date of last tetanus injection, if known +

WAIVER, RELEASE, & ACKNOWLEDGEMENT

In this Waiver, Release and Acknowledgement Form “the Society” means and includes all affiliated entities, servants or agents of the Society, all employees of the Society, all members of the Society and all volunteers of the Society and/or all affiliated entities. By participating in the Expo: 1. I acknowledge that it is a condition of participating in the Expo that I do so at my own risk. I accept all risk and release the Society from all claims, demands and proceedings arising out of or connected with my participation in the Expo and indemnify them against all liability for any injury, loss or damage arising out of or connected with my participation in the Expo. 2. I acknowledge that it is a condition of participating in the Expo that the Society and any person or body directly or indirectly associated with the Expo are absolved from all liability arising for injury or damage to myself or my property howsoever caused arising out of my participation in the Expo whatsoever whether due to negligent act, breach of duty, default and/or omission on the part of the Society and any person or body directly or indirectly associated with the Expo or otherwise. 3. I acknowledge that the Society relies on the information provided by me and state that all such information is accurate and complete. 4. I warrant that I am physically fit to participate in the Expo and that I have not been advised otherwise by a qualified medical practitioner. I acknowledge that I must disclose any pre-existing medical or other condition that may affect the risk that either myself, or any other person will suffer injury, loss or damage. 5. I consent to receiving any medical treatment including ambulance transportation that the Society and any person or body directly associated with the Expo think necessary as required during the Expo. 6. I acknowledge that it is a condition of participating in the Expo that I follow the instructions of the Society and any person or body directly or indirectly associated with the Expo at all times. I indemnify and keep indemnified the Society and any person or body directly or indirectly associated with the Expo from all claims, demands and proceedings arising out of or connected with a failure by me to comply with rules and/or directions given to me by the Society and any person or body directly or indirectly associated with the Expo. *

I agree

Signature of Participant (parent/guardian if participant is under 18) *

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MEDIA WAIVER AND RELEASE

I give Herefords Youth consent to reproduce his / her (as named above) photography in newsletters and / or newspaper publications The material may appear in printed or electronic form and may be available to a global audience on the World Wide Web. I authorise the use or reproduction of the photography by Herefords Youth for promotion purposes without acknowledgement and without being entitled to payment. The copyright ownership of the photography will be retained by Herefords Youth and the photographer. I understand that if I wish to withdraw this authorisation, it will be my responsibility to inform Herefords Youth. *

I agree

Signature of Participant (parent/guardian if participant is under 18) *

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ANIMAL INFORMATION

Do you require a loan animal *

Yes

No

Commercial Class (please tick the correct commercial class if animal 1 is a commercial animal and fill out it's details below).

Commercial Breeder

Carcase Competition

1. Animal Name

Animal Ident

Animal Date of Birth +

2. Animal Name

Animal Ident

Animal Date of Birth +

Additional Animal *

Additional Animal ($20)

No

Animal 2 Commercial Class (please tick if animal 2 is a commercial animal).

Commercial Breeder

Carcase Competition

Bred and Owned (Note: Animal must have been in the Participant's name at the time of breeding and current ownership)

Animal Ident

Owned Class (Animal purchased by youth member and must be in participants name at time of entry and Expo).

Animal Ident

Pestivirus Results and Animal Health Declaration

Herd Health Declaration

Pestivirus Results

Payment Information

Existing Financial Herefords Australia Youth member, all meals and snacks ($279)
Joining Herefords Australia Youth member, all meals and snacks + membership fee for 2024 ($316.50)

Please note: This is Youth membership, not Ordinary membership. To be eligible to participate at the Expo you must have a current financial YOUTH membership ($37.50 annually) If you need to renew your membership contact the office now 02 6772 1399

Registration Type *

Existing financial Herefords Australia Youth Membership number:

Non-participant meal packages $189/person - includes all meals and snacks including BBQ dinner on Thursday and Friday night (EXCLUDING Saturday night dinner. Dinner tickets can be purchased separately) *

Non-participant additional Saturday night dinner tickets $50/each. (Note: 1 dinner ticket is included in the Youth Expo participant entry fee). If you require more than 2 extra tickets please speak with Nikki. *

Any special dietary requirements? (participant and/or additional meals/dinner) *

No

Yes (please specify) Yes (please specify)

Additional Vest $69 providing your size is available.

Payment processing fee *

1.75%

Kids 6	Kids 8	Kids 10	Kids 12	Kids 14	Kids 16
Ladies 8	Ladies 10	Ladies 12	Ladies 14	Ladies 16	Ladies 18
Mens Small	Mens Medium	Mens Large	Mens XL	Mens 2XL	Mens 3XL
Mens 5XL

seizures/epilepsy	asthma	fainting
diabetes	allergies/anaphylaxis	heart problems including heart murmurs

Kids 6	Kids 8	Kids 10	Kids 12	Kids 14	Kids 16
Ladies 8	Ladies 10	Ladies 12	Ladies 14	Ladies 16	Ladies 18
Mens Small	Mens Medium	Mens Large	Mens XL	Mens 2XL	Mens 3XL
Mens 5XL