Exit PARTICIPANT RECONCILIATION 1. Participant Registration Details Question Title * 1. Contact Details REGISTERED NAME(Event Organiser/ Committee) Contact Name Address Suburb State Postcode Email Telephone Question Title * 2. Event Details Place of Event (incl. Suburb & P/code) Date(s) of Event PARTICIPANT NUMBERSPersonal Accident Cover is Compulsory for all riders, workers and officials, entering and participating inside the arena, back yards or stock handling areas at any NRCA affiliate nominated event or activity where public liability has been provided by NRCA. Question Title * 3. Confirmed (Actual) Competitors/Workers/Officials per person/per dayIf your event is more than one day, add each days figures i.e per person per day to obtain total amount for each category Example: 1st Day - 25 Seniors + 2nd Day - 10 Seniors -= Total: 35 Seniors at event. SENIORS JUNIORS JUNIORS (Poddy) CAMPDRAFT /GYMKHANA/HORSE SPORTS (Senior and/or Junior) BRONCO BRANDING/ STOCKMAN'S CHALLENGE (Senior and/or Junior) CAMEL/BUSH SPRINT RACE (Seniors ONLY) OFFICIALS/WORKERS Question Title * 4. NRCA Affiliation Fee @ $55 per event*This fee only applies to MAIN events & does not apply to schools/clinics YES I understand this fee applies per main event, in addition to participant registration fees NO This fee does not apply, I am running a school/practise day JUDGES SHEETSInclude all Judges sheets (events) or Rider Name Register (schools, jackpots, clinics) Question Title * 5. Judges Sheets/Rider Name Register will be supplied by: File Upload (Go to Q6) Email: enquire@nationalrodeocouncil.com.au Fax: 02 6737 3676 Post: NRCA, PO Box 463, Tenterfield NSW 2372 Question Title * 6. To Upload scanned Judges Sheets/Riders Register CHOOSE FILE below We accept documents in the following formats: PDF, JPG, JPEG file types only. Choose File Choose File No file chosen Remove File We accept documents in the following formats: EVENT SUMMARY REPORTAn EVENT Summary Report must be submitted as part of the terms and conditions of the policy. Question Title * 7. To Upload scanned Event Report CHOOSE FILE below We accept documents in the following formats: PDF, DOC, DOCX, PNG, JPG, JPEG, GIF file types only. Choose File Choose File No file chosen Remove File We accept documents in the following formats: INCIDENT REPORTINGAn incident report must be lodged for all incident occurrences at the event including participants, spectators or stock Question Title * 8. Were any injuries recorded at your event? Yes No (Go to Q9) Question Title * 9. If YES, please confirm how these forms will be supplied: a) File Upload (Go to Q9) b) Email: enquire@nationalrodeocouncil.com.au c) Post: NRCA, PO Box 463, Tenterfield NSW 2372 d) Fax: 02 6737 3676 Question Title * 10. To Upload scanned Injury Reports CHOOSE FILE below We accept documents in the following formats: PDF, DOC, DOCX, PNG, JPG, JPEG file types only. Choose File Choose File No file chosen Remove File We accept documents in the following formats: RELEASE & WAIVERSCompleted waivers must be submitted to our office with your event reconciliations as part of the terms and conditions of the policy Question Title * 11. Release and Waiver forms will be supplied by: File Upload (Go to Q11) Email: enquire@nationalrodeocouncil.com.au Fax: 02 6737 3676 Post: NRCA, PO Box 463, Tenterfield NSW 2372 Question Title * 12. To Upload scanned Waivers CHOOSE FILE below We accept documents in the following formats (pdf, jpg, jpeg). Please ensure scans are at least 200 dpi or actual size before uploading. PDF, JPEG, JPG file types only. Choose File Choose File No file chosen Remove File We accept documents in the following formats (pdf, jpg, jpeg). Please ensure scans are at least 200 dpi or actual size before uploading. Page1 / 1 100% of survey complete. YES! PLEASE SUBMIT MY INSURANCE RECONCILIATION
