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Rider Level Evaluation: Host Application
Requested Date for Examination
(Required)
Month
Day
Year
Facility Name
(Required)
Facility Address
Facility City
(Required)
Facility Province/Territory
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Postal Code
Co-ordinator (Host) Name
(Required)
Co-ordinator (Host) Email
(Required)
Co-ordinator (Host) Phone Number
(Required)
Evaluator Name
(Required)
I have the
(Required)
Evaluator's NCCP #
Evaluator's EC Sport License #
Evaluator's NCCP #
(Required)
Evaluator's EC Sport License #
(Required)
Discipline
(Required)
English
Drive
Western
List of Candidates
Candidate Full Name
(Required)
Levels
(Required)
Level 1
Level 2
Level 3
Level 4
Level 5
Level 6
Level 7
Level 8
Level 9
Level 10
Host Acknowledgement
Undersigned Name
(Required)
Please type the name of the undersigning party for the following acknowledgements
I understand that the $25 per certificate fee should be sent by etransfer to info@albertaequestrian.com and I will list in the etransfer message the following message: Rider Level Test Fee for First and Last Name of each Candidate listed in this application.
(Required)
I understand.
I agree that as the host conducting evaluations, I will ensure to provide safe facilities, have an emergency action plan in place, and have valid liability insurance and agree to accept full responsibility for this evaluation.
(Required)
I agree.
I agree that by submitting this application, I am electronically signing the application. I, the undersigned, solemnly declare that the information I have provided is true to the best of my knowledge.
(Required)
I agree.
COVID-19 Disclaimer
(Required)
I have:
- Reviewed, in detail, the Government of Alberta’s most recent rules and regulations surrounding the COVID-19 pandemic related to “Sport and Fitness” and the Restrictions Exemption Program, if applicable. I agree to adhere to the guidelines;
- Reviewed, in detail, all information provided on the AEF COVID-19 Updates for the Equestrian Community Page and agree to adhere to the guidelines set forth
- Designed a written COVID-19 Operation Plan for the examinations following the federal/provincial/territorial/regional and local restrictions and regulations, while taking into account the AEF/EC recommendations made;
- Liaise with local Health Authorities regarding the COVID-19 Operation Plan to ensure the examinations are following all current COVID-19 rules and regulations;
I/We (the undersigned), have read and fully understand the AEF 2021 Rider Level Examination COVID-19 Checklist and agree to abide by all expectations and regulations.
Signature
(Required)
Email
This field is for validation purposes and should be left unchanged.
