Alexander Park Dressage Club Inc

ALEXANDER PARK DRESSAGE CLUB INC.

ABN 99 839 310034

CHAMPIONSHIP WEEKEND

Salt Ash Sportsground, Richardson Rd Salt Ash

Saturday 1st October 2016Closed Restricted & Official Young Horse Qualifyer.

Event 1 Preparatory E JNR/YTH C/R See cond. 12 Event 9 Preliminary 1.2 C/R

Event 2Preparatory C JNR/YTH C/R See cond. 12 Event 10 Preliminary 1.3 C/R

Event 3Preliminary 1.2 JNR/YTH C/R Event 11 Novice 2.2 C/R

Event 4Preliminary 1.3 JNR/YTHC/R Event 12 Novice 2.3 C/R

Event 5 Novice 2.2 JNR/YTHC/R Event 13 Elementary 3.2 C/R & Jnr/Yth

Event 6Novice 2.3 JNR/YTHC/R Event 14 Elementary 3.3 C/R & Jnr/Yth

Event 7Open Preparatory EC/R Event 15 4 Year Old Young Horse Qualifyer

Event 8 Open Preparatory C C/R Event 16 5 Year Old Young Horse Qualifyer

NOTE: YOUTH RIDER – 14 to 18 YRS at 1st Jan 2016 Event 17 6 Year Old Young Horse Qualifyer

Sunday 2nd October 2016Official Competitive

Event 18 Preliminary 1.2 O/C Event 26Advanced 5.2O/C

Event 19 Preliminary 1.3 O/C Event 27Advanced 5.3 O/C

Event 20 Novice 2.2 O/C Event 28Prix St Georges 2009 O/C

Event 21 Novice 2.3 O/C Event 29Inter I 2009 O/C

Event 22 Elementary 3.2 O/CEvent 30Inter A 2015 O/C

Event 23 Elementary 3.3 O/CEvent 31Inter B 2015 O/C

Event 24 Medium 4.2 O/C Event 32Inter II 2015 O/C

Event 25 Medium 4.3 O/CEvent 33 Grand Prix 2015 O/C

PONIES CAN ENTER ANY CLASS – MUST BE NOTED ON ENTRY.

MINIMUM 3 RIDERS PER TEST FOR RIBBONS & 5 RIDERS FOR PRIZES.

Event No: Horse Bridle No. EA No Rider EA No: Entry Fee

Plus Ground fee $10 per rider

APDC MEMBERS $20 C/R & $30 Official

Non APDC members $35 Official TOTAL

DISCLAIMER FORM MUST BE COMPLETED

ENTRIES CLOSE 7th September, 2016

– ENQUIRIES 0419 873 321 – WENDY COTTON

Return entries to PO Box 695 Raymond Terrace 2324

Don’t forget your stamped self addressed envelope for the return of your draw or it can be

downloaded from our website

I/We agree to abide by the conditions of entry on this form………………………………………………………………….

Name:………………………………………………………..Phone:………………………………………………………

Address:………………………………………………………………………………………………………………………

CONDITIONS OF ENTRY

1. Events held under EA & FEI rules. 2. Horses may compete in two consecutive levels only.

3. Maximum 3 tests per horse per day. 4. Callers are permitted.

5. All riders ride at their own risk as per disclaimer. 6. Junior rider – must be under 14 years as at 1.1.16

7. Youth rider – must be 14 – 18 as at 1.1.168. To claim membership entry fee rider must be APDC member.

9. To help with the running of the competition it is expected that all competitors will be able to assist with pencilling or provide a helper.

10. No dogs allowed in the arena area. All dogs must be on a leash at all times.

11. Ponies eligible to enter any test but must be marked on entry form.

12. PREPARATORY EVENTS – are limited to any Associate horse of no higher than preliminary level. Any rider that has competed at elementary or above (irrespective of horse ridden) must ride HC in these tests.

RELEASE & WAIVER OF LIABILITY

EVENT 1st & 2nd October, 2016

In consideration for being permitted to participate in any way in horsesport activities, I, the undersigned, understand, acknowledge and accept that: horse sports are a dangerous recreational activity and horses can actin a sudden and unpredictable (changeable) way, especially if frightened or hurt.

There is a significant risk that serious INJURY or DEATH may result.

I knowingly and freely assume all such risks, both known and unknown, and I voluntarily PARTICIPATE at my OWN RISK and assume soleresponsibility for any injury, death or property damage I may suffer thatarises from my participation in horse sport activities.

I understand and acknowledge the dangers associated with the consumption of alcohol or any mind altering drugs before and during the activities and I takefull responsibility for any injury, loss or damage associated with theirconsumption. I agree not to drink alcohol or take drugs prohibited bylaw before or during any horse sports activities.

I agree to follow the directions of any event organizer or official and thatany misconduct or refusal by me to follow any direction of any

organizer or official can result in the CANCELLATION of my participationin the activities and my immediate removal from my horse NO MATTER wherethat may occur. I understand that any such non-compliance may result in injury, death and/or permanent disability as a result of myfailure to comply.

I agree to wear a helmet at all times whilst riding where this is required under the relevantEA and FEI rules and regulations and agree that I am solely responsible for ensuring thatwhilst riding I wear a suitable helmet at all times.

I have had sufficient opportunity to read this assumption of risk agreement,fully understand its terms and sign it freely and voluntarily.

Date______Signature of rider.______

For participants of Minority Age (Under Age 18)

This is to certify that I, as a parent/guardian with legal responsibility for this participant, acknowledge, understand and accept ALL OF THE ABOVE and consentand agree to my minor child's involvement or participation in horse sport activities.

Date:______Signature of parent/guardian______

PENCILLING ROSTER PLEASE CAN YOU HELP?

NAME OF HELPER______

EMAIL______or PHONE NUMBER______

I PREFER:BEFOREMY TEST □AFTER MY TEST□