Pinjarra Horse & Pony Club
All Breed Spectacular
2012
Roe Avenue Pinjarra
Start 8.30am
5 rings
Sashes, Prizes, Garlands, Rugs
Top 3 pony under 14.2hh
Supreme of Supreme Pony sponsored by Aryline Pony Stud
Top 3 Horse over 14.2hh
Supreme of Supreme Horse sponsored by WA Equestrian
Supreme Ridden Exhibit Sponsored by The Meeres Family
Entries close Tuesday 20th November 2012
Entries will be accepted on the day with late entry fee $10.00
Enquiries Phone Melissa Arnold 0419 024 590
Conditions of Entry



















Pre Entry essential, a copy of Breed registration Certificate and Current membership to accompany entry
form.
Late Entries may be accepted at the discretion of the organisers, acceptance will depend upon numbers of
entries received by closing date and payment of $10 late fee.
The organisers/committee of Pinjarra Horse and Pony Club reserve the right to cancel, alter or combine any
events they deem necessary on the day. If a ring is running behind time the committee reserve the right to
move a breed to another ring.
Stallions and Colts must be under control at all times. They must be wearing suitable and substantial head
gear. The age of the handler must be as per each respective Breed Society regulation, notwithstanding this
handlers may not be younger than 18 years for led classes and 16 years for ridden classes.
If a Judge or the Show Committee deems an Exhibit to be unruly it will be required to leave the grounds.
This rule is in the interest of the safety of all competitors, spectators and officials and must be abided by.
All handlers must wear safe enclosed footwear and appropriate attire in accordance with Breed Society
Regulation.
Riders must wear a current approved safety helmet and riding boots at all times whilst mounted on their
horse or pony.
Proof of registration must accompany your entry and should be available if requested on the day. If required
by your Breed, Height Certificates should be current and should be available if requested. Age of the rider
and handler will be as at the day of the event. Proof of age may be requested.
It is the responsibility of the competitor to ensure they are ringside in time to compete in their class. If
classes clash it is the responsibility of the competitor to choose which event they will compete in. Classes
will not be held up.
The decision of the Judge is final. Poor sportsmanship will not be tolerated. Failure to abide by this and any
of our other rules may lead to disqualification and forfeiture of entry fees.
Exhibits with multiple registrations may compete in all eligible classes AND Other registered Breeds only
if the registration is not covered in any of the other rings..
Refunds (less administration costs) will only be made on production of a Medical or Veterinary Certificate.
A copy of the certificate must be supplied to the Organising Committee within 5 days of the event.
Supreme of Supremes will be selected from the Supreme Champion of each section. The Supreme
Unregistered Horse and Supreme Unregistered Pony are eligible for the Supreme of Supremes.
Pinjarra Horse & Pony Club, it’s Committee and Members do not accept any liability for any accident, loss,
damage, illness or injury to horses, owners, riders, spectators or any other person or property whatsoever.
No Dogs. Allowed on the grounds
Day Insurance is payable by Non PCAWA members or EA members
Exhibits may only be entered in either the Show Hunter Class or Show Hack – Not Both.
Show Hunters must be shown in plain browband
Please remember to thank your judges official’s and fellow competitors and have a great day
Handler classes
Junior Handler 10 years and under
Intermediate 11 years to 17 years
Senior Handler 18 years and over
Ring 1
Judge: Bayley Thomas
Standardbred
Thoroughbred
Combined Warmblood
Fresian
Combined Clydesdale & Heavy Draft
Show Hack Under 14.2h
Show Hack 14.2h and Over
Ring 2
Judge: Kate Vaughan
Riding Ponies
Arabian
Arabian Derivative 14.2h & under
Arabian Derivative over 14.2h
Andalusisian
Andalusisan Part Bred
Palomino
Ring 3 Judge: Janeen Mc Robert
Australian Stock Horse
Quaterhorse
Appaloosa
Paint
Buckskin & Dun
Cremello / Perlino
Pinto
Ridden Classes
Ridden Ring Hacks- Judge Lisa Yang
Champion & Reserve
Ridden Ring Western- Janeen McRobert
Champion & Reserve
Ridden Ring Ponies – Judge Tia Turner
Champion & Reserve
Supreme Ridden Exhibit
Sponsored by the Meeres Family
Combined Broken Coloured Horse Society WA
Inc
Ring 4
Judge: Neryl Simmons
Shetland
Australian
Welsh A
Welsh B
Welsh C & D
Part bred welsh
Highland
Connemara
Ring 5 Judge: Di Norman
Miniature Horse / Small Horse
Miniature Pony/small pony
Other Registered Breed
Unregistered Horse (14 hands & Over)
Unregistered Pony (under 14 hands)
Show Hunter 14.2h & Under
Show Hunter over 14.2h
Supreme of Supreme
Top 3 - 14.2 Hands & under
Supreme of Supreme 14.2 Hands & Under
Sponsored by Aryline Pony Stud
Top 3 – Over 14.2 Hands
Supreme of Supreme Over 14.2 Hands
Sponsored by WA Equestrian
Judge: Bayley Thomas
Ring 1
Standardbred
1. Best Presented Exhibit
2. Stallion 4 years and over
3. Colt 3 years and under
Champion / Reserve
4. Mare 4 years and over
5. Filly 3 years and under
Champion / Reserve
6. Gelding 4 years and over
7. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored by WA Equestrian
Thoroughbred
8. Best Presented Exhibit
9. Stallion 4 years and over
10. Colt 3 years and under
Champion / Reserve
11. Mare 4 years and over
12. Filly 3 years and under
Champion / Reserve
13. Gelding 4 years and over
14. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored By WA Equestrian
Combined Warmblood
15. Best Presented Exhibit
16. Stallion 4 years and over
17. Colt 3 years and under
Champion / Reserve
18. Mare 4 years and over
19. Filly 3 years and under
Champion / Reserve
20. Gelding 4 years and over
21. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored by Sylvania Farms
Fresian
22. Best Presented Exhibit
23. Stallion 4 years and over
24. Colt 3 years and under
Champion / Reserve
25. Mare 4 years and over
26. Filly 3 years and under
Champion / Reserve
27. Gelding 4 years and over
28. Gelding 3 years and under
Champion / Reserve
Supreme Fresian Exhibit
Combined Clydesdale & Heavy Draft
29. Best Presented Exhibit
30. Stallion 4 years and over
31. Colt 3 years and under
Champion / Reserve
32. Mare 4 years and over
33. Filly 3 years and under
Champion / Reserve
34. Gelding 4 years and over
35. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Show Hack 14.2h & Under
36. Best Presented Exhibit
37. Stallion 4 years and over
38. Colt 3 years and under
Champion / Reserve
39. Mare 4 years and over
40. Filly 3 years and under
Champion / Reserve
41. Gelding 4 years and over
42. Gelding 3 years and under
Champion / Reserve
Show Hack Over 14.2 hands
43. Best Presented Exhibit
44. Stallion 4 years and over
45. Colt 3 years and under
Champion / Reserve
46. Mare 4 years and over
47. Filly 3 years and under
Champion / Reserve
48. Gelding 4 years and over
49. Gelding 3 years and under
Champion / Reserve
Supreme Champion Show Hack Exhibit
Sponsored by Kelladee Park home of Rosedale
Eton
Judge: Kate Vaughan
Sponsored by WA Equestrian
Ring 2
Andalusisian (must be member AHAA)
78. Best Presented Exhibit
79. Stallion 4 years and over
80. Colt 3 years and under
Champion / Reserve
81. Mare 4 years and over
82. Filly 3 years and under
Champion / Reserve
83. Gelding 4 years and over
84. Gelding 3 years and under
Champion / Reserve
Riding Ponies
50. Best Presented Exhibit
51. Stallion 4 years and over
52. Colt 3 years and under
Champion / Reserve
53. Mare 4 years and over
54. Filly 3 years and under
Champion / Reserve
55. Gelding 4 years and over
56. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored by Regan Park
Arabian
57. Best Presented Exhibit
58. Stallion 4 years and over
59. Colt 3 years and under
Champion / Reserve
60. Mare 4 years and over
61. Filly 3 years and under
Champion / Reserve
62. Gelding 4 years and over
63. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Arabian Derivative 14.2h & Under
64. Best Presented Exhibit
65. Stallion 4 years and over
66. Colt 3 years and under
Champion / Reserve
67. Mare 4 years and over
68. Filly 3 years and under
Champion / Reserve
69. Gelding 4 years and over
70. Gelding 3 years and under
Champion / Reserve
Supreme Champion Arabian Derivative under
14.2hh Exhibit
Sponsored by Kismet Park
Arabian Derivative Over 14.2h
71. Best Presented Exhibit
72. Stallion 4 years and over
73. Colt 3 years and under
Champion / Reserve
74. Mare 4 years and over
75. Filly 3 years and under
Champion / Reserve
76. Gelding 4 years and over
77. Gelding 3 years and under
Champion / Reserve
Supreme Champion Arabian Derivative Over
14.2hh Exhibit
Supreme Andalusian Exhibit
Sponsored by AHAA
Andalusian Part Bred (must be member AHAA)
85. Best Presented Exhibit
86. Stallion 4 years and over
87. Colt 3 years and under
Champion / Reserve
88. Mare 4 years and over
89. Filly 3 years and under
Champion / Reserve
90. Gelding 4 years and over
91. Gelding 3 years and under
Champion / Reserve
Supreme Part Bred Andalusian Exhibit
Sponsored by AHAA
Palomino
92. Best Presented Exhibit
93. Stallion 4 years and over
94. Colt 3 years and under
Champion / Reserve
95. Mare 4 years and over
96. Filly 3 years and under
Champion / Reserve
97. Gelding 4 years and over
98. Gelding 3 years and under
Champion / Reserve
Supreme Champion Ehibit
Sponsored by WA Equestrian
Judge: Janeen McRobert
Ring 3
Australian Stock Horse
103. Best Presented Exhibit
104. Stallion 4 years and over
105. Colt 3 years and under
Champion / Reserve
106. Mare 4 years and over
107. Filly 3 years and under
Champion / Reserve
108. Gelding 4 years and over
109. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Quaterhorse
110. Best Presented Exhibit
111. Stallion 4 years and over
112. Colt 3 years and under
Champion / Reserve
113. Mare 4 years and over
114. Filly 3 years and under
Champion / Reserve
115. Gelding 4 years and over
116. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored by Cry Greenwood
Appaloosa
117. Best Presented Exhibit
118. Stallion 4 years and over
119. Colt 3 years and under
Champion / Reserve
120. Mare 4 years and over
121. Filly 3 years and under
Champion / Reserve
122. Gelding 4 years and over
123. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Paint
124. Best Presented Exhibit
125. Stallion 4 years and over
126. Colt 3 years and under
Champion / Reserve
127. Mare 4 years and over
128. Filly 3 years and under
Champion / Reserve
129. Gelding 4 years and over
130. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Dilute – Buckskin & Dun
131. Best Presented Exhibit
132. Stallion 4 years and over
133. Colt 3 years and under
Champion / Reserve
134. Mare 4 years and over
135. Filly 3 years and under
Champion / Reserve
136. Gelding 4 years and over
137. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Pinto
138. Best Presented Exhibit
139. Stallion 4 years and over
140. Colt 3 years and under
Champion / Reserve
141. Mare 4 years and over
142. Filly 3 years and under
Champion / Reserve
143. Gelding 4 years and over
144. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored By WABA
Combined Broken Coloured Horse
152. Best Presented Exhibit
153. Stallion 4 years and over
154. Colt 3 years and under
Champion / Reserve
155. Mare 4 years and over
156. Filly 3 years and under
Champion / Reserve
157. Gelding 4 years and over
158. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Cremello/Perlino
Best Presented Exhibit
159. Stallion 4 years and over
160. Colt 3 years and under
Champion / Reserve
161. Mare 4 years and over
162. Filly 3 years and under
Champion / Reserve
163. Gelding 4 years and over
164. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored By WABA
Judge: Neryl Simmons
Ring 4
Shetland
165. Best Presented Exhibit
166. Stallion 4 years and over
167. Colt 3 years and under
Champion / Reserve
168. Mare 4 years and over
169. Filly 3 years and under
Champion / Reserve
170. Gelding 4 years and over
171. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Australian Pony
172. Best Presented Exhibit
173. Stallion 4 years and over
174. Colt 3 years and under
Champion / Reserve
175. Mare 4 years and over
176. Filly 3 years and under
Champion / Reserve
177. Gelding 4 years and over
178. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored By Shantelle Bezant
Welsh A
179. Best Presented Exhibit
180. Stallion 4 years and over
181. Colt 3 years and under
Champion / Reserve
182. Mare 4 years and over
183. Filly 3 years and under
Champion / Reserve
184. Gelding 4 years and over
185. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored by Kismet park
Welsh B
186. Best Presented Exhibit
187. Stallion 4 years and over
188. Colt 3 years and under
Champion / Reserve
185. Mare 4 years and over
186. Filly 3 years and under
Champion / Reserve
187. Gelding 4 years and over
188. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored by Kismet Park
Welsh C & D
189. Best Presented Exhibit
190. Stallion 4 years and over
191. Colt 3 years and under
Champion / Reserve
192. Mare 4 years and over
193. Filly 3 years and under
Champion / Reserve
194. Gelding 4 years and over
195. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored by Dynamik Stallions
Part-bred Welsh
196. Best Presented Exhibit
197. Stallion 4 years and over
198. Colt 3 years and under
Champion / Reserve
199. Mare 4 years and over
200. Filly 3 years and under
Champion / Reserve
201. Gelding 4 years and over
202. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored by Kismet Park
Highland
203. Best Presented Exhibit
204. Colt / Stallion
205. Mare / Filly
206. Gelding
Champion / Reserve
Connemara
208. Best Presented Exhibit
209. Colt / Stallion
210. Mare / Filly
211. Gelding
212. Champion / Reserve
Supreme Champion Highland / Connemara
Sponsored by Currie Park
Judge: Di Norman
Ring 5
Miniature Horse
213. Best Presented Exhibit
214. Stallion 4 years and over
215. Colt 3 years and under
Champion / Reserve
216. Mare 4 years and over
217. Filly 3 years and under
Champion / Reserve
218. Gelding 4 years and over
219. Gelding 3 years and under
Champion / Reserve
Miniature Pony
220. Best Presented Exhibit
221. Stallion 4 years and over
222. Colt 3 years and under
Champion / Reserve
223. Mare 4 years and over
224. Filly 3 years and under
Champion / Reserve
225. Gelding 4 years and over
226. Gelding 3 years and under
Champion / Reserve
Supreme Champion Miniature Horse/Pony Exhibit
Sponsored by Panther Park Horse Recue
Other Registered Breed
227. Best Presented Exhibit
228. Stallion 4 years and over
229. Colt 3 years and under
Champion / Reserve
230. Mare 4 years and over
231. Filly 3 years and under
Champion / Reserve
232. Gelding 4 years and over
233. Gelding 3 years and under
Champion / Reserve
Supreme Champion Exhibit
Sponsored by Olivia, Rachel and Michael Cross
Unregistered Horse (Over 14h)
234. Best Presented Exhibit
235. Stallion 4 years and over
236. Colt 3 years and under
Champion / Reserve
237. Mare 4 years and over
238. Filly 3 years and under
Champion / Reserve
239. Gelding 4 years and over
240. Gelding 3 years and under
Champion / Reserve
Supreme Unregistered pony
Sponsored by Rodellis Riding Horses
Unregistered Pony (14h & Under)
241. Best Presented Exhibit
242. Stallion 4 years and over
243. Colt 3 years and under
Champion / Reserve
244. Mare 4 years and over
245. Filly 3 years and under
Champion / Reserve
246. Gelding 4 years and over
247. Gelding 3 years and under
Champion / Reserve
Supreme Champion Unregistered Exhibit
Sposnored by Rodellis Riding Horses
Show Hunter 14.2 h & Under
(To be Shown in a plain browband)
248. Best Presented Exhibit
249. Stallion 4 years and over
250. Colt 3 years and under
Champion / Reserve
251. Mare 4 years and over
252. Filly 3 years and under
Champion / Reserve
253. Gelding 4 years and over
254. Gelding 3 years and under
Champion / Reserve
Show Hunter Over 14.2h
(To be shown in a plain browband)
255. Best Presented Exhibit
256. Stallion 4 years and over
257. Colt 3 years and under
Champion / Reserve
258. Mare 4 years and over
259. Filly 3 years and under
Champion / Reserve
260. Gelding 4 years and over
261. Gelding 3 years and under
Champion / Reserve
Supreme Champion Show Hunter Exhibit
Ridden Events
Ring 1
Judge – Lisa Yang
Ridden Thoroughbred
Ridden Standard bred
Ridden Warmblood
Ridden Arab
Ridden Derivative over 14 hh
Ridden Andelusion
Ridden Any Other Breed
Ridden unregistered breed over 14hh
Ridden Stallion
Ridden Mare
Ridden Gelding
Ridden Grey
Ridden Bay
Ridden Chestnut
Ridden any other colour
Hack 14hh to 15hh
Hack over 15hh to 16hh
Hack over 16hh
Pleasure Hack
Best combination Hack
Champion & Reserve
Ring 2
Judge- Tia Turner
Ridden Australian Pony
Ridden Riding Pony
Ridden Welsh A
Ridden Welsh B
Ridden Welsh C & D
Ridden Derivative under 14 hh
Ridden Highland
Ridden Any Other Breed under 14hh
Ridden Unregistered breed under 14hh
Ridden Stallion
Ridden Mare
Ridden Gelding
Ridden Grey
Ridden Bay
Ridden Chestnut
Ridden any other colour
Pony up to 12.hh
Pony 12hh to 13hh
Pony 13hh to 14hh
Pleasure Pony
Best combination Pony
Champion & Reserve
Ring 3
Judge – Janeen McRobert
Beginner Pleasure
Novice pleasure
Junior Pleasure horse under 6yrs
Senior pleasure horse 6yrs and over
Amateur Owner Pleasure
Beginner Horsemanship
Novice Horsemanship
Junior Horsemanship
Senior Horsemanship
Amateur Owner Horsemanship
Western Hunter Hack
Beginner Working Class Hunter
Novice Working Class Hunter
Junior Working Class Hunter
Senior Working Class Hunter
Amateur owner Working Class Hunter
Beginner Hunter
Novice Hunter
Junior Hunter
Senior Hunter
Amateur Owner Hunter
Beginner Seat Equitation
Novice Seat Equitation
Junior Seat Equitation
Senior Seat Equitation
Amateur Owner Equitation
Beginner Western Trail
Novice Trail
Junior Trail
Senior Trail
Amateur Owner Trail
Champion & Reserve
Supreme Champion Ridden Exhibit
Sponsored by The Meeres Family
Entry Form
Pinjarra Horse and Pony Club All Brreds
ALL DAY FEE per Horse $60.00
(PH&PC) Members only $40.00
Entry per Class $8 (PH&PC) Members only $5
Class
No.
Exhibit
Handler
Breed
Reg no.
Total Classes Amount or All Day Fee
Non Member of EA SHC OR PCAWA $20.00 Fee PH&PC Day Member
Ground Fee Compulsory per horse
Late Entry Fee $10.00
Please enclose Payment and Copies of Breed Papers and Memebrship Make Cheques payable to:
Pinjarra Horse & Pony Club PO Box 3077 Mandurah WA 6210
Total Amount Payable
Amount
$
$5.00
$
Name of Owner/ Rider/ Handler:
........................................................................................................................................... .........................
Address:
....................................................................................................................................................................................
..................
Telephone #: Home: ........................................................................ Mobile:
............................................................................................
Email:
....................................................................................................................................................................................
......................
Name of Rider/Handler: .........................................................................................Age & Date of Birth (if under
18 years): ......................................
Rider: EFA #: ...................................................... SHC #: ...................................................... PCAWA #:
......................................................
Send Entries to Pinjarra Horse & Pony Club P O Box 3077 MANDURAH WA 6210
Entries Close Tuesday 20th November 2012
Enquiries please phone Melissa Arnold 0419 024590
Non-Member Application / Entry Form
Release of Waiver of Liability
A Non-Member is a person who wishes to participate and is not a direct Member of the EWA or of an EWA-insured club.
Participants in Club-organised horse activity days, who are not registered members of the Club, are upon completion of this
form deemed to be members of the club during such activities for the purposes of participation only. Protection is afforded to
the participant under the club’s public liability policy during such activities where they are liable for bodily injury or
property damage to others. Please note this membership does not provide EWA Personal Accident Insurance.
Full Name of attendee (and of guardian if under 18 years) …………………………………………………………..
............................................................................................................................. .........................................................
Address ........................................................................................................................................................................
State ………………………………..Post Code ...................................... Date of birth .......................................... ....
Horse’s name ................................................................................................................ .............................................
Event / Activity Pinjarra Horse & Pony Club
Address of Event / Activity Roe Ave Pinjarra 6208
Date(s) of Temporary Membership 25th November 2012
Name of club holding Event / Activity Pinjarra Horse & Pony Club
Horse Sports are a Dangerous Activity
In consideration for being permitted to participate in any way in horse sport activities and in particular this event, I, the
undersigned, understand, acknowledge and accept that Horse sports are a dangerous recreational activity and horses can act
in a sudden and unpredictable (changeable) way, especially if frightened or hurt. There is a significant risk that serious
INJURY or DEATH may result from horse sport activities and in particular this event. I knowingly and freely assume all
such risks, both known and unknown, even if arising from the negligence of The Equestrian Federation of Australia and/or
the event organiser (hereafter referred to as the "Releasees") or others and I voluntarily PARTICIPATE at my OWN RISK
and assume sole responsibility for any injury, death or property damage I may suffer that arises 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 activity and I take full responsibility for any injury, loss or damage associated with their
consumption. I agree not to drink alcohol or take drugs prohibited by law before or during this event. I agree to follow the
directions of any event organiser or official and that any misconduct or refusal by me to follow any direction of any
organiser or official can result in the CANCELLATION of my participation in the event and my immediate removal from
my horse NO MATTER where that may occur. I understand that any such non-compliance may result in injury, death and/or
permanent disability and I agree to indemnify the Releasees against all claims made by any person as a result of my failure
to comply. I agree to wear a helmet at all times whilst participating in the sport where this is required under the relevant
EWA and FEI rules and regulations and agree that I am solely responsible for ensuring that whilst participating I wear a
suitable helmet at all times where required under the relevant EWA and FEI rules and regulations and take sole
responsibility for my actions. I, for myself and on behalf of my heirs, assigns, personal representatives and next of kin,
hereby release and hold harmless and agree not to sue The Equestrian Federation of Australia and/or the event organiser,
their officers, officials, volunteers, coaches, agents and/or employees, other participants, sponsoring agencies, sponsors, state
bodies, affiliated clubs and if applicable, owners and lessors of premises used to conduct the activities (all of whom are
referred to as "Releasees") with respect to any and all injury, disability, death, or loss or damage to person or property,
whether caused by the negligence of the releasees or otherwise.
Effect of this Document
I have had sufficient opportunity to read this release of liability and assumption of risk agreement, fully understand its terms,
understand that I have given up substantial rights by signing it, and sign it freely and voluntarily without inducement of any
kind. I understand that my signature to this document constitutes a complete and unconditional release of all liability of the
Releasees, to the greatest extent allowed by law in the event of me and/or the children under my care, suffering injury or
death.
Dated: ___/___/___ 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 consent and agree to his/her release as provided above of all the Releasees, and, for myself, my
heirs, assigns, and next of kin, I release and agree to indemnify and hold harmless the Releasees from any and all liabilities
arising from my minor child's involvement or participation in horse sport activities and in particular, this event, even if
arising from the negligence of the Releasees
Dated: ___/___/___ Signature of parent/guardian …………………………………………………………………….
Member Release and
Waiver of Liability
Full Name of participant (and of guardian if under 18 years)........................................................ ...
............................................................................................................................. ...........................
Address...........................................................................................................................................
State ………………………………..Post Code............................Date of birth..................................
Name of Club/Organisation Insured with.........................................................................................
Membership No. .............................................................................................................. ................
Address of Event / Activity Pinjarra Pony Club Championship Hack Show Roe ave Pinjarra W.A 6208 25th November 2012
In consideration for being permitted to participate in any way in horse sport activities, I, the undersigned, understand,
acknowledge and accept that:
Horse sports are a dangerous recreational activity and horses can act in a sudden and unpredictable (changeable) way,
especially if frightened or hurt.
There is a significant risk that serious INJURY or DEATH may result from horse sport activities. I knowingly and freely
assume all such risks, both known and unknown, and I voluntarily PARTICIPATE at my OWN RISK and assume sole
responsibility for any injury, death or property damage I may suffer that arises 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 take full responsibility for any injury, loss or damage associated with their
consumption. I agree not to drink alcohol or take drugs prohibited by law before or during any horse sports activities.
I agree to follow the directions of any event organiser or official and that any misconduct or refusal by me to follow any
direction of any organiser or official can result in the CANCELLATION of my participation in the activities and my
immediate removal from my horse NO MATTER where that may occur. I understand that any such non-compliance may
result in injury, death and/or permanent disability as a result of my failure to comply.
I agree to wear a helmet at all times whilst participating in the sport where this is required under the relevant EWA and FEI
rules and regulations, and agree that I am solely responsible for ensuring that whilst participating I wear a suitable helmet at
all times where required under the relevant EWA and FEI rules and regulations, and take sole responsibility for my actions. I
have had sufficient opportunity to read this assumption of risk agreement, fully understand its terms and sign it freely and
voluntarily.
Dated: ___/___/___ 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 consent and agree to my minor child's involvement or participation in horse sport
activities.
Dated: ___/___/___ Signature of guardian …………………………………………………