APSB WESTERN PROMOTIONAL GROUP

DETAILS OF EXHIBITOR

Owner Name

Exhibitor Name

Address

Phone Number/s

Email Address

PIC Number

APSB Member Number

DETAILS OF EXHIBITS

1st Pony Details

Pony Registered Name

Pony Registration Number

Height of pony

RIDDENLEADING REININ HAND

5A5B

Rows	1st Class	2nd Class	3rd Class	4th Class	5th Class	6th Class	7th Class	8th Class	Entry Fee's $25.00 Per Person
Class Number

2nd Pony Details

Pony Registered Name

Pony Registration Number

Height of pony

RIDDENLEADING REININ HAND

5A5B

Rows	1st Class	2nd Class	3rd Class	4th Class	5th Class	6th Class	7th Class	8th Class	Entry Fee's $25.00 Per Person
Class Number

3rd Pony Details

Pony Registered Name

Pony Registration Number

Height of pony

RIDDENLEADING REININ HAND

5A5B

Rows	1st Class	2nd Class	3rd Class	4th Class	5th Class	6th Class	7th Class	8th Class	Entry Fee's $25.00 Per Person
Class Number

4th Pony Details

Pony Registered Name

Pony Registration Number

Height of pony

RIDDENLEADING REININ HAND

5A5B

Rows	1st Class	2nd Class	3rd Class	4th Class	5th Class	6th Class	7th Class	8th Class	Entry Fee's $25.00 Per Person
Class Number

5th Pony Details

Pony Registered Name

Pony Registration Number

Height of pony

RIDDENLEADING REININ HAND

5A5B

Rows	1st Class	2nd Class	3rd Class	4th Class	5th Class	6th Class	7th Class	8th Class	Entry Fee's $25.00 Per Person
Class Number

Please include a $10 Venue Fee.

TOTAL ENTRY FEE

Payment to be made via Bank Deposit. You can pay via Internet Banking or Over the Counter.

Deposit Details: WESTPAC BANK. Western Promotional Committee APSBS.

BSB: 033 205 ACC: 130053

***Make sure you put your surname as reference on the deposit***

I am a Current APSB Member. Number provided above.Non APSB Member. I agree that I have read and understand the Liability Waiver.

LIABILITY WAIVER*

APSB WESTERN PROMOTIONAL GROUP.
NON APSB MEMBER LIABILITY WAIVER.
EXCLUSION OF CERTAIN RIGHTS TO SUE.
The purpose of this agreement is to limit the liability of the Provider to exclude liability for any personal injury or death to the Participant and other people in the care and control of the Participant howsoever caused who reads this form as acknowledgment of the terms and conditions of this agreement. By reading this form you are waiving your rights to sue the Provider for losses relating to personal injury or death. Under the provisions of the Trade Practices Act and Various State Laws conditions are implied into contracts that mean that the Provider of Recreational Services, noted below, is required to ensure that the Recreational Services it sells to you are: rendered with due care and skill, are fit for the purpose for which they are commonly bought as it is reasonable to expect in the circumstances or might reasonably be expected to achieve the result you have made known to the Provider.
Name and address of Provider: APSB WESTERN PROMOTIONAL GROUP.
The Participant acknowledges that the activity being undertaken is for the purposes of recreation, enjoyment or leisure which involves a significant degree of physical risk. The Provider acknowledges that they are providing Recreational Services detailed below which means; providing facilities for participation in a recreational activity, or training a person to participate in a recreational activity, or supervising, adjudicating, guiding or otherwise assisting a person’s participation in a recreational activity.
The Participant hereby acknowledges that in attending the recreational activity that there are inherent risks involved to him or her or other people in their care and control. This agreement is directed and limited to inherent risks that are patent. The participants also acknowledges that the purpose of the recreational activity is for the benefit of the Participant and for the benefit of those people attending with the Participant and that at all times the Participant is responsible for his or her own actions and the actions of those other people in his or her care and control.
Description of Recreational Services: APSB WESTERN PROMOTIONAL GROUP EVENT.
Steps taken by Provider to avoid the danger of personal injury or death.
The Participant acknowledges that during all times while he or she is attending the recreational activity he or she does so at his or her own risk and that the Participant and other people in the care and control of the Participant will not hold the Provider or any of its employees or agents liable for any personal injury or breach of contract whether caused by the negligence of the Provider its employees or agents howsoever caused or otherwise. The Participant acknowledges that in the event that he or she or any of the other people in their care and control find either or any of them is in difficulty that they are to stop the activity or request that the activity be stopped if appropriate, and seeks help and/or assistance and advice.
By reading this agreement I understand that the Recreational Services about to be sold to me as set out in this document may cause my and or my dependants personal injury or death. By reading this agreement I understand that I and my dependants waive our rights to sue the Provider for losses relating to my and or my dependants personal injury or death that result from any negligence caused by the Provider.

PLEASE PRINT THIS FORM FOR YOUR OWN RECORDS BEFORE YOU PRESS SUBMIT

E-mail

* Ridden = Pony ridden independently. * Leading Rein = Pony ridden by child with assistance from a competant handler. * In Hand = Pony is led, not ridden.