APM EQUESTRIAN CENTRETIGARAKSA - TANGERANG

30th October - 1st November 2015

T E C H N I C A L H A N D B O O K

Event Organizer

Adria Pratama Mulya (APM) Team

VenueAPM Equestrian Centre

Jl. Raya Arya Wangsakara, Desa Tapos Tigaraksa – Tangerang – Banten

P. 021-29418691 | E. cintaindonesiaopen2015@gmail.com www.adriapratamamulya.com

ORGANIZING COMMITTEE President of Event Nadia Marciano (INA)Event Director Dyah Krisnawan (INA)Event Secretary Dyah Kartini Paramita (INA) Stable Manager Jendry Palandeng (INA)Treasurer Dyah Kartini Paramita (INA) Rama Putra Sahetapy (INA) Press Coordinator Ruminta (INA)Public Relation Rama Putra Sahetapy (INA)Master of Ceremony OZ FM Team (INA)Graphic Design Linegra (INA)Food & Beverages Prima Ika (INA) Mahalia Santini (INA)Special Event Coordinator Dian Adiratri (INA) Octa Yuniar Nurrazak (INA)Music Director SMA APM Team (INA)

OFFICIALS Show Director Adi Katompo (INA)Show Secretary Jupri Mardi (INA) Technical Delegate Rafiq H. Radinal (INA)Dressage Judge Lorraine MH Bottreau (ARG)Dressage Judge Nico Pelealu (INA)FEI Level 3 Jumping Judge Ho Na Yeu (SIN)FEI Level 3 Course Designer Christoph Johnen (GER)Assistant Course Designer Letda Kav. Yudi Irianto (INA)Course Builder Sekolah Kavaleri Berkuda Team (INA)Time Keeper Moelyono Sugito (INA)Veterinary Commission Mayor CKM drh. Joko Suranto (INA)Treating Veterinarian drh. Ardhinta Irawan (INA)Course Builder, Scorer & Scriber APM Equestrian Centre Team (INA)Chief Steward Mr. Nurcahyo (INA)Stewards Sekolah Kavaleri Berkuda Team (INA)

The event will be held in accordance with • FEI General Regulation, 23rd edition, 1st January 2009, updates effective 1st January 2015• FEI Dressage Rules, 25th edition, effective 1 January 2014• FEI Jumping Rules, 25th edition, 1st January 2014, updates effective 1st January 2015• FEI Eventing Rules, 24th edition, effective 1st January 2015

ENTRY CLOSING DATE/ PENUTUPAN PENDAFTARANAll entries must be made using the attached forms. Entries must reach the organizer by Friday, 23rd October 2015. Entries may be made in person, via email to cintaindonesiaopen2015@gmail.com together with the waiver and liability forms. Riders will not be allowed entry in the competition arena unless all payments have been made. Entry fees are not refundable, though changing classes is allowed.Semua pendaftaran harus menggunakan formulir yang telah ditentukan dan harus sampai ke panitia sebelum hari Jum’at, 23 Oktober 2015. Pendaftaran bisa langsung ke panitia, melalui fax atau email bersamaan dengan penyerahan formulir waiver. Peserta tidak akan diperkenankan memasuki arena pertandingan sebelum semua pembayaran dilakukan. Tidak ada pengembalian uang pendaftaran, tetapi boleh mengganti dengan kelas yang lainnya. PAYMENT / PEMBAYARANAll cash payment should be made to the organizing committee.Pembayaran secara tunai langsung ke sekretariatAll transfer payment should be to the account number : 6340281282 BCA, account name : Yayasan Pendidikan Adria Pratama MulyaPembayaran dapat dilakukan secara transfer ke nomor rekening 6340281282 BCA, atas nama Yayasan Pendidikan Adria Pratama Mulya

WAIVER FORM / FORMULIR PELEPASAN HAKThe waiver form must be signed by participating riders. Riders under the age of 18 must provide a guardian consent letter and returned with the entry forms.Formulir pernyataan harus di kembalikan setelah ditandatangani oleh atlet yang akan bertanding. Bagi yang masih berumur dibawah 18 tahun harus ditandatangani oleh wali yang bersangkutan.

INSURANCE/ ASURANSIAll horse owners and competitors are personally responsible for damages caused by themselves, their employees, their agents and their horses. They are therefore strongly advised to take out third party insurance providing full coverage for participation in equestrian events at home and abroad, and to keep their policy up to date.Pemilik kuda dan para peserta bertanggung jawab penuh atas segala kerusakan dan kehilangan yang disebabkan oleh diri sendiri pekerja, staff dan kuda mereka. Oleh karenanya sangat disarankan untuk melindunginya dengan asuransi.

GENERAL RULES AND REGULATIONS

Bathing your horses should be done at the wash bay area only and not inside the stables. You must provide plastic trash bags for the disposal of dung and other refuse. The dung must be removed from the sawdust daily and disposed of in a proper manner. At the end of the competition, all stables must be cleaned of all dung and leftover feed. The stables and other areas occupied by participants must be kept clean and tidy at all times. You are not allowed to burn sawdust or any other material inside the stable. Cooking inside the stable is not permitted.Memandikan kuda dilakukan hanya di tempat khusus pemandian kuda, bukan di dalam kandang. Anda harus menyiapkan kantung plastik untuk membuang kotoran dan sampah lainnya. Kotoran harus dibersihkan dari serbuk dan dibuang sebagaimana mestinya. Pada akhir acara, semua kandang harus dibersihkan dari kotoran dan juga sisa makanan. Kandang dan sekitarnya harus selalu bersih. Tidak diperbolehkan membakar serbuk dan benda lainnya di dalam kandang. Memasak dalam kandang juga tidak diperbolehkan.

STABLING FEES / SEWA KANDANGThe stabling fee is Rp. 250.000, per horse/per day. To be paid to the treasurer of the event. Horses will not be allowed to leave the premises until the stabling fees have been paid. Sewa kandang kuda tersedia dengan Rp. 250.000,- per kuda/hari dan harus dibayarkan langsung ke bendahara event. Kuda – kuda tidak diperbolehkan meninggalkan kandang sebelum sewa kandang dibayar lunas.

HORSE & TRAILER AND/OR RUCK / KUDA & ALAT PENGANGKUTPlease disinfect your horse trailer and/or truck before and after transporting your horse.Upon arrival at the venue your horse trailer and/or truck will be disinfected by organizing staff.All the horses’ temperature will be checked by the competition veterinarian to ensure the health of each horse before entering the competition stable. Based on the results, the horses that are not in good health will not be permitted to enter the stable.Mohon dilakukan disinfektan terhadap kereta kuda dan/atau truk anda, sebelum dan sesudah digunakan untuk mengangkut kuda ke tempat pertandingan. Sesampai di tempat pertandingan, semua alat pengangkut kuda akan dilakukan penyemprotan desinfektan ulang oleh petugas dari panitia. Sebelum memasuki kandang pertandingan kuda-kuda akan dilakukan pemeriksaan suhu badan kuda. Jika menurut hasil pemeriksaan ada kuda yang tidak dalam kondisi sehat yang baik, maka kuda tersebut tidak diizinkan memasuki kandang pertandingan. RULES OF COMPETITION / PERATURAN PERTANDINGANThe competition will run under the Fédération Equestre Internationale (FEI), as stated above. In circumstances where FEI is not available, the organizing committee will have the authority to make decision.Pertandingan akan diselenggarakan menggunakan peraturan FEI, sebagaimana tersebut diatas. Dalam hal keadaan tidak diketemukannya peraturan pertandingan pada peraturan FEI maka akan ditentukan oleh panitia pertandingan.

GENERAL CONDITION

PRIZE GIVING CEREMONY / UPACARA PEMBAGIAN HADIAHWinners that are not available at the prize giving ceremony will not receive their prizes.Hadiah tidak akan diberikan kepada pemenang yang tidak hadir dalam upacara pembagian hadiah.

PRIZES / HADIAHIf there is only 1 participant in the class, it is regarded as an exhibition class and the prizes will not be provided. If there are only 2 participants in the class, the prize will be given to the first winner only. If there are only 3 participants in the class, the prizes are allocated to the first and second winners only. Prize money will not be available for children classes and junior classes but other prizes will be provided.Jika dalam satu kelas hanya ada 1 peserta, maka kelas tersebut akan dianggap sebagai eksibisi dan tidak disediakan hadiah. Jika hanya ada 2 peserta maka hadiah hanya akan diberikan kepada pemenang pertama. Jika ada 3 peserta maka hadiah hanya akan disediakan untuk pemenang pertama dan kedua. Hadiah uang tidak tersedia untuk kelas – kelas children dan junior tetapi akan disediakan hadiah dalam bentuk lain.

THE OC RESERVE THE RIGHT/ HAK PANITIA• Alter advertised times if necessary • Cancel, divide or combine any class or event • Refuse an entry • Increase or decrease the height of the obstacles depending on the entries or other conditions.• Mengganti jadwal waktu yang telah diinformasikan• Membatalkan atau membagi kelas atau event• Menolak pendaftaran • Menambah atau menurunkan tinggi rintangan tergantung daftar peserta atau keadaan yang lain.

APPEALSComplaints and appeals must be in writing and signed by the authorized person from the club making the complaint and presented personally to the Ground Jury together with any supporting notes, evidence and names of witnesses and a deposit of Rp. 2,000,000,-. Complaints must be made no later than 30 minutes after the results are announced. If the complaint is accepted, OC will refund the deposit. If the complaint is not accepted, the deposit will remain with the OC. Refer to the FEI Art. 167 Of General Rules & regulations for more details.Protes harus dilakukan secara tertulis dan ditandatangani oleh penanggung jawab club lalu diserahkan kepada Ketua Dewan Juri dengan disertai uang jaminan sebesar Rp 2.000.0000 (dua juta rupiah). Protes harus diajukan paling lambat 30 menit setelah hasil pertandingan diumumkan. Jika protes diterima maka uang jaminan akan dikembalikan, tapi jika tidak diterima uang jaminan menjadi hak panitia pertandingan.

COMPETITION GROUND/ LAPANGAN PERTANDINGAN- Jumping : Sand- Dressage : Sand

HORSE NUMBERS / NOMOR KUDAHorse numbers are not distributed by the organizer. Riders must provide the horse number and they are responsible for displaying the correct number on their horses at all time.Panitia tidak menyediakan nomor kuda. Atlet harus menyediakan sendiri nomor kuda dan bertanggung jawab atas pemasangan nomor kuda dan dipasang dengan benar pada saat pertandingan berlangsung. Panitia tidak akan memberikan nomor kuda.

Classes are judged under the FEI rules. For the in-house rules read below.1. Open : Classes are open for riders of all ages and horses of all grades.

Terbuka bagi atlet dan kuda di semua umur dan level.2. Children : Athletes aged fourteen (14) and under as of the end of the year.

Atlet yang sampai akhir tahun ini mencapai usia 14 tahun.3. Junior : Athletes aged eighteen (18) and under as of the end of the year.

Atlet yang sampai akhir tahun ini mencapai usia 18 tahun.4. Young Horse : Horses aged six (6) and under as of the end of the year.

Untuk kuda sampai akhir tahun ini mencapai umur 6 tahun.5. Riders will be eliminated if they enter the class with wrong age category.

Atlet akan tersisih jika mendaftarkan pada kategori usia yang salah.6. In the non-jump off classes below 1m, one horse can be ridden by up to three (3) riders.

Pada kelas non jump off dibawah 1m, satu kuda dapat dinaiki 3 orang.7. In the classes below 1m, three (3) refusals are allowed.

Penolakan sebanyak 3 kali diperbolehkan untuk kelas dibawah 1m.8. No horse may take part with more than one rider in the same class/day/competition, except

in the 30-50cm class. Tidak ada kuda yang boleh dipakai lebih dari 1 orang pada kelas/hari/pertandingan yang sama, kecuali untuk kelas 30-50cm.

Classes are judged according to the FEI rules. The in-house rules are listed below:Penjurian dilakukan berdasarkan peraturan FEI. Peraturan penyelenggara adalah sebagai berikut: 1. No horse may take part with more than one rider in the same class/day/competition, except

for walk-trot class and under 18 year old classes. Kuda tidak boleh dinaiki oleh lebih dari 1 orang pada kelas/hari/ pertandingan yang sama, kecuali kelas walk trot dan kelas anak-anak dibawah 18 tahun.

2. In the walk-trot class, one horse can be ridden by up to three (3) riders. Kuda boleh dinaiki 3 kali pada kelas walk trot.

DRESS CODE1. Headgear : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : : :

Top hats are allowed in medium classes and up. In other classes hard hats (helmet) are compulsory for anyone riding at the event.

2. Spurs : : : Spurs capable of wounding horses are forbidden. Spurs must be made of smooth metal. There must be a shank pointing only towards the rear, which must be no more than 3.5 cms long. The end must be blunt in order to prevent wounding. If the shank is curved, the spurs must be worn only with the shank directed downwards.

JUMPING RULES & AGE REGULATIONS

DRESSAGE RULES & REGULATIONS

3. Whips : Whips up to 120 cm in length are permitted to use during the tests. The children/pony length limit is 100 cm.

4. Boots : : In all the level, boots (other than part of regulation service uniform/attire) must be black. They must either be long boots in one piece or a full grain smooth leather leg piece and leather boot.

5. Bridle : : Snaffle bridles are compulsory for all dressage classes up to Elementary level. Double bridles are optional for medium and advanced levels, but compulsory for Prix St. Georges. If using a double bridle, spurs must be worn.

6. Walk Trot Class : : Simple side reins and whips up to 100 cm in length are permitted. Spurs are not allowed. The children/pony length limit is 100 cm.

STARTING POSSIBILITIES:Rider/horse combination :A rider/horse combination is allowed to start in two different classes with no more than one level difference, i.e.: preliminary-elementary, elementary-medium, medium-advanced or advanced-PSG, etc.Kombinasi atlet dan kuda dalam kelas dressage diperbolehkan masuk 2 kelas yang tidak beda lebih dari 1 level tes.

ATTIRE & SADDLERY

DRESS : : A black or dark blue tail coat, with a top hat, white or off-white breeches, stock or tie, gloves, black riding boots and spurs must be worn for Prix St. Georges. For Advanced class, the tail coat is optional. For classes below Prix St. Georges, a black or dark blue jacket with a bowler hat or hunting cap is also permitted. However, in extreme heat, judges may give the option not to wear a jacket. A white shirt is compulsory. Black half leather chaps will are allowed.

RIDERS UNDER 16 YEARS : : Dark riding jacket. White or off-white breeches or jodhpurs, white shirt with a tie or hunting stock, helmet. Gloves must be worn. Riding boots. Top hats are not allowed. A whip up to 100 cm is allowed. Spurs are optional. No spurs are allowed in the Walk-Trot class.When mounted, protective headgear secured by a three point retention harness is compulsory.

DRESSAGE GENERAL RULES (additional)

SADDLERY : : For Prix St. Georges, double bridle is compulsory. For advanced and medium Level the double bridle is allowed. For elementary and Preliminary levels, an ordinary snaffle must be used. This applies in the practice and competition arenas. Whips are allowed in all levels. For adults the whip should not be more than 120 cm, for children no longer than 100 cm.

HORSE SCHOOLINGA horse can’t be schooled by anyone other than the competitor, mounted in the saddle from 00:00 hours on the day of the class except for article i and ii.

EARPHONESEarphones and other electronic communication devices are not permitted at Dressage Competitions whilst competing and is penalized by elimination. These devices are permitted during training and warm-up.

HORSE DECORATIONSAny decorations of the Horse with extravagant items, such as ribbons or flowers in the mane or/and tale is strictly forbidden. Normal plaiting of the Horse’s mane and tail is allowed. SALUTEAthletes must still be in control and salute with 1 (one) hand.Saat hormat, atlet tetap memegang tali kendali dan hormat dengan 1 (satu) tangan lainnya.

OUTSIDE ASSISTANCEAny outside help by voice, signs, etc. is considered illegal/unauthorized assistance to an athlete or a horse. The horse rider combination will be eliminated, in this case. Reading of the test is allowed in the Walk Trot class only.Semua jenis tindakan bantuan baik teriakan suara, isyarat atau aba-aba kepada atlet ataupun kuda, dianggap illegal. Jika hal ini terjadi maka kombinasi kuda dan atlet akan dieliminasi.Membaca teks dressage hanya diperbolehkan di kelas Walk Trot.

BELLAfter the sound of the bell, the Athletes must enter the arena within forty five (45) seconds. Horse and Rider combinations failing to enter arena at the A mark after 90 seconds of the bell will be eliminated.Dalam kelas dressage setelah bel berbunyi, atlet harus memasuki arena pada huruf A dalam hitungan 45 detik. Jika dalam waktu 90 detik setelah bell belum memasuki arena, maka dianggap tersisih.

PRIZE GIVINGParticipation in the prize-giving ceremony is compulsory. The Athletes who do not enter the prize-giving ceremony will lose the classification and prizes (rosette, prize money etc.) Exceptions to this rule can be granted by the ground jury in specific cases. Attire and saddlery has to be the same as in the Competition, however black or white bandages are allowed.Rosettes should be placed on the Horses’ bridles prior to prize giving.Mengikuti upacara pembagian hadiah adalah wajib bagi para pemenang. Atlet yang tidak hadir pada saat pembagian hadiah akan kehilangan klasifikasi kemenangannya dan segala hadiah (rosset, hadiah uang, maupun hadiah lainnya). Pengecualian untuk peraturan dapat diberikan ground jury dalam kasus – kasus tertentu. Pakaian dan perlengkapan kuda harus sama seperti pada saat bertanding. Rosset dipasang pada kendali sebelum pembagian hadiah.

Secretariat Phone : +62 812 9608 847 (Mita) +62 811 110 409 (Dian) Email : cintaindonesiaopen2015@gmail.com Stable Manager mobile : +62 878 7186 2828 (Jendry) +62 818 713 834 (Jendry) Email : jendrypalandeng@gmail.com Event Secretary Mobile : +62 812 9608 847 (Mita) +62 813 4202 2277 (Octa) Email : cintaindonesiaopen2015@gmail.com Show Secretary Mobile : +62 812 1163 994 (Jupri) Email : jeffzian@yahoo.com

HOTEL : Amaris Hotel Perumahan Citra Raya Blok KA 01 Kav. No. 2 Kawasan Commercial Life Style Tangerang 15811 Phone : +62 21 22597777 www.amarishotel.com

HOSPITAL : Ciputra Hospital Jl. Citra Raya Boulevard Blok V.00/08 Sek 3.4 Panongan – Tangerang 15710 Phone : +62 21 5940 5555 www.ciputrahospital.com

Siloam Hospitals Lippo Village Jl. Siloam No. 6, Lippo Karawaci 1600 Tangerang 15811 Phone : +62 21 546 0055 www.siloamhospitals.com

CONTACT

DIRECTORY

COMPETITION SCHEDULE & CLASS

Time Class Location Rules Entry Fee (IDR)

Thursday, 29th October 2015

15:00 Trot Up - Jumping Horses 120cm and above -

17:00 Technical Meeting Club House - -

Friday, 30th October 2015

08:00 CS-01 SJ 50-70 cm Open Indoor Arena Art. 274

(Power & Speed) 500,000

09:00 CS-02 SJ 70-90 cm Open Indoor Arena Art. 274

(Power & Speed) 500,000

10:00 CS-03 SJ 90-100 cm Open Indoor Arena Art. 274 (Power & Speed) 500,000

11:00 CD-01 Dressage Medium Open Outdoor Arena FEI WDC Medium Test 550,000

13:00 CD-02 Dressage Advanced Open Outdoor Arena FEI WDC Advanced Test 600,000

14:00 CD-03 MIB Dressage Preliminary Open Outdoor Arena FEI WDC

Preliminary Test 450,000

15:00 CD-04 Linegra Dressage Elementary Open Outdoor Arena FEI WDC

Elementary Test 500,000

16:00 CD-05 Dressage Prix St. George Outdoor Arena FEI WDC PSG Test 650.000

Saturday, 31st October 2015

07:30 CD-06 Walk Trot Interschool Small Arena Walk Trot Test 2 350,000

10:30 CD-07 Introductory Interschool Small Arena USDF Introductory Level 350,000

13:00 CD-08 Preliminary Interschool Small Arena FEI WDC Perliminary 400,000

08:30 CS-04A SJ 90 - 100 cm Interschool Indoor Arena Art. 238.2.1 450.000

09:00 CS-04B SJ 90 – 100 Open Indoor Arena Art 238.2.1 450.000

10:30 CS-05 Multi Wira Mandiri SJ 120 cm Open Indoor Arena Art. 238.2.1 550,000

12.30 CS-06 AG Peduli SJ 130 cm Open Indoor Arena

Art. 238.2.2 – Against the clock with jump off

550,000

13:30 CS-07 SJ 50-70 cm Interschool Indoor Arena Table A – Optimum Time 350,000

14:45 CS-08 SJ 70-90 cm Interschool Indoor Arena Table A – Optimum Time 400,000

15:30 CS-09 Sugar Labinta SJ 110 cm Open Indoor Arena Art. 274.5.3. – Two

phase 500,000

16:30 CS-16 Games Ride & Drive (Horse Owner + Rider) Indoor Arena Table C _

SPECIAL EVENTS

SHOW JUMPING CLINIC WITH MARC BOES (BEL)Will be held from October 26th to 28th. (Three days clinic plus assist in competition)Registration Fee : RP. 3.000.000

PHOTOGRAPHY AND VIDEOGRAPHY CONTESTCinta Indonesia Open’s photography and videography competition is one of the fun parts of this annual equestrian event hosted by APM Equestrian Centre. Our goal is to inspire new equestrian photographers and let them showcase their capabilities at the exhibition at the end of the event. Participants are free to explore their artistic and technical skills based on the theme “Winners Never Quit”. This competition is open to both professional and amateur photographers of all ages. The prizes are sponsored by by Canon (tba).

Sunday, 1st November 2015

08:00 CS-10 SJ 60-80 cm Interschool Indoor Arena Art. 238.2.1 400,000

08:45 CS-11 SJ 70-90 cm Open Indoor Arena Art. 238.2.1 600,000

10:00 CS-12A SJ 100 cm Interschool Indoor Arena Art. 238.2.1 450,000

follow CS-12B Delima Mandiri SJ 100 cm Open Indoor Arena Art. 238.2.1 500,000

12:00 PERFORMANCES

14.00 CS-13 MARCIANO CUP SJ 125-135 cm Open Indoor Arena Art. 238.2.1 550,000

15.00 CS-14 APM Challenge SJ 145 cm Open Indoor Arena Art. 273.3.3.1

(2 Rounds) 600,000

16.00 CS-15 OSO Group SJ 115 cm Open Indoor Arena Art. 269.5. -

Accumulator 500,000

PARENTAL/GUARDIAN CONSENT ACKNOWLEDGEMENT AND RELEASE

Parental/Guardian Consent, Acknowledgement and Release (to be completed and signed by a parent/guardian when divorced or separated, parent/guardian with legal custody must sign).

PLEASE read carefully before signing

A. I/we hereby give consent for my/our child……………………………………..(My ID card no./birth certificate no./passport no…………………………………………….) to participate in the Cinta Indonesia Open 2015, 30th October - 1st November 2015.

B. I/we know, and acknowledge that my/our child knows the risks involved in their athletic participation includes serious injuries, such as permanent disability and even death. With full understanding of the risks involved, I/we release and hold harmless Cinta Indonesia Open 2015, 30th October - 1st November 2015 and its respective members, directors, agents, employees, associates, staff, sponsors and independent contractors all responsibility and liability for any injury claim resulting from the such athletic participation and agree to take no legal action against Cinta Indonesia Open 2015, 30th October - 1st November 2015 because of any accident or mishap involving the athletic participation of my child/ward. I/we authorize emergency medical treatment for my child/ward should the need arise for such treatment while my/our child/ward is competing. I/we further hereby authorize the disclosure of my/our child’s individually identifiable health information should treatment for illness or injury become necessary. I/we consent to the disclosure, by Cinta Indonesia Open 2015, 30th October - 1st November 2015 of all records relevant to their athletic eligibility including, but not limited to, their records relating the results, age, discipline, finances and residence.

C. I/we grant the Cinta Indonesia Open 2015, 30th October - 1st November 2015 the right to photograph and/or videotape my child and further use said child’s name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising, promotional and commercial materials without reservation or limitation. Cinta Indonesia Open 2015, 30th October - 1st November 2015, however, is under no obligation to exercise said rights herein.

D. I/we understand that the authorizations and rights granted herein are voluntary and that I/we may revoke all of them at any time by submitting said revocation in writing to removing Cinta Indonesia Open 2015, 30th October - 1st November 2015. By doing so, however, I/we understand that my/our child will no longer be eligible for participation in of the competitions.

I/WE HAVE READ THIS CAREFULLY AND KNOW IT CONTAINS A RELEASE.

Date

_____________________________ ____________________________________ Name of Parent/Guardian Signature of Parent/Guardian

IMPORTANT (This form must be completed by competitors who have not reached 18 years old by 30 October 2015.)

GENERAL RELEASE OF LIABILITY AND WAIVER

PLEASE read carefully before signing. This form must be signed before you compete

In consideration of the Cinta Indonesia Open 2015, 30th October - 1st November 2015 Organizing Committee (hereinafter referred to as “the Organizer”) granting me permission to participation in Cinta Indonesia Open 2015, 30th October - 1st November 2015 (hereinafter referred to the competition), I agree:

A. GENERAL RELEASE OF LIABILITY AND WAIVERi. that prior to participating in any of the event, I will inspect the facilities and equipment I will use during

the event during that event and that the facilities and equipment are in good condition;ii. that I understand that I may be engaging in activities that involve risk of serious injury, including

permanent disability and death, and severe social and economic losses which might result from my actions or inactions, but also from the intentional or negligent acts of others, the rules of Competition and their application, the condition of the premises and/or equipment, and other causes now unknown or reasonably foreseeable; and

iii. to fully release, discharge and hold harmless the Organizer and its respective members, directors, agents, employees, associates, staff and independent contractors from any and all claims, actions, liabilities and causes of action which I may now have or which may accrue as a result of or incidental to my voluntary participation in any of the sporting or non sporting activities incidental to or in connection with the Competition.

B. ACKNOWLEDGEMENT OF RULES AND REGULATIONSi. to abide by all the rules and regulations of the Organizer;ii. to refrain from consuming alcoholic beverages or using any substances in a manner which would

decrease or impair my level of performance during my participation in the sporting activities of the Competition;

iii. to refrain from unsportsmanlike conduct or any conduct bringing discredit upon the Competition, including physically or verbally assaulting or abusing any official, competitor, spectator, volunteer or any person involved in the management of the Competition and that any such conduct may meet with expulsion from the Competition and appropriate criminal or civil action against me; and

iv. to be filmed, photographed or interviewed as a participant in the Competition when requested to do so by any officer or official of the Organizer.

v. I acknowledge that I execute this ‘General Release of Liability and Waiver’ and ‘Acknowledgement of Rules and Regulations’ freely and voluntary, and do not rely on any inducements, promises or representations made by the aforementioned organization or individuals involved, or associated in any way with the Competition.

I do hereby declare that I am aware and I shall abide by all of the rules that are being adopted by the Organizer of Cinta Indonesia Open 2015, 30th October - 1st November 2015.

Date

_____________________________ ____________________________________ Name of Entrant Signature of Entrant/Parent/Guardian

ENTRY FORM Entries Closed – October 23rd, Friday, 17.00. Late Entries Fee: Add 50%

Club : Email :

Contact : Phone :

No

Rider

(for CH; JR; YR provide date of birth)

Date Of Birth Horse Name Class Entry Fee

1

2

3

4

5

7

8

TOTAL ENTRY FEE

STABLING REQUEST FORM Stabling Fee Per Day : Rp. 250.000,-

Club : Email :

Contact : Phone :

No Horse Name Date of Birth

Date of Arrival

Date of Departure

Total Stabling

DaysStabling Fee

1

2

3

4

5

6

7

8

9

10

TOTAL STABLING FEE