ENTRY PACK - APSB WA Branch Stud Show 2020 - WA 6010 & at Higham Park Claremont Showgrounds
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APSB WA Branch
FORTY THIRD ANNUAL
Stud Show 2020
Saturday 29th February
&
Sunday 1st March
at
Higham Park
Claremont Showgrounds
WA 6010
ENTRY PACKSHOW REGULATIONS AND CONDITIONS
1.0 CLOSING DATE FOR ENTRIES
1.1 Wednesday 29th January 2020 - Please ensure you lodge your entries early. LATE ENTRIES WILL NOT BE
ACCEPTED. A copy of each pony’s APSB Registration papers and a copy of your current APSB
Membership card must be forwarded with your entries.
2.0 ENTRY FEES
CATEGORY CLASS DETAILS COST
BREED CLASSES This covers all led breed classes for Stud Book and Non-Stud Book. $10.00 per class
Progeny of Sire or Dam. Nominate Sire or Dam on entry form, 2 ponies
PROGENY CLASSES $10.00 per class
per class. Need not be the same owner to compete.
OWNERS GROUP 2 of 3 ponies owned by the same person. $10.00 per class
FOAL CLASS Open to any foal born in the 2019/2020 Stud Season whether at foot or $10.00
weaned at time of show.
UNITY CLASSES Short in hand test for Leading rein and children 17yrs of age and $10.00 per class
under.
PERFORMANCE Covers Handler, Lead Rein, First Ridden, Child’s Ridden, Ridden, Show $10.00 per class
CLASSES Hunter, Handy Pony, and Harness classes
DRESSAGE TESTS $15.00 per test
RAS GROUND FEE Covers the ground fee applied by the RAS for use of Stables etc. $12.00 per pony
Applied per pony per day competing. per day.
ADMINISTRATION FEE Compulsory fee that covers Competitor Numbers, Admin fees, $35.00
Catalogue, Printing etc. per Exhibitor
CLEANING FEE Compulsory charge - Money will be refunded on inspection of a clean $20.00 Per Pony
stable/float area upon leaving. Maximum charge is $60 per Exhibitor.
Preferred payment of Cleaning Fee is with your entry. Please see note on
refunds below.
BUNKROOMS Covers the hire fee charged by the RAS for use of Bunkrooms. 3 or 4 $66.00 per
beds per room. night.
DONATION Any donations towards running costs of the APSB Stud Show gratefully $__________
accepted.
FUTURITY CLASSES Open to ponies 2yrs and under previously nominated for FUTURITY Pre-paid Entry
only.
FANCY DRESS Free Entry please nominate name of competitor and Fancy Dress FREE
Theme on Entry.
REFUNDS Cleaning Fee refunds will be by Direct Deposit within 14 days of the events completion.
3.0 CONDITIONS OF ENTRY
3.1 SOCIETY’S LIABILITY:
Lodgment of an entry form is deemed to be acknowledgement by the exhibitor of his or her agreement that the
organising committee accepts no liability for any accident, damage or illness to horses, riders, grooms, spectators
or any other person or property whatsoever. Parking and Camping on the RAS Grounds is undertaken at your own
risk and the APSB WA Branch accepts no liability for any damage or loss whatsoever.
3.2 RAS LIABILITY:
Parking and Camping on the RAS Grounds is undertaken at your own risk and the RAS accepts no liability for any
damage or loss whatsoever.
3.3 SOCIETY’S DISCLAIMER:
The attached Disclaimer MUST be completed and signed by all Exhibitors and accompany your entries.
3.4 EXHIBITORS:
Must be financial members of the APSB Society. In each case, the exhibitor must be the owner/lessee as recorded on
the registration papers with the APSB Society at time of close of entries.
3.5 DOGS:
Under RAS rules and regulations no dogs are permitted on the grounds, any exhibitor/spectator found with a dog will
be asked to remove it immediately.
3.6 EXHIBITS:
Must be Adult Registered or Foal Recorded within their appropriate section of the APSB Society.
3.7 AGEING:
A pony’s age shall be reckoned from 1st August. All foals born on or after 01.08.2019
3.8 ACCEPTANCE OF ENTRIES:
The Committee reserves the right to:
a. reject or cancel an entry at any time
Page 2 of 11b. cancel any event or class
c. alter the time at which any class or event is to take place
d. alter conditions of entry
e. remove any exhibit/s from the venue
f. transfer an exhibit or exhibitor from any class to any other class
g. split or combine any event or class
h. empowered to substitute a judge
3.9 THIRD GENERATION AUSTRALIAN PONIES:
Registration certificates must be recorded as Third Generation (3G) or above.
4.0 LODGEMENT OF ENTRIES
4.1 ENTRIES:
Must be on the official entry forms supplied by the society unless otherwise permitted by the secretary.
4.2 FEES:
As set out in 2.0 ENTRY FEES must be forwarded with each entry. Please ensure that entry forms are correct, and the correct
fees have been paid as incomplete entries WILL be automatically rejected.
4.3 REFUND:
Withdrawal of entries may only be refunded at committee discretion on presentation of doctor or vet certificate. Admin fee
may be charged.
5.0 ELIGIBILITY TO COMPETE
5.1 BREED SECTION:
A pony may compete in only one breed section of the show. Handlers may carry a whip that is not to exceed 75cms excluding
the tail.
5.2 RIDDEN & DRIVEN EXHIBITS:
Must be Adult Registered with the Society and be three (3) years of age and over.
5.3 OVERHEIGHT PONIES:
Ponies exceeding the maximum height of their breed are ineligible to be shown except for PURE-BRED GELDINGS registered
in the OVERHEIGHT GELDING REGISTRY.
5.4 HEIGHT CERTIFICATES:
If you are entering a Purebred pony who is close to or on the minimum or maximum height limit as specified in the ponies
breed standard, please ensure you include a current height certificate with your entries.
5.5 PERFORMANCE CLASSES:
All ponies entering Performance Classes need not enter appropriate breed classes prior to competing under saddle or in
Harness.
5.6 AGE OF RIDERS and HANDLERS:
Where specified is as at 29th February 2020. Proof of age may be requested on the day.
5.7 RIDERS, DRIVERS and HANDLERS:
Of stallions and colts must be competent and are to be 14 years and over as at the 29th February 2020.
5.8 STALLIONS AND COLTS:
Are not eligible to compete in Leading Rein, First Ridden, or Children’s Handler/ Ridden Classes. They may however compete
in the senior handler classes and in the Fancy Dress class 2-93.
5.9 BROODMARES:
With a foal at foot are ineligible for ridden and/or harness classes.
5.10 EXHIBITS:
Which in the opinion of the committee are not in reasonable healthy show condition or are diseased or sick may at the
discretion of the committee be removed from the venue
5.11 NOVICE HARNESS PONY:
A pony that has not won 4 First places in Harness classes (except for Pleasure & Novelty) at the time of entry. Not eligible for
Champion.
5.12 NOVICE SADDLE PONY:
A pony that has not won 4 first places or a Champion Novice in any Ridden competition at the time of entry. Not eligible for
Champion. MUST be ridden in a SNAFFLE BRIDLE only.
5.13 DRESSAGE:
In Classes 7-240 – 7-245 a rider/pony combination may only compete in one class. Class 7-239 is only open to riders
competing in the First Ridden Section. All tests are EFA latest edition tests. Class 7-241 results do not count towards any High
Point trophies other than Shetland Performance. All tests are run under EA rules. All riders must be gear checked and failure
to be gear checked will incur immediate elimination.
5.14 HANDY PONY:
In Classes 8-247 – 8-249 a Rider/Pony combination may only compete in one class. Class 8-246 is only open to riders
competing in the First Ridden Section.
5.15 KINDY LEAD REIN:
Mare or gelding - to be ridden by a child 5 years and under. Pony must wear a snaffle bridle and to be led on foot from a
loose rein attached to the back of a cavesson noseband. No spurs or whips are permitted to be worn or carried by a rider,
Handlers may carry a small whip not exceeding 40cm in length. The rider is only eligible to compete in Lead Rein and the
relevant Child Handler class, but pony may compete in other classes with a second rider. The leader of the pony must be 18
years and over and MUST wear correct footwear that covers the top of the foot.
5.16 JUNIOR LEAD REIN:
Mare or gelding - to be ridden by a child over 5 up to and including 8yrs. Pony must wear a snaffle bridle and to be led on
foot from a loose rein attached to the back of a cavesson noseband. No spurs or whips are permitted to be worn or carried
Page 3 of 11by a rider. Handlers may carry a small whip not exceeding 40cm. The rider is only eligible to compete in Lead Rein and the
relevant Child Handler class, but pony may compete in other classes with a second rider. The leader of the pony must be 18
years and over and MUST wear correct footwear that covers the top of the foot.
5.17 FIRST RIDDEN:
Open to riders 5 and under 12 years of age. Pony to wear a Snaffle bridle with cavesson noseband only, no spurs, and whips
must not exceed 40cm. Ponies will walk and trot on the circle and canter can be asked for in individual workouts only. The
rider is only eligible to compete in the Preparatory Walk/Trot Dressage Test, First Ridden Handy Pony, nominated Child
Handler, and First Ridden classes. The pony may, however, compete in other classes with a second rider. First Ridden rider
not to have competed in any open official competition other than first ridden or rider class.
5.18 OPEN RIDDEN SADDLE CLASSES:
Rider may be any age to compete. Whips that have a leather flap must be at least 5cm long and 2cm wide and must not
exceed 75cm in length inclusive of the leather flap.
5.19 CHILD’S RIDDEN SECTION:
All ponies must compete in a snaffle bridle. No spurs. Unless stated otherwise, the age of rider is 17 years & under. Whips
that have a leather flap must be at least 5cm long and 2cm wide and must not exceed 75cm in length inclusive of the leather
flap.
5.20 HARNESS:
All Harness competitors must be accompanied by a groom who is to be 18yrs of age or over and MUST wear correct footwear
that covers the top of the foot.
5.21 JUNIOR DRIVERS:
To adhere to the regulations of the ACDS.
5.22 FANCY DRESS:
Junior exhibitors in the Fancy Dress section must wear a helmet regardless of being mounted or leading in hand. Adult
exhibitor’s MUST wear a helmet when mounted at all times. All Exhibitors MUST wear correct footwear that covers the top of
the foot.
6.0 STANDARD FOR EXHIBITORS
6.1 ALL RIDERS:
Must be helmeted at all times whilst mounted. Approved helmets that are permitted to be worn are -: Current Australian
standard AS/NZS 3838 (2006 onwards) provided they are SAI Global marked. New Australian standard ARB HS 2012 provided
they are SAI Global marked. Current American standard ASTM F1163 (2004a or 04a onwards) provided they are SEI marked.
Current American standard SNELL E2001.Current British standard PAS 015 (1998 or 2011) provided they are BSI Kitemarked.
Interim European Standard VG1 (01.040: 2014-12) with or without BSI Kitemark.
6.2 RECOMMENDED DRESS STANDARDS FOR HANDLERS:
Handlers must dress neatly and presentable at all times.
6.3 PLEASE NOTE ALL SHOES MUST COVER THE TOP OF YOUR FOOT AS PER RAS REGULATIONS.
6.4 RECOMMENDED DRESS STANDARDS FOR RIDERS:
Riders must dress neatly and presentable with appropriate safety items such as helmets and boots etc.
6.5 NO PERSON:
Shall in anyway consult or interfere with or attempt to interfere with the Judge or endeavour to interfere with his/her
freedom of choice of judgment. No Exhibitors or persons shall address the Judge unless authorised by the Steward in
charge of the class or the Judge.
6.6 ALL EXHIBITORS:
And competitors shall accept the decision of the Judge as final.
7.0 MANAGEMENT
7.1 PONIES AT THE SHOW:
No horse/pony shall be brought onto the grounds other than those entered in the show. The ground jury reserves the right
to have any exhibit deemed to be dangerous removed from the grounds.
7.2 HEAD GEAR:
All horses/ponies must be equipped with suitable head gear to facilitate safe handling at all times.
7.3 STALLIONS & COLTS (2 YRS & OVER):
Must be `bitted’ and be handled by a competent person 14 year and over.
7.4 RIDDEN EXHIBITS (3YRS & OVER):
All ridden exhibits must be ‘bitted’. Ridden Stallions/Colts must be ridden by a competent person 14 years and over.
7.5 EXHIBITS:
NO Exhibit is to be left unattended unless confined to a stable, STALLIONS must at all times be stabled unless under direct
control of their handler and MAY NOT be tied to a float whilst unaccompanied.
7.6 FOALS:
Are to be handled by a competent person and must be restrained at all times. Foals must not be bitted. Foals exhibited in
age classes may not be accompanied by their Dam whilst competing. Pure Bred Foals under 12mths are NOT TO BE
CLIPPED.
7.7 CRUELTY:
In the event of any unnecessary or undue cruelty to a pony the ground jury has the right to disqualify or reprimand the
competitor. In the event of disqualification, the competitor may forfeit any prizes, ribbons and trophies.
7.8 PRAMS:
Are not permitted in the marshalling/warm up area on the grounds and are to be confined to the spectator areas.
7.9 PROTESTS:
Any Exhibitor or Competitor may lodge a PROTEST on any placing or Hi Point Award won by an Exhibit or Competitor as
Page 4 of 11long as the following rules are followed.
a. Any PROTEST must be made in writing on the official protest form, giving reasons for the PROTEST and signed
and submitted to the Head of the Ground Jury, Ms Sue-Ellen Kiesling via the Armband Office not more than
THIRTY(30) Minutes after the running of the CLASS for any protest on eligibility to compete.
b. A PROTEST based on a scoring irregularity must be lodged with the Head of the Ground Jury no later than 30
minutes after the scores are posted prior to being declared correct and winners announced.
c. Any protest MUST be accompanied by a deposit of $100 which may be forfeited to the APSB WA Branch if in the
opinion of the Ground Jury the PROTEST is unfounded, Frivolous or Vexatious.
d. All Provisional results (ie Dressage, Handy Pony) will be posted at the Arm Band Office and are subject to the
above PROTEST regulations on any score discrepancy or query prior to results being finalised.
e. IF an Exhibitor is awarded a prize and is subsequently disqualified, the prize WILL NOT automatically be awarded
to the next place getter.
8.0 EXTREME WEATHER POLICY
8.1 Code Red Extreme Weather and Cancellation Policy – In accordance with the APSB Committee Ruling, if cancellation is
required due to predicted or existing severe weather and or dangerous conditions such as: Code Red Fire
Warnings/Flood/Travel Warnings or Disease Outbreaks exhibitors will be notified.
8.2 If the event has commenced and has to be abandoned, there will be no refunds.
8.3 If the event is cancelled prior to the commencement of the event – costs incurred by the committee prior to the show will
be paid and remaining funds will be reimbursed to the member if the amount per exhibitor is $10.00 or more.
8.4 If the event is postponed, entries will be transferred to the new date.
9.0 AWARDS
9.1 SUPREME JUNIOR EXHIBIT: All Purebred Junior Champions are eligible to compete. NOT ELIGIBLE for Champion of
Champions.
9.2 SUPREME NON-STUD BOOK JUNIOR EXHIBIT: To be selected from the Junior Champion Part Bred, Riding Pony and
Gypsy Cob Exhibit. NOT ELIGIBLE for Champion of Champions.
9.3 SUPREME PURE-BRED LED GELDING: All Champion Geldings from Pure Bred Classes are eligible, NOT ELIGIBLE for
Champion of Champions.
9.4 SUPREME LED NON-STUD BOOK GELDNG: To be selected from the Champion Part Bred, Riding Pony and Gypsy Cob Gelding
Winners. NOT ELIGIBLE for Champion of Champions.
9.5 CHAMPION OF CHAMPIONS PURE-BRED LED EXHIBIT: To be selected from Supreme Champions of each Purebred breed.
9.6 CHAMPION OF CHAMPIONS NON-STUD BOOK EXHIBIT: To be selected from the supreme champions from the
Part-Bred, Riding Pony and Gypsy Cob Sections.
9.7 SUPREME RIDDEN APSB PURE-BRED EXHIBIT: To be selected from Champion Ridden Gelding, Mare & Stallion APSB
Pure-Bred section.
9.8 SUPREME RIDDEN NON-STUD BOOK EXHIBIT: To be selected from the Non-Stud Book Champion Ridden Mare,
Champion Ridden Gelding and Champion Ridden Stallion.
9.9 PART-BREDS, GYPSY COBS & APSB RIDING PONIES: Ineligible to compete in any Purebred Led or Purebred Performance
class / award.
9.10 POINTS ALLOCATION FOR AWARDS:
a. 1st Place – Awarded 3 Points
b. 2nd Place – Awarded 2 Points
c. 3rd Place – Awarded 1 Point
d. Champion – 5 Points
e. Reserve Champion – 3 Points
f. Junior Champion – 5 Points
g. Supreme – 5 Points
10.0 GUIDELINE TO ORDER OF JUDGING (May be subject to minor changes, depending on number of entries.)
10.1 SATURDAY:
The morning will commence with the Pure Bred section, Senior Handler followed by the Novice Ridden Pure Bred and the
APSB Pure Bred ridden classes, Harness then Fancy Dress.
10.2 SUNDAY:
Morning will commence with Non-Stud Book Section, Junior Handlers, Senior Non-Stud Book Handlers, Non-Stud Book
Novice and Ridden Classes, Show Hunter, Dressage, Handy Pony and Unity.
DON’T FORGET TO ORDER YOUR BBQ PACKS FOR THE SATURDAY NIGHT
SOCIAL DINNER.
Page 5 of 11APSB STUD SHOW 2020 ENTRY FORM – One Exhibitor (Owner) Per Form
Horses registered with different owners must be on a separate form
Eg horses owned by Tom Jones should be on one form, horses owned jointly by Tom Jones and Eve Smith should be on a second form
Exhibitors Name APSB Membership No.
Email Phone
PIC Number
Address
(Recommended)
Registered Name of Exhibit
Breed
Sire Dam
Registration Number DOB of Exhibit
Halter Classes Entered
List ALL Class Numbers
Performance Classes
Entered
List ALL Class Numbers
Fancy Dress Theme
ADDITIONAL HORSES OWNED BY THE SAME EXHIBITOR (this page can be copied more than once if entering more than three horses)
Registered Name of Exhibit
Breed
Sire Dam
Registration Number DOB of Exhibit
Halter Classes Entered
List ALL Class Numbers
Performance Classes
Entered
List ALL Class Numbers
Fancy Dress Theme
Registered Name of Exhibit
Breed
Sire Dam
Registration Number DOB of Exhibit
Halter Classes Entered
List ALL Class Numbers
Performance Classes
Entered
List ALL Class Numbers
Fancy Dress Theme
Page 6 of 11High Point Perpetual Trophy Award Nominations (Horse/Rider Combination)
Horse/Rider Horse/Rider Horse/Rider
Combination (1) Combination (2) Combination (3)
Ellenjay Perpetual Trophy - Lead Rein
Dimity Gal Perpetual Trophy – First Ridden
Judaroo Pony Stud Trophy – 17/U
Tyalla Pony Stud Perpetual Trophy – 18/O
Stable & Locker Requirements
*Cleaning fee still required if a stable is not used
Stable/s Required Friday No. of stables required
Saturday
Sunday
Locker/s Required Friday No. of lockers required
Saturday
Sunday
APSB STUD SHOW 2020 ENTRY FORM
Entries Close – Wednesday 29th January 2020
Breed Class $ 10.00 per class $
Progeny Class $ 10.00 per class $
Owners Group $ 10.00 per class $
Foal Class $ 10.00 per class $
Unity Class $ 10.00 per class $
Performance Class $ 10.00 per class $
Dressage $15.00 per test $
No. of Ponies A
Ground Fees No. of Days B
Total A x B x $12.00 $
Administration Fees (Compulsory) $ 35.00
Cleaning Bond (Refundable) $ 20.00 per pony (max $60.00) $
Friday Night No. of rooms A
Saturday Night No. of rooms B
Bunkrooms
Sunday Night No. of rooms C
Total (A + B + C) x $ 66.00 $
Donation $
Friday Night Canteen Order $
Ensure you have completed your canteen order form
Saturday Night Canteen Order $
Total fees payable $
It is the responsibility of the person completing the entries to ensure the correct amount is paid and all paperwork is
included. Reimbursement of overpaid entries will not be given unless requested.
I hereby declare that the exhibits entered are registered with the APSB Society and comply with all Conditions of Entry. I hereby certify the
correctness of each Exhibit’s particulars. I agree to abide by the rules of the Australian Pony Stud Book Society (including rules for this
show) and Claremont Showgrounds. I also agree that I will not be recompensed for exhibits that are not shown or do not comply, whatever
the reason, and I will not seek a refund.
Registered Owners Signature (Guardian if under 18yrs) _____________________________________ Date __________________________
Page 7 of 11List of ALL People who will be Handling, Grooming, Showing, Riding, Driving your horse/s at this Show
Name Contact
Address
Classes this
person is
competing in
*(S) if Strapping
Liability Form Youth Birth Certificate
YES NO YES NO
Attached Attached (If Required)
Name Contact
Address
Classes this
person is
competing in
*(S) if Strapping
Liability Form Youth Birth Certificate
YES NO YES NO
Attached Attached (If Required)
Name Contact
Address
Classes this
person is
competing in
*(S) if Strapping
Liability Form Youth Birth Certificate
YES NO YES NO
Attached Attached (If Required)
Name Contact
Address
Classes this
person is
competing in
*(S) if Strapping
Liability Form Youth Birth Certificate
YES NO YES NO
Attached Attached (If Required)
Name Contact
Address
Classes this
person is
competing in
*(S) if Strapping
Liability Form Youth Birth Certificate
YES NO YES NO
Attached Attached (If Required)
Name Contact
Address
Classes this
person is
competing in
*(S) if Strapping
Liability Form Youth Birth Certificate
YES NO YES NO
Attached Attached (If Required)
Page 8 of 11Entry Checklist
All sections of the Entry Form completed and signed – please ensure ALL
pages of this entry are included from pg 6-12. If not, entries will be
returned with an additional $10.00 admin fee.
Copy of APSB 2020 Liability Waiver Form for all involved
Copy of youth birth certificate (If Required)
Copy of CURRENT Membership Card.
Copy of all horses/s registration papers.
Copy of Current Official Height Certificate if Required.
ENTRIES MUST BE RECEIVED BY THE SHOW COMMITTEE ON
OR BEFORE WEDNESDAY 29TH JANUARY 2020.
Emailed entries are to be in PDF Format only to apsbwastudshow@gmail.com
OR posted to PO Box 319, Serpentine WA, 6125
Direct Deposits can be paid to BSB 036-032 Account Number 550108.
Please use your last name or membership number as reference.
Pease include a COPY of your deposit receipt (Receipt number is not sufficient)
PLEASE READ THE ABOVE CHECKLIST CAREFULLY
You will receive a complimentary email on receipt of your entries. After that, incorrect and
incomplete entries will incur a $10.00 admin fee.
Unpaid entries or entries with missing paperwork will not be processed.
CLEANING BOND
Will be refunded within 14 days of events completion
Exhibitor Name
Bank Name
Account Name
BSB Account No.
Page 9 of 11LIABILITY WAIVER FORM
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 signed this form as
acknowledgement of the terms and conditions of this agreement. By signing 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 still, are fit for the purpose for which they
are commonly thought 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
Australian Pony Stud Book Society
P.O. Box 267 Glenbrook NSW 2773
The participant acknowledges that the activity being undertaken is an activity being undertaken for the purpose 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 control. The agreement is directed and limited to inherent risks that are present. The
participants also acknowledge 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 people in his or her care and control.
Description of Recreational Service
Registering Body, promotion and conductor of shows, events and education days
Steps taken by Provider to avoid the danger of personal injury or death
Equipment inspections, qualified staff, staff/participation ratio compliant with industry Standard, adherence to industry code
of practice, code of conduct or accreditation scheme, emergency procedures in place, contingency plans in place for
emergencies, qualified first aid personnel available, communication procedures in place, etc.
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 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, seek help and/or assistance and advice.
Declaration and signature
By signing this agreement I understand that the Recreational Services about to be sold to me as set out in this form may
cause me and my dependents personal injury or death. By signing 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.
Printed Name Address
Signature of Participant
Membership Name Date
Page 10 of 11FRIDAY NIGHT CANTEEN ORDER FORM
All food must be ordered prior to the evening
Drinks will be available for purchase on the night
If you have any special dietary requirements please inform us (Gluten Free etc)
TH
ORDERS TO BE PLACED WITH YOUR ENRTY AND PAID FOR BY WEDNESDAY 29 JANUARY 2020
Name No. of People
Hamburgers A $10.00 ea
Steak Burgers B $12.00 ea
Bacon & Egg Burgers C $7.00 ea
Sausage Sizzle D $3.00 ea
TOTAL (A x $10.00) + (B x $12.00) + (C x $7.00) + (D x $3.00) $
SATURDAY NIGHT BBQ ORDER FORM
DIY BBQ Dinner, all food must be ordered prior to the evening
The APSB provides salads, bread rolls & dessert free of charge
Salads include Toss, Coleslaw, Potato & Pasta
Drinks will be available for purchase on the night
BBQ’s will be provided from 6pm onwards
If you have any special dietary requirements or only want salads and/or dessert please inform us so we can
provide enough food
TH
ORDERS TO BE PLACED WITH YOUR ENRTY AND PAID FOR BY WEDNESDAY 29 JANUARY 2020
Name No. of People
No. of Sausages (GF) A $1.00 ea
No. of Steak B $4.00 ea
No. of Hamburgers (GF) C $2.00 ea
Salads No. of People FREE
Ice Cream
Desserts – No. Required Cheesecake Pavlova FREE
w/toppings
TOTAL (A x $1.00) + (B x $4.00) + (C x $2.00) $
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