SHCV WINTER SCHOOL SALE GIPPSLAND EQUESTRIAN CENTRE 26 Hopkins Road, Fulham SUNDAY 21 JULY 2013 Instructor: Darryl

l Hayes INFORMATION This clinic can be attended by financial SHCV members or financial members of a SHC Affiliate Non-Members are welcome to attend at a slightly higher fee and payment of listed insurance fee Lessons commence at 9:00am sharp and finish at 4:00pm. One or Two lessons per horse/rider combination available. Lessons 45 min duration. If choosing the 2 lesson option, you may wish to use a different horses for each lesson, this if fine however please be sure to pay the appropriate facility fees. Separate forms for each horse please. Times of lessons will be confirmed prior to the SHCV Winter School at Sale. (email is first preference) BYO lunch. Tea and coffee provided please bring a cup! If you have any request(s), please make them known when submitting your application to attend the Winter School. The organising committee will make every effort to accommodate your request(s); no guarantee will be given. One form per person per horse. Additional forms can be downloaded at www.shcv.com.au Verifying of horses will be available on the day, by appointment. REFUND: A refund on a booking (less $20 administration fee) will ONLY be given upon the presentation of a Vet or Doctors Certificate to the organising committee no later than 8 July 2013. If notice is received after this date, a refund (less $20 administration fee) will be given providing the organising committee is able to fill the vacated position in the Winter School. Non Members MUST complete and return the SHC Non Member Release of Liability Form and ALL riders/handlers/ people entering the indoor arena must complete and return the Gippsland Equestrian Centre Waiver Form. CLOSING DATE: 26 June 2013 ENQUIRIES: E: shcv@eques.com.au (preferred), Nicole Morrison (0488 791 060) or Sue-Ellen Latham (0412 523 408)
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PAYMENT Cheque or Money Order payable to SHCV Inc. / Credit Card MEMBERS NON MEMBERS STABLING $50 per horse/rider combination (One lesson ONLY) $85 per horse/rider combination (Two lessons AM & PM) $75 per horse/rider combination (One lesson ONLY) $120 per horse/rider combination (Two lessons AM & PM (These fees include $10 Insurance fee, waiver MUST be completed Booking through Gippsland Equestrian Centre 0413 703 720 or 03 51 447 711

ONE FORM PER PERSON PER HORSE - Instructor: Darryl Hayes

Name: Address: Email: Contact Number: Emergency Contact: Horse Name: Mobile Phone Number: Phone Number of Emergency Contact: Age: Height: Riders Age SHCV Member Number

Riders Ability: Novice Intermediate Experienced

Horses Experience: Green Novice Educated

APPLICATION PROCESS POSTAL ENTRIES Complete form (one form per person per horse) and post to SHCV by closing date. Attach payment (cheque / money order payable to SHCV Inc or Credit Card) Forward to: SHCV, PO Box 5374, Cranbourne VIC 3977 (both forms MUST be returned)

PAYMENT SHEET
MEMBERS NAME ...................................................................................................................... ADDRESS:.............................................................................................................................. PHONE: .............................................. EMAIL: ................................................................... SHCV MEMBERSHIP No............................... (if applicable) PROCESS REQUIRED: ..............................................................................................................

PAYMENT DETAILS
Please accept my Cheque / Money Order made out to: Show Horse Council of Victoria for the amount of $ ........................................
CREDIT CARDPAYMENT OPTION: I wish to pay by o Mastercard o Visa

Amount: $.......................................... Expiry Date: ............................................. Card Number: __ __ __ __ / __ __ __ __ / __ __ __ __ / __ __ __ __

Cardholders Name: ................................................................................ Cardholders Signature: .......................................................................................................................

Please return this form to : SHCV Inc P O Box 5374 CRANBOURNE VIC 3977
OFFICE USE: Recd: Processed:

Non-Member Application / Entry Form Release of Waiver of Liability

Full Name of attendee and guardian (if under 18 years) ........................................................................................................ ........................................................................................................................................................................................... Address ............................................................................................................................................................................... State..............................................Post Code ..................................... Date of birth ............................................................ Horse's name ....................................................................................................................................................................... Event/Activity ..................................................................................................................................................................... Address of Event/Activity ................................................................................................................................................... Date of Event/Activity......................................................................................................................................................... Name of affiliate holding Event/Activity..............................................................................................................................

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 proprietors of the Show Horse Council of Australasia Inc (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 noncompliance 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 during the event and agree that I am solely responsible for ensuring that I wear a suitable helmet at all times 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 proprietors of the Show Horse Council of Australasia Inc, 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/guardian 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

CONDITIONS OF USE OF GIPPSLAND EQUESTRIAN CENTRE NO dogs allowed in the indoor arena or outside loose or tied up to cars or trailers. There are dog kennels and runs available for $10 per day or $20 over night All manure MUST be cleaned up in arena, roundyard, car park, tie up area before you leave. This is greatly appreciated. Tea and coffee facilities will be available in the arena. Paper cups will be supplied. Stables are available for day use - $20 but bookings must be made prior by contacting the facility. Overnight camping is available in trucks and floats from Friday Sunday with the use of shower facilities and toilets. $50 per night per truck/float. Barbeque and use of fridge is available for overnight campers. To park your vehicles --- turn LEFT at the end of the driveway and please shut the gate at entrance. Thank you. All riders / handlers / people entering the indoor arena MUST complete and return a completed Gippsland Equestrian Centre Waiver Form. As this venue is a privately owned facility the SHCV ask that you please abide by all the above conditions, keep the facility clean & tidy, place all rubbish in bins provided and treat the venue as you would your own property. For all direct enquiries for your personal needs please contact Geoffrey & Hikka Grogan on (03) 51 447711 or 0413 703 720

WAIVER FORM TO BE SIGNED BY ALL TERMS AND CONDITIONS OF RIDING AT GIPPSLAND EQUESTRIAN CENTRE By signing this document, I understand that I waive my rights to sue the provider Geoffrey and Hilkka Grogan being the proprietors of Fulham Lodge Gippsland Equestrian Centre, 26 Hopkins Road, Fulham Victoria 3851 for any personal injury or death, loss or damage to me or to any of my possessions. I understand that horse riding is a dangerous activity and that horses can act in sudden and unpredictable (changeable way) especially if frightened or hurt. I understand and acknowledge that serious injury or death may occur when riding/handling horses at the property owned by Geoffrey and Hilkka Grogan at 26 Hopkins Road, Fulham and that I RIDE AT MY OWN RISK and the proprietors will not be liable for any injury and wave my rights to sue the provider/proprietor for any losses relating to my injury or death which may result from any negligence caused by the provider or by riding/handling horses on their property.

NAME.................................................................................................................. ADDRESS............................................................................................................. SUBURB...................................................................................PC........................ SIGNATURE......................................................................................................... CONTACT PHONE NO.. DATED.................................................................................................................