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Sunday 11th October 2015, at Cooma Showgrounds. Phone Cooma Monaro Shire Council for overnight camping 02 6455 1745. Cars and floats enter from Boundary St. Prizes will be awarded to winners of each class and ribbons to fifth place. Classes 1-6 for Juniors: For each of Classes 1-6, there will be separate events for open and junior riders. For Classes 1-6, prizes will also be awarded to junior (under 18 years) winners and ribbons will be awarded to juniors to 5th place. Day Membership: All events except Class 7 (Elementary 3.1) will be run as Closed Unrestricted Competition meaning that any MEA and/or EA members can compete including those purchasing day membership. Event 7 however is a Closed Restricted Competition and as such is only available to MEA members including those purchasing “Day Membership. Non MEA/EA members who wish to participate for the day, can pay a $15 insurance fee (Day Membership) and ride in any classes that are open to MEA members, i.e. Closed Unrestricted and Closed Restricted. All riders in Class 7, (Elementary 3.1) must be either MEA members or have paid day membership. Program 1. Prep A 2. Prelim 1:1 3. Novice 2:1 4. Prep C 5. Prelim 1:3 6. Novice 2:3 7. Elementary 3:1 8. MEA Prep Pairs 9. MEA Prep Pairs for adult and child 10. MEA Encouragement Prix Caprilli 11. MEA Prelim/NoviceFreestyle Enquiries: Jeannine Stockl 0414 702 415, [email protected] Entry forms and MEA tests at: www.mea.net.au & MEA Facebook Page Entries close: Thursday 1 st October Prizes donated by THE FEED SHED, BUNGENDORE. There will also be a lucky-draw prize for all riders and helpers attending the presentation at the end of the day. …including classes for juniors…

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Sunday 11th October 2015, at Cooma Showgrounds.

Phone Cooma Monaro Shire Council for overnight camping 02 6455 1745. Cars and floats enter from Boundary St.

Prizes will be awarded to winners of each class and ribbons to fifth place.

Classes 1-6 for Juniors: For each of Classes 1-6, there will be separate events for open and junior riders. For Classes 1-6, prizes will also be awarded to junior (under 18 years) winners and ribbons will be awarded to juniors to 5th place.

Day Membership: All events except Class 7 (Elementary 3.1) will be run as Closed Unrestricted Competition meaning that any MEA and/or EA members can compete including those purchasing day membership. Event 7 however is a Closed Restricted Competition and as such is only available to MEA members including those purchasing “Day Membership”. Non MEA/EA members who wish to participate for the day, can pay a $15 insurance fee (Day Membership) and ride in any classes that are open to MEA members, i.e. Closed Unrestricted and Closed Restricted. All riders in Class 7, (Elementary 3.1) must be either MEA members or have paid day membership.

Program

1. Prep A 2. Prelim 1:1 3. Novice 2:1

4. Prep C 5. Prelim 1:3 6. Novice 2:3 7. Elementary 3:1

8. MEA Prep Pairs 9. MEA Prep Pairs for adult and child 10. MEA Encouragement Prix Caprilli 11. MEA Prelim/NoviceFreestyle

Enquiries: Jeannine Stockl 0414 702 415, [email protected]

Entry forms and MEA tests at: www.mea.net.au & MEA Facebook Page

Entries close: Thursday 1st October

Prizes donated by THE FEED SHED, BUNGENDORE. There will

also be a lucky-draw prize for all riders and helpers attending

the presentation at the end of the day.

…including classes for juniors…

October Dressage Competition Sunday 11 October 2015

Cooma Showgrounds

Entries closing date Thursday 1st October

PLEASE CHECK www.mea.net.au FOR COPIES OF TESTS, ENTRY FORMS & DISCLAIMERS. ALL ENQUIRES CONTACT Jeannine Stockl 0414 702 415 or Sue Wallace 0418 649 869

CLOSED UNRESTRICTED – MEA & EA members

1. Preparatory A 7. Elementary 3.1*

2. Preliminary 1.1 8. MEA Prep Pairs Test

3. Novice 2.1 9. MEA Prep Pairs Test Adult and Child

4. Preparatory C 10.MEA Encouragement Prix Caprilli Test

5. Preliminary 1.3 11. MEA Prelim/Novice combined Freestyle test

6. Novice 2.3

Classes 1-6 : For each of Classes 1-6, there are separate events for open and junior riders. Riders competing as a junior must mark their entry forms accordingly for these classes.

We are now able to offer “Day Membership” - Non MEA/EA members who wish to participate for the day, can pay a $15 insurance fee and ride in any classes that are open to MEA members. Riders participating in Class 7, must be MEA members or have paid the day membership.

Please note that camping is permitted at Cooma Showgrounds. This should be pre-booked directly with Cooma Monaro Shire Council, phone 02 6455 1745.

CONDITIONS OF ENTRY

This competition will be held in accordance with the rules of the EA. For example:

o No substitution for the horse after the finalisation of the draw. o EA numbers and horse’s points must be shown on the entry form. o All competitors must wear an ASA Approved Safety Helmet or will not be allowed to compete. o All competitors must present to the Gear Steward. Failure to do so may incur elimination. o Temporary yards/fences made substantially of electrical fencing/rope are not permitted.

For classes 1-7, horses may compete in a maximum of three tests within two consecutive levels, eg, Prep/Preliminary,Preliminary/Novice, Novice/Elementary.

For each of Classes 1-6, there are separate events for open and junior riders. Riders competing as a junior must mark their entry forms accordingly for these classes.

A maximum of two horses per rider per test will be permitted.

Only one rider per horse per test is permitted.

A horse can be ridden in only one pairs test. The same horse cannot compete in both Classes 8 and 9.

Callers allowed.

Dress can be informal but appropriate for a dressage competition.eg Adult riding club members may wear cream or white jodhpurs/breaches and their club’s shirt and vest/jacket. Juniors’ attire may be cream or white jodhpurs/moleskins with ponyclub or school uniform. Plaiting is not compulsory.

Fancy dress or co-ordinated attire is encouraged in the Freestyle and Pairs classes.

If entering the Pairs classes (Class 8 or 9) the name of the other rider who makes up the pair should be in brackets beside your horse’s name. Only one entry fee is required from the two riders for a Pairs Test.

Riders who have already won three Preparatory level dressage tests may not enter competitively at this level again. Riders wishing to ride Hors Concours (HC) must declare their intention at time of entry.

For Class 11, Prelim/Novice Combined Freestyle Test, riders must provide their music on iPhone, iPod, android phone or similar. The device should be clearly marked with the rider’s name. The name of the track and the instructions explaining how to play the device must also be attached. To ensure that their device is compatible with the MEA sound equipment, riders of the Freestyle must consult with the operator of the sound equipment at least an hour prior to the event. Riders may be automatically disqualified from the Freestyle if their device is incompatible or faulty, or the music is inaudible.

Prizes will be awarded for 1st place only. Ribbons will be awarded to fifth place for all classes.

Bridle numbers are compulsory and must be clearly seen on either side of the horse. Horses are not required to stop at the judge’s car, but must be ridden in front of the judge to ensure that the judge has acknowledged the rider. The use of bridle numbers allows the day to run more efficiently.

Bridle numbers are issued to all horses from Dressage NSW. The horse/owner does not have to be a member of the EA. To obtain a bridle number, please call the Equestrian NSW office on 02 9620 2660.

Riders/helpers are encouraged to remain for the presentations. Presentations will be made at the end of the day’s competition after the arenas have been packed away.

At the end of the presentations there will be a prize awarded to a helper or rider from a lucky-draw. Names will continue to be redrawn until the name of a rider/helper who is present is called.

If unable to attend the presentations, riders may leave an envelope with $1.00 for postage, and also their full name and address, so their tests can be mailed to them.

Late entries will not be accepted. Entry fees must accompany entries. No refund of entry fees will be given after the closing date. 50% of entry fees will be refunded if a veterinary or medical certificate is produced no later than 24 hours after the event.

The MEA is not responsible for any damage, loss or injury to persons, animals or equipment.

The Organising Committee reserves the right to alter, amend or cancel any section of the program without notice. It is up to the competitor to check for draw changes up to the start of competition.

Dogs are strongly discouraged, but if absolutely necessary are to be kept on a lead at all times and kept away from competition and warm up areas.

All entries must be accompanied by a completed EA Disclaimer Statement (copies available at www.mea.net.au) or riders will not be allowed to compete.

Rider’s Name: Under 18? Yes /No

Address/email:

Telephone: Mobile

Class

No.

Test Horse’s Name PIC No: EA No Bridle No:

Horse’s Points

Entry Fee $

MEA member?

Yes / No

EA member?

Yes / No

EA No: Day membership @$15/rider?

Yes / No

Ground fee @ $10/rider

Total:

$

October Dressage

Sunday 11 October, 2015

Cooma Showgrounds

Entries Close: Thursday 1st October 2015

Enquiries to Jeannine Stockl 0414 702 415, or Sue Wallace 0418 649 869.

*If riders are entered for any of the first events of the day, those who are coming from afar, will be scheduled in the draw as late as

possible.

I agree to abide by the Conditions of Entry. Signed: ___________________________ Dated: ____________

Cheques should be made payable to the Monaro Equestrian Association Inc and posted with entries to PO Box

1113 Cooma NSW 263.

Alternatively, entry fees may be paid directly to Monaro Equestrian Association Inc BSB 032720, ACC 155285,

include surname of rider and month of competition as reference eg McCosker Oct. If paying by direct deposit

please email entries to Bridget McCosker at [email protected] .

The draw will be available to download from the website www.mea.equestrian.org.au , or MEA’s Facebook

page.

Rider’s Entry Form

Entry Fees

MEA Members Only $15.00

Non MEA members $20.00

Will you be driving for

more than an hour to come

to this comp?

Yes* / No

COMBINED PRELIMINARY/NOVICE FREESTYLE TO MUSIC

INSTRUCTIONS:

To be ridden in an ordinary snaffle.

Trot work is optional sitting or rising

Arena: 60m x 20m

Time Allowed: Performance should be between 4:00 and 4:30 minutes. Time commences at the move off from the

first halt and finishes at the final salute. Entry music: 20 seconds maximum

Music: Rider to provide their music on iPhone, iPod, android phone or similar, at least 60 minutes prior to the event.

See conditions of entry.

BRIDLE NO: HORSE NAME: RIDER:

JUDGE’S NAME: DATE: VENUE:

Time Penalty – Outside allowed time will be penalised (-5 marks)

COMPULSORY MOVEMENTS

REMARKS

1. The entry up the centreline and the first halt to salute judge

10

2. Medium walk – a minimum of 20 metres of medium walk

10 2

3. Free walk – a minimum of 20 metres of free walk on a long rein

10

4. Working trot – including a half or full 10 or 20metre circle on both the left and right rein

10

5. Working canter – including a half or full 15 or 20 metre circle on the left and right rein

10

6. Transitions to canter from trot (left and right leads)

10

7. Straightness along centreline and final halt to salute judge

10

Total for Technical Execution

80

Artistic Presentation

8. Rhythm, energy and elasticity

10 2

9* Harmony between rider and horse

10 3

10* Choreography. Use of arena. Inventiveness. Costume.

10 3

11* Choice of music and interpretation of the music

10 3

Total for Artistic Presentation 110 Judge's Signature:

FINAL SCORE 190

TOTAL PERCENTAGE SCORE

MEA Encouragement Prix Caprilli Dressage Test

Event: _________________ Date: _________________ Judge’s Name: ______________________________

Rider’s Name: ____________________________Horse’s Name:___________________________________

This is an encouragement test and can be completed in walk and trot. Canter is optional for the rider. However, the judge will award more

marks if canter is attempted. All trot work is to be done rising.

Mark Score* Judges comments

A Enter working trot

1 X Halt, immobility, salute. Proceed in working trot

10

C Track right

2 MXK Change rein and jump Fence#1.

Return to working trot. 10 X2

3 A Circle left 20m

10

4 After A Turn onto quarter line and jump Fence#2. Return to working trot. 10

X2

5 C Medium walk. 10

HB Free walk.

6 B Medium walk 10

F Working trot

7 Between AK Working canter right lead 10

8 KXM Change rein and jump Fence#1,

landing in working canter. 10 X2

9 M Working trot

10

10 Between CH Working canter left lead 10

11 E Half 15m circle and jump Fence#2, proceed straight ahead. 10

X2

12 Level with M Working trot, then go large, left rein 10

13 C Circle left 20m, letting the horse stretch and lower his neck

10

Before C Retake the reins, working trot.

14 HXF Change rein and jump Fence # 3. Return to working trot before F 10 X2

15 A Turn right up the centre line, working trot

10

X Halt, immobility, salute.

Judge’s Signature ___________________________________________________________________________

Guidelines for Scoring MEA Encouragement Prix Caprilli Test

Prix Caprilli dressage tests have the same movements as dressage and are judged according to

conventional dressage rules. However, Prix Caprilli tests include several small jumps. The aim of Prix Caprilli

dressage tests is to show that the horse can complete a dressage test in a relaxed and obedient manner

without the jumps disrupting the performance.

The emphasis is not the jumping style of the horse, it is on the horse’s relaxation, obedience and evenness

of pace.

The rider should establish a jumping position that will assist the horse in freely

jumping over the fences without any resistance. This will usually require the rider

to shorten his/her stirrups for the test. All trot work is rising and canter is

optional. More marks will be awarded if canter is attempted.

Refusals and knockdowns are considered as “errors of course”. If a rail is knocked

down, and is required to be replaced, the judge will sound the horn, the rider

shall stop and wait for the rail to be replaced, and then continue the test at the

point where the judge’s horn was sounded.

Dressage gear rules apply except horses are permitted to wear protective boots.

The location of the fences (height = cross bars) is shown in the diagram of the

arena on the left. The arena is 20x60m.

Collective marks

Paces (freedom and regularity)

X2

Impulsion (desire to move forward, elasticity of the steps, relaxation of the back and engagement of quarters)

X2

Submission ( attention and confidence, harmony, lightness and ease of the movements, acceptance of the bridle)

X2

Rider (position and seat, correctness and effect of the aids)

X2

Total: 280

#3

#2

#1

C

A

B E

MEA Prep Pairs Dressage Test

Event: _________________ Date: _________________ Judge’s Name: ______________________________

Riders’ Names: ________________________________ _______________________________________

Horses’ Names: _________________________________ _______________________________________

Judge’s Signature: _____________________________________________________________________________

* See over page the guidelines for judges for scoring MEA pairs tests. Mark Score* Judges comments

1 A Enter side by side in working trot

X Halt, immobility, salute. Proceed in working trot as a pair

10

2 C Track left side by side

HE Working trot side by side 10

3 E Circle left 20 metres side by side

10

4 EKAF Working trot side by side

10

5 FXH Change rein in working trot side by side. Before X medium walk, 6 paces medium walk through X as a pair. Proceed in working trot.

10

6 HCM Working trot side by side

10

7 B Circle right 20 metres side by side

10

8 BF Working trot side by side

10

9 A Down centre line side by side

10

10 G Medium walk

10

11 C Split (one track right, one track left)

(MXK)(HXF) Change rein in free walk on a long rein passing nose to tail over X

10

12 (K) (F) Medium walk

A Down centre line as a pair 10

D Working trot

13 C Split ( one track left, one track right)

(HEK)(MBF)

Proceed down each long side of the arena in working trot staying level with each other

10

14 A Down centre line as a pair

G Halt, immobility, salute 10

Total: 140

Guidelines for Scoring MEA Pairs Dressage

The aim of pairs dressage tests is primarily to show that the riders and their horses can work happily

together. At all times the riders should be in harmony, being aware of where their partner is positioned

and being ready to accommodate their partner. Ideally, the horses should be compatible and relaxed.

When the pair is working side by side, the outline should appear to be as just one horse and rider from the

judge’s lateral perspective. Furthermore, when working as a pair the horses should be as close as possible

so that the riders’ inside legs appear to be almost in contact. Consequently the guidelines for judging a

pairs dressage test emphasises the success the riders can create as a pair. The higher the score, the more

closely the pair has worked together. For example, a six in the pairs test (Pairs 6 = the movement was

performed accurately and harmoniously as a pair) is not the same six that an individual can earn in a

conventional dressage test (Conventional dressage 6 = movement was performed at a satisfactory level).

The judge may penalise the riders for the use of voice (-2 marks on each occasion). When riders are

working individually, whenever they pass head on, they should pass left hand to left hand.

Score in MEA Pairs Test

Descriptor

0 The movement was not attempted by either horse

2 The movement was executed by only one horse

4 The movement was performed by both horses but not as a pair

6 The movement was performed harmoniously and as a pair.

8 The movement was performed accurately, harmoniously and both horses maintained a good outline, rhythm and impulsion

10 The movement was performed accurately, harmoniously and both horses maintained the same good outline, rhythm and impulsion, with synchronised footfall.

Non-member participants in Club-organised horse activity days are, upon completion of this form, deemed to be members of the Club during such activities for the purposes of participation only. 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 club 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 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 riding during the event and agree that I am solely responsible for ensuring that I wear a suitable helmet at all times whilst riding 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/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

The Equestrian Federation of Australia ACN 077 455 755 ABN 19 077 455 755 Non-Member Application / Entry Form

Release and Waiver of Liability

Member Release and Waiver of Liability

The Equestrian Federation of Australia ACN 077 455 755 ABN 19 077 455 755

Full Name of participant (and guardian if under 18 years) .........................................................

...................................................................................................................................................

Address......................................................................................................................................

State ………………………………..Post Code............................Date of birth............................

Name of Club/Organisation........................................................................................................

Membership No. ........................................................................................................................

Address of Event / Activity .........................................................................................................

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 riding where this is required under the relevant EFA and FEI rules and regulations and agree that I am solely responsible for ensuring that whilst riding I wear a suitable helmet at all times where required under the relevant EFA 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/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 my minor child's involvement or participation in horse sport activities. Dated: ___/___/___ Signature of rider/guardian

Release and Waiver of Liability Horse Sports are a Dangerous Activity

Supplier of recreational service:

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 significant risk that serious INJURY or DEATH may result from horse sport activities and in particular this activity. I/We confirm the Recreational Service Supplier has explained this document to me/us and I/we am/are aware of the implications, intent and effect of agreeing to signing the document. I/We furthermore confirm I/we am/are aware of the obvious risks associated with activities involving horses and I/we knowingly and freely assume all such risks, both known and unknown, even if arising from the negligence of the Recreational Service Supplier (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 related 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 activity. I agree to follow the directions given to me and that any misconduct or refusal by me to follow any direction can result in the CANCELLATION of participation in the activity and my immediate removal from any 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 riding 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 Recreational Service Supplier, their officers, officials, volunteers, coaches, agents and/or employees, other participants, sponsoring agencies, sponsors 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. Name of Participant: Phone: Date of birth: Occupation: Details of riding experience:

Agreement to exclude, restrict or modify your rights:

I agree that the liability of the above named Recreational Service Supplier for any personal injury that may result from the supply of the recreational services that may be suffered by me (or a person for whom or on whose behalf I am acquiring the services) is completely and unconditionally —

(a) excluded;

I/we have had sufficient opportunity to read this release of liability and assumption of risk agreement or where required, explained to me/us, fully understand its terms, understand that I/we have given up substantial rights by signing it, and sign it freely and voluntarily without inducement, undue pressure or influence of any kind.

Signature of Participant: Dated:

Name and address of Participant

Signature of witness: Dated:

Name and address of witness: