Pinto Poker Ride Camberwarra, Lower Light

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1 Pinto Poker Ride Camberwarra, Lower Light Saturday -13 April, 2019 Trail ride with a twist. Come for the ride, collect 5 cards and see if you have the winning poker hand. All horses and riders welcome, day insurance available for non-pinto association members. Prizes include bags of feed, hay bags, halters, saddle blankets and more. The best three poker hands in every group of ten riders wins a prize. There is also a $60 Horse Shoes R Us gift voucher for the person who gets the joker card on the day. 10:00am start- 15 km ride through the scrub along scenic trails, with great footing. You might even see a kangaroo or two if you are lucky. ($15) 10:15am start- 10km ride through the scrub. ($10) 10:30am start- 5km ride along the start track, led riders welcome. ($10) Sausage sizzle and drinks available for purchase from 11am -1:30pm Entries close Tue 9 April, (Late entry available at double fee) Enquiries to Anita Trenwith Directions- Travelling north on Port Wakefield Rd 3.2km past Lower Light, turn left onto Crabb Rd. Follow 4.3km to ride base at the end of the road Travelling south on Port Wakefield Rd 8km past Dublin, turn right onto Crabb Rd. Follow 4.3km to ride base at the end of the road

2 Terms and Conditions 1. Riders and handlers must follow instructions provided from PASA organising team. 2. Riders/ handlers are to stay on the designated riding paths. 3. Handlers of led riders must be competent at handling horses. 4. When passing other horses, you must let your intention be known and you must pass at a walk. 5. No dogs allowed on the grounds 6. Judging of the poker hands will be in accordance to PASA house rules By the end of the ride 5 cards will be provided and this will become the entrant s poker hand. Results will be recorded in groups of ten riders according to the time they check in after they complete the ride. The top 3 hands in each group will win a prize. The rider that gets the joker card will win a Horse Shoes R Us gift voucher. 7. Riders/handlers must attend the ride brief 5 minutes before start time 10km and 15km tracks 5km and led riders track.

3 Entry Form for Pinto Association of SA Inc. Pinto Poker Ride 13 April 2019 Completed entry form, together with payment to Pinto Association of SA by cheque, money order, direct deposit or credit card. Direct Deposit to: Pinto Association of SA Inc. BSB Acc Now accepting Credit card payments, see attached form. Cost of entries 5km and 10km $10 per rider, 15km $15 per rider Send entry forms, waivers and proof of payment to 12 Tilshead Rd, Elizabeth North SA 5113 Rider Horse Distance 5km 10km or 15km Fee $10 / $15 All persons listed on PASA Inc membership automatically have insurance coverage. Non members need to pay a fee of $10 per person and complete the waiver form. All persons attending the event and handling horses need to be covered. Total Entries $ Day insurance $ ($10 per rider if not a pinto association member) Donation $ Total Fees $ Name of contact person - Name of all riders/ handlers - Phone number - - Address - Property PIC number I/we hereby certify that the above details are correct and in accordance with the Conditions of Entry, which I have read on the attached sheet and I /we agree to comply with the Conditions of Entry, as set down by the event convenors. I /we hereby acknowledge and accept that I/we are responsible for any non members who accompany me/us. Further, I and those persons accompanying me/us, agree to abide by the rules and regulations of PASA inc. I /we acknowledge and have made those accompanying me/us aware that equine sports have the potential to be dangerous and accept that while every effort will be made with regard to safety, I and those accompanying me will not hold PASA Inc responsible for any damage, loss or injury incurred. Signed - Print Name - Date - Please note entries that are ineligible, incomplete or without correct fees will be returned and you could miss the closing date of 9 April 2019.

4 Credit card payment *Credit card payments incur a 3% processing fee. This fee will be added to your listed total below. Total amount to be paid: $ for the payment of: Show entry / Membership / Registration / Other (please list) I authorize the above amount plus the 3% processing fee to be charged to my Credit Card : Credit Card Type: Name on Card: Credit Card Number: Expiry Date: / CCV (3 digit number on back of card): Signed: Date: / / Privacy Disclaimer: PASA Inc. Does not keep credit card details. Once payment is processed successfully, your details will be disposed of in a secure manner. Payments will not be processed without the listed card holders consent.

5 The Pinto Association of South Australia Inc. Participant Risk Warning, Indemnity and Waiver Form The Pinto Association of South Australia Inc. advises that the participation, including passive participation in horse sport activities at any show, event or activity contains an element of risk of both obvious and inherent. Horse sports are a dangerous recreational activity and animals can act in a sudden and unpredictable way, especially if frightened or hurt. The risks involved may result in property or personal injury, loss, damage or death. I/We the undersigned acknowledge, agree, and understand that participation, including passive participation in horse sports such as this, or at any show, event or activity conducted by The Pinto Association of South Australia Inc. contains an element of risk of property or personal injury, loss, damage or death. I/We acknowledge that I/we undertake any such risk voluntarily of my/our own free will and at my/our own risk. I/We the undersigned acknowledge, agree, and understand the dangers associated with the consumption of alcohol or any mind-altering drugs before, and during the show, event or activities and I/we take full responsibility for any property or personal injury, loss, damage or death associated with their consumption. I/We agree not to drink alcohol or take drugs prohibited by law before or during any show, event or activity, especially horse sport activities conducted by The Pinto Association of South Australia Inc. I/We the undersigned acknowledge the risks as referred above and agree to waive any and all rights that I/we or any other person claiming through me/us, may have against The Pinto Association of South Australia Inc. in relation to any property or personal injury, loss, damage or death that is suffered by me or any other person claiming through me as a result of my/our participation at this or any show, event or activity especially horse sport activities conducted by The Pinto Association of South Australia Inc. I/We the undersigned agree to continually indemnify The Pinto Association of South Australia Inc. on a full indemnity basis against any claim or proceeding that is made, threatened or commenced and any liability, loss (including consequential loss and loss of profits), damages or expense (including legal costs on a full indemnity basis) that The Pinto Association of South Australia Inc, incurs or suffers, as a direct result of my participation in any show, event, activity or horse sport activities conducted by The Pinto Association of South Australia Inc. I/We have read this Participant Risk Warning, Indemnity and Waiver Form and acknowledge and agree with its contents. I have made further enquiries which I feel are necessary or desirable and fully understand the risks involved in any show, event or activity especially horse sport activities conducted by The Pinto Association of South Australia Inc. CONDITIONS OF ENTRY AND BEFORE ENTRIES WILL BE ACCEPTED PLEASE COMPLETE ALL SECTIONS ON THE BACK OF THIS FORM

6 The Pinto Association of South Australia Inc. Participant Risk Warning, Indemnity and Waiver Form CONDITIONS OF ENTRY AND BEFORE ENTRIES WILL BE ACCEPTED PLEASE COMPLETE ALL SECTIONS THIS FORM I/ We the undersigned understand that by participating in any show, event or activity conducted by The Pinto Association of South Australia Inc. contains an element of risk of property or personal injury, loss, damage or death. I/We agree that any/all minors in my care may also become exposed to the risk of property or personal injury, loss, damage or death and I/we consent and assert that the Minors named below have voluntarily consented to participation. I/We the undersigned, and minors named below or any other person agree to continually indemnify The Pinto Association of South Australia Inc on a full indemnity basis against any claim or proceeding that is made, threatened or commenced and any liability, loss (including consequential loss and loss of profits), damages or expense (including legal costs on a full indemnity basis) that The Pinto Association of South Australia Inc. incurs or suffers, as a direct or indirect result of my participation in any show, event, activity or horse sport activities conducted by The Pinto Association of South Australia Inc. I/We the undersigned, any Minors named below, or any other person agrees to waive any and all rights that I/ We the undersigned, any Minors named below, or any other person may have against The Pinto Association of South Australia Inc. Details below are for those requiring day coverage for Event - Pinto Poker Ride at Camberwarra, Crabb Rd, Lower Light Date- 13 April 2019 Name of all adults 18 years and over to be covered Name of all minors under 18 years to be covered Total number of persons $10 each = $ paid Full name and details of responsible adult/ parent or guardian Name - Address - Contact Number - PIC number- Signed - Date -

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