Technical Hand Book - Adria Pratama Mulya

APM EQUESTRIAN CENTRE
TIGARAKSA - 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
Venue
APM 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 EventNadia Marciano(INA)
Event DirectorDyah Krisnawan(INA)
Event SecretaryDyah Kartini Paramita(INA)
Stable ManagerJendry Palandeng(INA)
TreasurerDyah Kartini Paramita(INA)
Rama Putra Sahetapy(INA)
Press CoordinatorRuminta(INA)
Public RelationRama Putra Sahetapy(INA)
Master of CeremonyOZ FM Team(INA)
Graphic DesignLinegra(INA)
Food & BeveragesPrima Ika(INA)
Mahalia Santini(INA)
Special Event CoordinatorDian Adiratri(INA)
Octa Yuniar Nurrazak(INA)
Music DirectorSMA APM Team(INA)
OFFICIALS
Show DirectorAdi Katompo (INA)
Show SecretaryJupri Mardi(INA)
Technical DelegateRafiq H. Radinal (INA)
Dressage JudgeLorraine MH Bottreau (ARG)
Dressage JudgeNico 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 KeeperMoelyono Sugito(INA)
Veterinary Commission
Mayor CKM drh. Joko Suranto (INA)
Treating Veterinariandrh. Ardhinta Irawan(INA)
Course Builder, Scorer & Scriber
APM Equestrian Centre Team
(INA)
Chief StewardMr. Nurcahyo(INA)
StewardsSekolah Kavaleri Berkuda Team(INA)
GENERAL RULES AND REGULATIONS
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 Eventing Rules, 24th edition, effective 1st January 2015
•
FEI Jumping Rules, 25th edition, 1st January 2014, updates effective 1st January 2015
ENTRY CLOSING DATE/ PENUTUPAN PENDAFTARAN
All 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 / PEMBAYARAN
All cash payment should be made to the organizing committee.
Pembayaran secara tunai langsung ke sekretariat
All transfer payment should be to the account number : 6340281282 BCA, account name : Yayasan
Pendidikan Adria Pratama Mulya
Pembayaran dapat dilakukan secara transfer ke nomor rekening 6340281282 BCA, atas nama
Yayasan Pendidikan Adria Pratama Mulya
WAIVER FORM / FORMULIR PELEPASAN HAK
The 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/ ASURANSI
All 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 CONDITION
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 KANDANG
The 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 PENGANGKUT
Please 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 PERTANDINGAN
The 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.
PRIZE GIVING CEREMONY / UPACARA PEMBAGIAN HADIAH
Winners 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 / HADIAH
If 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.
APPEALS
Complaints 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 KUDA
Horse 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.
JUMPING RULES & AGE REGULATIONS
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. 2. Children : Athletes aged fourteen (14) and under as of the end of the year.
3. Junior : Athletes aged eighteen (18) and under as of the end of the year.
4. Young Horse : Horses aged six (6) and under as of the end of the year.
Terbuka bagi atlet dan kuda di semua umur dan level.
Atlet yang sampai akhir tahun ini mencapai usia 14 tahun.
Atlet yang sampai akhir tahun ini mencapai usia 18 tahun.
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.
DRESSAGE RULES & REGULATIONS
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 CODE
1. 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.
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.
DRESSAGE GENERAL RULES (additional)
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.
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 SCHOOLING
A 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.
EARPHONES
Earphones 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 DECORATIONS
Any 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.
SALUTE
Athletes 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 ASSISTANCE
Any 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.
BELL
After 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 GIVING
Participation 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.
CONTACT
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
DIRECTORY
HOTEL
:
Amaris Hotel
Perumahan Citra Raya Blok KA 01 Kav. No. 2
Kawasan Commercial Life Style
Tangerang 15811
Phone : +62 21 22597777
HOSPITAL:
Ciputra Hospital
Panongan – Tangerang 15710
www.amarishotel.com
Jl. Citra Raya Boulevard Blok V.00/08 Sek 3.4
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
COMPETITION SCHEDULE & CLASS
Time
Class
Location
Entry Fee
(IDR)
Rules
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
09:00
CS-02
10:00
CS-03
SJ 90-100 cm Open
Indoor Arena
11:00
CD-01
Dressage Medium Open
Outdoor Arena
13:00
CD-02
Dressage Advanced Open
Outdoor Arena
14:00
CD-03
15:00
CD-04
16:00
CD-05
SJ 50-70 cm Open
SJ 70-90 cm Open
MIB
Dressage Preliminary Open
Linegra
Dressage Elementary Open
Dressage Prix St. George
Indoor Arena
Indoor Arena
Outdoor Arena
Outdoor Arena
Art. 274
(Power & Speed)
Art. 274
(Power & Speed)
Art. 274
(Power & Speed)
FEI WDC
Medium Test
FEI WDC
Advanced Test
FEI WDC
Preliminary Test
FEI WDC
Elementary Test
500,000
500,000
500,000
550,000
600,000
450,000
500,000
Outdoor Arena
FEI WDC PSG Test
650.000
Walk Trot Test 2
350,000
Saturday, 31st October 2015
07:30
CD-06
Walk Trot Interschool
Small Arena
10:30
CD-07
Introductory Interschool
Small Arena
13:00
CD-08
Preliminary Interschool
Small Arena
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
13:30
CS-07
SJ 50-70 cm Interschool
Indoor Arena
14:45
CS-08
SJ 70-90 cm Interschool
Indoor Arena
15:30
CS-09
16:30
CS-16
Sugar Labinta
SJ 110 cm Open
Games Ride & Drive (Horse
Owner + Rider)
Indoor Arena
Indoor Arena
USDF Introductory
Level
FEI WDC
Perliminary
Art. 238.2.2 –
Against the clock
with jump off
Table A – Optimum
Time
Table A – Optimum
Time
Art. 274.5.3. – Two
phase
Table C
350,000
400,000
550,000
350,000
400,000
500,000
_
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
Art. 238.2.1
550,000
PERFORMANCES
12:00
14.00
CS-13
15.00
CS-14
16.00
CS-15
MARCIANO CUP
SJ 125-135 cm Open
APM Challenge
SJ 145 cm Open
OSO Group
SJ 115 cm Open
Indoor Arena
Indoor Arena
Indoor Arena
Art. 273.3.3.1
(2 Rounds)
Art. 269.5. Accumulator
600,000
500,000
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 CONTEST
Cinta 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).
PARENTAL/GUARDIAN CONSENT
ACKNOWLEDGEMENT AND RELEASE
IMPORTANT
(This form must be completed by competitors who have not reached 18 years old by 30 October 2015.)
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
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 WAIVER
i. 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 REGULATIONS
i. 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 :
Rider
No
(for CH; JR; YR provide
date of birth)
Date Of
Birth
Horse Name
Class
1
2
3
4
5
7
8
TOTAL ENTRY FEE
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
Days
1
2
3
4
5
6
7
8
9
10
TOTAL STABLING FEE
Stabling Fee