Sekretariat office Phone :

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1 V. CONTACT: Sekretariat office Phone : acs@apmequestrian.com Alia Ningtyas P (Event Secretary) Mobile : (WA) alianingtyasp@gmail.com alia.pangestika@pordasi.co.id Nila Permata Sari (Treasurer) Mobile : acs@apmequestrian.com Kurniadi Mustopo (Event Dir) Jupri Mardi Mobile : (WA) Mobile : (WA) VI. DIRECTORY/ DIREKTORI HOTEL : Olive Hotel Jl. Imam Bonjol No. 777, Karawaci Phone : marketing@hoteloliveindonesia.com Amaris Hotel Perumahan Citra Raya Blok KA 01 Kav. No. 2 Kawasan Xommercial Life Style Tangerang Banten Phone : HOSPITAL : Ciputra Hospital Jl. Citra Raya Boulevard Blok V.00/08 Sek 3.4, Panongan Tangerang Phone :

2 APPENDIX-1 GENERAL RELEASE OF LIABILITY AND WAIVER PLEASE read carefully before signing this form must be signed before you compete In consideration for my permission to participate in the APM CHARITY SHOW 2018 &ASIAN GAMES QUALIFIER 2 (competition name) organized by PP PORDASI & APM Equestrian Centre ('the Organizers') at APM Equestrian Centre, on April 2018 (dates), I agree: i. that prior to participating in any event, I will inspect the facilities and equipment to be used by me during that event; 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, from the rules of competition and their application, from the condition of the premises and/or equipment, and from other causes now unknown or not now 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. And Acknowledgement of Rules and Regulations In consideration for my permission to participate in the APM CHARITY SHOW 2018 &ASIAN GAMES QUALIFIER 2 (competition name) organized by PP PORDASI & APM Equestrian Centre ('the Organizers') at APM Equestrian Centre, on April 2018 (dates), I agree: i. to abide by all the rules and regulations of the Organizer as in force from time to time; 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 without limitation physically or verbally assaulting or abusing any official, competitor, spectator, volunteer or any person involved in the conduct and management of the Competition and that any such conduct may meet with expulsion form 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. 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 in the Competition, or any person associated in any way with the Competition. Date Name of Entrant/Guardian Signature of Entrant/Guardian

3 IMPORTANT This form must be completed by competitor who has not reached 18 years old on 09 March Parental/Guardian Consent, Acknowledgement and Release (to be completed signed by a parent/guardian, where divorced or separated, parent/guardian with legal custody must sign). PLEASE read carefully before signing A. I/We hereby give consent for mu child,. (My ID card no / passport no:.. to participate in APM CHARITY SHOW 2018 &ASIAN GAMES QUALIFIER 2 (competition name) organized by PP PORDASI & APM Equestrian Centre ('the Organizers') at APM Equestrian Centre, on April 2018 (dates), (here in after referred to AS The Competition ) B. I/we know of, and acknowledge that my child/ward knows of, the risk involved in the athletic participation, understand that serious injury, permanent disability and even death, is possible in such participation and choose to accept any and all responsibility for his/her safety and welfare while participating in athletics. With full understanding of the risks involved, I we release and hold harmless APM CHARITY SHOW 2018 &ASIAN GAMES QUALIFIER 2 and its respective members, directors, agents, employees, associates, staffs, 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 APM CHARITY SHOW 2018 &ASIAN GAMES QUALIFIER 2 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 child/ward is competing. I/we further hereby authorized the use or disclosure my child s/ward s individually identifiable health information should treatment for illness or injury become necessary. I/we consent to the disclosure, by the APM CHARITY SHOW 2018 &ASIAN GAMES QUALIFIER 2 of all records relevant to his/her athletic eligibility including, but not limited to, his/her records relating the results, age, discipline, finances and residence. C. I ve grant the APM CHARITY SHOW 2018 &ASIAN GAMES QUALIFIER 2 the right to photograph and/or videotape my child/ward and further to use said child s/ward s name, face, likeness, voice and appearance in connection with exhibitions, publicity, advertising, promotional and commercial materials without reservation or limitation. APM CHARITY SHOW 2018 &ASIAN GAMES QUALIFIER 2, 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 and or all of them at any time by submitting said revocation in writing to the APM CHARITY SHOW 2018 &ASIAN GAMES QUALIFIER 2 By doing so, however, I/we understand that my/our child/ward will no longer be eligible for participation in any competitions. dan jika protes tidak diterima maka uang deposit menjadi hak dari Panitia. I/WE HAVE READ THIS CAREFULLY AND KNOW IT CONTAINS A RELEASE. / Name of Parent/Guardia (printed) & Signature of Parent/Guardian Date

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6 TIME (aprx) CLA SS NO COMPETITION SCHEDULE CLASSES CAT / AGE REMARK Arena Entry Fee Wednesday, April 25, :00-17:00 Cross Country Rehearsal Thursday, April 26, :00-12:00 Cross Country Inspection Walk The Course Cross Country 16:00-17:00 Horse Inspection Classes: Eventing, PSG, Inter I, Jumping 130 and above 17:00-18:00 Technical Meeting 08:00 CD01 Friday, April 27, 2018 Dressage Prix St George * Open FEI PSG updated ,000 09:45 CE Eventing Dressage * Open FEI 1* Test B 1.500,000 13:30 CD02 Dressage Elementary Junior FEI CHD Team 2015, updated ,000 CD03 Dressage Elementary Open FEI CHD Team 2015, updated ,000 16:30 CS18 Warmp Up Jumping 120 Open Max. 90 sec 250,000 Saturday, April 28, :00 CE Cross Country * Open Eventing Rules Pemda 10:30 CD05 Dressage Preliminary Primary Preliminary Test 1, Based on German NF Test A 5/1 CD06 Dressage Preliminary Junior High Preliminary Test 1, Based on German NF Test A 5/1 CD07 10:30 CS01 CS02 CS03 Dressage Preliminary Show Jumping cm Show Jumping cm Show Jumping cm Senior High Preliminary Test 1, Based on German NF Test A 5/1 Children Equitation Junior Equitation! Senior Novive Rider 12:30 CS04 Show Jumping 100 cm Junior CS05 Show Jumping 100 cm Junior Equitation 2015! Art (Special Two Phases) Art (Special Two Phases)! 450,000! 450,000 13:45 CS06 Show Jumping 110cm Open Art (Two Phases)! 450,000 14:45 CS07 Show Jumping 120 cm Open Art.269 (Accumulator)! 500,000

7 TIME (Aprx ) CLA SS NO CLASSES CAT / AGE REMARK Arena Entry Fee Sunday, April 29, :00-07:30 2nd Horse Inspection-Eventing 07:30 CD04 Dressage Intermediate I * 07:45 CD08 Dressage Walk Trot Open Primary FEI Inter I 2009, update 2018 Test 2 750,000 CD09 Dressage Walk Trot Junior High Test 2! CD10 Dressage Walk Trot Senior High Test 2! 10:30 CS09 Show Jumping 105 Junior Art. 269 (Accumulator) 450,000 CS10 Show Jumping 105 Open Art. 269 (Accumulator)! 450,000 12:00 CS11 Show Jumping 115 Young Rider Art. 269 (Accumulator)! 500,000 CS12 Show Jumping 115 Open Art. 269 (Accumulator)! 500,000 13:00 CS13 Show Jumping Open Art (Against The Clock) 14:00 CE Eventing SJ 115cm * Open Eventing Rule!! 600,000 15:00 CS14 Show Jumping 140* Open Art (Against The Clock with Jump Off)! 650,000 16:00 CS14 Show Jumping Children Art (Two Phases)! 450,000 CS15 Show Jumping Junior Art (Two Phases)! 450,000 CS17 Show Jumping * Qualifier classes Senior Novice Rider Art (Two Phases)! 450,000

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