Entries & Payment cheques/money orders payable to: Dilutes Australia Ltd South Qld Branch Banking details for EFT payment Bendigo Bank BSB 633 000 Acct# 123 342 529 Acct name Dilutes Australia Sth Qld Branch- Reference is your name & Clrma include transaction receipt with entries) COLOURAMA SPECTACULAR 2017 16 th September 2017 Gatton Showgrounds, Woodlands Drive, Gatton OFFICIAL ENTRY FORM PRE ENTRIES(preferred) or Entries on day For Post entries to: Branch Treasurer: Beth Dezius, 1332 Brisbane Valley H way, Fernvale, Q 4306 Owner Name: Address: Phone: Email: Handler/Rider Name: Open/Amateur/Youth All persons must complete and sign a waiver form and submit with your entries IF COPIES OF ALL REGISTRATIONS AND MEMBERSHIPS ARE NOT ENCLOSED WITH ENTRIES, THEY WILL BE RETURNED. Class Numbers- @ $8 each BRIDLE NUMBER DEPOSIT @ $10 per horse (refundable on return of ) TOTAL OF ENTRIES FROM OTHER PAGE/S STABLES FRI SAT SUN Stables @ $25 per 24 hours per horse Stables x Days STABLE CLEANING: $25 refundable stable bond (One cleaning fee per stable) _ Refundable stable bond must be paid before use. STABLES MUST BE LEFT CLEAN OR DEPOSIT WILL FORFEITED. Stables will be inspected for cleanliness CAMPING -FRI SAT SUN PLEASE CIRCLE Camping @ $20 per site per night nights x sites @ $20 each *NON MEMBER SHOWING LEVY @ $15 per person- see programme PLEASE ENSURE 1 FORM PER PERSON IS COMPLETED more available at Show Office people @ $15 each Total: I hereby apply to enter the events indicated above. I have read the Conditions of Entry and agree to abide by them at all times. I am a financial member of all Breed Societies listed above that require financial membership to show. I hereby release Dilutes Australia Ltd and the Queensland Branch from any claim, accident, injury or loss that may occur to any person (competitor or spectator), property or livestock during the course of the show. Signature: Date: * Non Member Showing Levy explanation in programme on pages 2 & 4
Page 2 2017 Colourama Spectacular Entry Form Owner s Name. All persons must complete and sign a waiver form and submit with your entries IF COPIES OF ALL REGISTRATIONS AND MEMBERSHIPS ARE NOT ENCLOSED WITH ENTRIES, THEY WILL BE RETURNED. Class Numbers @ $8 each TOTAL $ Class Numbers @ $8 each TOTAL $ 2 TOTAL ENTRIES PAGE 2 $.
Horse Health Declaration BIOSECURITY INFORMATION Competitors MUST complete Pre-Movement Biosecurity Declaration (see below). This form MUST be handed into the Office. These will be recorded against entries- No form no ride!!!!!! EVENT Name: COLOURAMA SPECTACULAR 2017 Declaration by owner or person in charge of horse/s I, declare that the horse/s named above has / have been in good health, eating normally and not shown signs of illness during the last 3 days leading up to the above mentioned event. I give my authorisation for the designated Steward to call for veterinary inspection of the horse/s named above and in my care should they be showing signs of illness at any time during the course of the event. I agree to pay any veterinary fees incurred as a result of this. I AGREE TO ENSURE THAT: 1. If required before movement, all horses will be shampooed, rinsed and allowed to dry, and their hooves are picked clean of all solid material and washed with shampoo. 2. All vehicles and equipment accompanying the horses should be in a clean condition at the start of travel to the above mentions event. 3. The information contained in this Horse Health Declaration is true and correct to the best of my knowledge. 4. I agree to abide by all conditions and directions of the EQ rules and regulations and Event organisers. 5. I acknowledge that failure to comply with the above may result in refusal of entry to the venue, disqualification or other disciplinary action as decided by DA Judiciary / Disputes Committee. 6. In the event of horse movement restrictions, each participant will be responsible for the care, maintenance and cost of their horse including feeding and watering. Name Signature Date 3
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