PARTICIPATE IN THE 55+ BC GAMES

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Published: September 1, 2017 Page 1 of 5

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The 55+ BC Games is an annual multi-sprt event prduced by the BC Senirs Games Sciety fr the availability f the Active fr Life cmmunity t participate in the 27 individual Sprts. The average participatin is 3,500, leaving behind a $3.5 M ecnmic impact in the cmmunity. PARTICIPATE IN THE 55+ BC GAMES 2017! Equestrian Cmpetitin: Wednesday, September 13th, 2017 t Saturday, September 16, 2017. Venue: Armstrng Fairgrunds, 3371 Pleasant Valley Rd, Armstrng, BC V0E 1B0 55+ BC Games Website: http://www.55plusbcgames.rg/ 55+ BC Games 2017 Vernn & Area Website: http://www.55plusgames.ca/ Sprt Chair Equestrian: Carlyn Farris Email: c.farris@hcbc.ca Phne: 250-546-6083 Fr mre infrmatin cntact: Hrse Cuncil BC Email: cmpetitin@hcbc.ca P 604-856-4304 ext. 1005 F 604-856-4302 Tll Free 1-800-345-8055 x 1005 Equestrian Events will be gverned by the 2017 HCBC Rule Bk. Exhibitrs may register fr mre than ne sprt discipline at the 55+ BC Games, hwever, crss entry will be limited t a maximum f tw divisins. Dressage: First Level and Secnd Level EC Tests 2 & 3 Western Dressage: Training Level and First Level HCBC Tests 2 & 3 Muntain Trail Hrse Open Western Perfrmance: Ranch Riding Hrse & Ranch Trail Hrse Driving: Pleasure Driving & Arena Driving Derby Equestrian Sprt Schedule: (Tentative Subject t Entries) Wednesday, September 13 Participant Check in at 55+ BC Games Accreditatin Center Stabling Open. Thursday, September 14 Cmpetitin Day 1 8 am 5 pm Dressage, Western Dressage, Ranch Riding Hrse. 1 pm 5 pm Muntain Trail, Ranch Hrse Trail, Pleasure Driving, Driving Derby Friday, September 15 Cmpetitin Day 2 8 am 5 pm Dressage, Western Dressage, Ranch Riding Hrse 1 pm 5 pm Muntain Trail, Ranch Hrse Trail, Pleasure Driving, Driving Derby Saturday, September 16 Clsing Ceremnies Registratin Deadline: HCBC received by June 30 th, 2017. Ttal Entry Fees: $ 95.00 (includes GST) Cmplete all f the fllwing entry frms: 55+ BC Games Equestrian Sprt Frm Cst $20.00 BC Senir Games Sciety Membership Frm Cst $20.00 55+ BC Games Registratin Frm Cst $50.00 Waiver Frm signed, dated, witnessed GST $5.00 HCBC members may submit cmplete registratin frms with payment by cheque r credit card t: Hrse Cuncil BC, 27336 Fraser Hwy, Aldergrve, BC V4W 3N5 email; cmpetitin@hcbc.ca P 604-856-4304 x 1005 F 604-856-4302 Tll Free 1-800-345-8055 HCBC will submit all entry frms with payment t 55+ BC Games Zne Representatives.

Year 2017 EQUESTRIAN SPORT FORM Zne Entries must cmply with 55+ BC Games Sprt Specific Rules and the BCSGS Rules and Plicies Categry: 55-64 65+ Preferred First Name Last Name Tests/classes/patterns will be ridden each day and the results will be determined by the cmbined High scre f bth days. Participant must ride the same hrse bth days. Cmpetitin t be Gverned by the HCBC Rulebk. Driving Arena Driving Trials Pleasure Drive Driving Derby Hrse Pny VSE Dressage EC Tests 2 and 3 will be used in each level First Level Secnd Level Western Dressage HCBC Western Dressage Tests 2 and 3 will be used in each level Training Level First Level Western Perfrmance Ranch Riding Hrse Ranch Trail Hrse Muntain Trail Patterns t be psted day f cmpetitin Open Stabling Fees (PAYABLE UPON ARRIVAL AT EQUESTRIAN VENUE) (Internal zne registratin nte: enter as an event ) $ 25.00 per day per hrse fr stabling in permanent shw stalls Includes shavings and manure remval $ 25.00 refundable cleanut depsit fr stabled hrses. If wners clean ut their stall n Departure the depsit is returned $ 15.00 per hrse per day haul-in fee fr hrses that d nt stable at Armstrng Exhibitin Grunds Hw many hrses are yu bringing t the Games? Maximum 2 hrses per rider (Internal zne registratin nte: put name f hrse in partner field ) One: Name f hrse: Reserve Stall Tw: Name f hrse Reserve Stall

MEMBERSHIP FORM WE STRONGLY RECOMMEND THAT ALL PARTICIPANTS OBTAIN SUPPLEMENTAL HEALTH / DENTAL INSURANCE TO PROTECT THEIR INTERESTS IN THE EVENT OF INJURY. Initial SPORT Zne # (if applicable) Current Year Preferred First Name Last Name Mailing Address City Pstal Cde Cntact Phne # Email Address It will nly be used t send yu BCSGS crrespndence and infrmatin pertinent t the Games Gender Male Female Birth Date YYYY MM DD Membership in the BC Senirs Games Sciety requires a yearly membership fee f $20.00. A signed cpy f the Release f Liability, Waiver f Claims and Assumptin f Risk Frm is needed t participate in the 55+ BC Games. This entitles a member t participate fr any Zne play-ff that may be needed. There will be additinal fee(s) fr thse wh enter the Games. A Registratin Frm signed by each member is a requirement f ur Risk Management and a cnditin f entry in Zne play-ffs and the 55+ BC Games. The Release f Liability, Waiver f Claims and Assumptin f Risk Frm will be stred as part f the Zne recrds. Participant infrmatin is cllected under the authrity f the BC Senirs Games Sciety as cllectr and custdian f this infrmatin. The infrmatin prvided will be used t determine the eligibility t participate in the annual 55+ BC Games. The name, hme twn, and sprt f the registered participant will be prvided t media utlets and available n the BC Senirs Games Sciety and/r the annual Hst Sciety websites. The name, address, and image f the registered Participants may be used in nn-cmmercial prmtin/develpment f sprt by the BC Senirs Games Sciety. The names and addresses, and images may be prvided t the Premier and the Minister Respnsible fr Cmmunity, Sprt, and Cultural Develpment. The annual Hst Sciety, the BC Senirs Games Sciety, the BC Games Sciety, and the Prvince f British Clumbia d nt assume respnsibility fr lss f wages, medical, dental r hspital care fr athletes, fficials, r vlunteers during the annual Games r as a result f participatin in the Games. Signature Date If yu will be a participant r nn-participant at the Games, yu must cmplete the Registratin Frm. Revised Nvember 2016

REGISTRATION FORM Year * Zne * Sprt * Preferred First Name* Last Name* (This frmat is hw yur name will appear n yur badge, schedules, draws, results, etc.) Membership Status* Participant Nn-Participant Member Gender: * Male Female Birthdate: * / / Year Mnth Day Hme Phne* Cell Phne Email Address Emergency Cntact Name* Phne N. 1* (fr use during the Games) Emergency Cntact Phne N. 2 (fr use during the Games) Hme Address* City* Pstal Cde* Prvince BC Cuntry Canada Waiver signed * Yes N Transprtatin Required* Yes Nt Required Is this persn a new member? * Yes N OPTIONAL: Are yu f Abriginal ancestry including First Natins, Metis, Inuit? Yes N I,, signed and dated n cnfirm that I agree that all f my abve infrmatin is true in this registratin applicatin. *these items are mandatry Please make cheques payable t BC Senirs Games Sciety Zne # FOR ZONE USE ONLY: Registrars/Crdinatrs may use this sectin as part f their recrd keeping: BCSGS Membership ID # Membership Card issued Yes N Date Online Registratin Cmpleted Date OnLine Registratin Checked Membership Fee ($20.00 Paid Participant Fee ($50.00) Paid Nn Participant Fee ($35.00) Paid Sprt Fee Paid Revised December 2016

RELEASE OF LIABILITY, WAIVER OF CLAIMS AND ASSUMPTION OF RISK BY SIGNING THIS DOCUMENT YOU WAIVE CERTAIN LEGAL RIGHTS INCLUDING THE RIGHT TO SUE! Initial PLEASE READ CAREFULLY! I, (please print name f participant) agree that in cnsideratin f being permitted t participate in the 55+ BC Games (the Event ), and all related activities rganized r perated by the Hst Sciety, the BC Senirs Games Sciety and the BC Games Sciety: 1. I WAIVE ANY AND ALL CLAIMS I MAY NOW HAVE AND IN THE FUTURE HAVE AGAINST, AND RELEASE FROM ALL LIABILITY AND AGREE NOT TO SUE the Hst Sciety, the BC Senirs Games Sciety, the BC Games Sciety, and the Prvince f British Clumbia, their members, fficers, directrs, emplyees, spnsrs, independent cntractrs, vlunteers and agents (cllectively, the Released Parties ) fr any persnal injuries, death r prperty lsses which I may suffer as a result f my participatin in the Event due t any cause whatsever, including, withut limitatin negligence, breach f statutry duty including duties arising frm ccupier s liability legislatin n the part f the Released Parties. 2. I ACKNOWLEDGE THAT THERE ARE SERIOUS DANGERS AND RISKS OF BODILY INJURY, INCLUDING PERMANENT DISABILITY, PARALYSIS AND DEATH, AND PROPERTY LOSS INHERENT IN PARTICIPATING AT THE 55+ BC GAMES. These dangers and risks may be caused by my wn actins, inactin r negligence r by the actin, inactin r negligence f thers including the Released Parties r ther participants in the Event. 3. I FULLY ACCEPT ALL THE ABOVE DANGERS AND RISKS, AND ASSUME ALL RESPONSIBILITY fr any lss that I may suffer as a result f my participatin in the Event. 4. In entering in t this agreement, I am nt relying n any ral, written r visual representatins r statements made by the Released Parties t induce me t participate in the Event. 5. I cnfirm that I am 19 years r age r lder and I have read and understd this agreement prir t signing it and agree that this agreement will be binding n my heirs, next f kin, executrs, administratrs and successrs. SIGNED ON THIS DAY OF, 20 Witness Signature Participant s Signature Witness Printed Name Revised Nvember 2015