Particulars of Rider

1. NAME

2. PASSPORT/NIRC NO

3.COUNTRY/CLUB

4. DATE OF BIRTH 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 JANUARY FEBRUARY MARCH APRIL MAY JUNE JULY AUGUST SEPTEMBER OCTOBER NOVEMBER DECEMBER    5. AGE

6. OCCUPATION

7. SEX MALE FEMALE 8. NETT WEIGHT (KG)

9. FEI REGISTRATION ID

10. ADDRESS

11. POSCODE   12. CITY

13. STATE

14. COUNTRY

15. PHONE 16. FAX

17.  MOBILE

18. EMAIL

19. NAME AND CONTACT NUMBER OF PERSON IN CASE OF EMERGENCY

NAME

CONTACT NO

20. BRIEFLY STATE YOUR (RIDER) EXPERIENCE IN ENDURANCE RIDES

Particulars of Horse

1. NAME OF HORSE

2. BREED

3. HORSE'S STUD BOOK INITIALS

4. COUNTRY OF BIRTH

5. SEX MALE FEMALE   6. AGE 7. FEI REGISTRATION ID

8. BRIEFLY STATE YOUR (HORSE) EXPERIENCE IN ENDURANCE RIDES

Horse passport MUST be made available and surrendered to the Secretariat during the registration.

Enclosed please find cash / bank draft [#] in the sum of RM as Participation Fees together with the Stabling Fees of RM200.00.[ Payment is to be made payable to: EDARAN ENDURANCE CLASSIC ] #

In consideration of the Organizing/Working Committee of the EDARAN ENDURANCE CLASSIC 2007 allowing me to participate in the said Ride; I hereby for myself, my hires, assign executors and administration, shall at all time hereafter keep the Organizing/Working Committee, the Sponsors and any other persons or bodies however connected with the Ride together with their heirs, assigns, assign executors and administrators indemnified against all actions proceedings liability claims damages cost and expenses arising out of any damages, loss of life or injuries whether permanent or temporary sustained or suffered by me or my animal or any damage or loss of my properties during the entire duration of Ride.