Office Use Only Data Input by ………….…… ABN: 65 861 621 504 Junior Judges/Paraders Nomination Form By nominating below, I confirm that I (and/or my Guardian) have read the Show Rules, Conditions of Entry and the Dangerous Activity Acknowledgement and agree to be bound thereby. Exh No Office Use Only Sect No Class No Name of Junior Judge/Parader Telephone (07) 4091 4260 Age of Judge/ Parader School or Stud Name Email: athertonshow@westnet.com.au Phone No Paraded Y/N Stewards Web: www.athertonshow.com.au Placing Steward Use Only Dangerous Activity Acknowledgement In consideration for being permitted to participate in any way in cattle/goat handling activities, I understand, acknowledge and accept: • • • That cattle/goat handling is a dangerous activity and cattle/goats can act in a sudden and unpredictable (changeable) way, especially if frightened or hurt. That there is a significant risk that serious injury or death may result from cattle/goat handling activities. The dangers associated with the consumption of alcohol or any mind altering drugs and agree not to drink alcohol or take drugs prohibited by law before or during any cattle/goat handling activities. I agree to follow the directions of any event organiser or official and that any misconduct or refusal by me to follow any direction of any organiser or official can result in the cancellation of my participation in the activities and my immediate removal from the Arena or the Showgrounds no matter where that may occur. I agree to take all appropriate safety measures at all times whilst participating in the activities. I agree to indemnify the Atherton Tableland Agricultural Society Inc, against Liability for any accident, damage, loss or illness caused to anyone, including but not limited to myself or my property, or a member of the public during any part of the event, including but not limited to preparation, competition, judging, performing or displaying. I have had sufficient opportunity to read this Dangerous Activity Acknowledgement and fully understand its terms and sign it freely and voluntarily. Signature of participant …………………..……………………………………… Date………………………………...…… For Participants of Minority Age (Under Age 18) This is to certify that I, as a parent/guardian with legal responsibility for this participant, acknowledge, understand and accept all of the above and consent and agree to my minor child's involvement or participation in wood-chopping activities. Signature of guardian ………………..……………………………………… Date……………………………………...…… Telephone (07) 4091 4260 Email: athertonshow@westnet.com.au Web: www.athertonshow.com.au