FEDERATION EQUESTRE INTERNATIONALE Certificate of Capability

2015 PanAmerican Games, Toronto (CAN) , 10-25 July 2015 JUMPING

TO BE RECEIVED NO LATER THAN 15th JUNE 2015 BY: FEI Jumping Department

email , fax +41 21 310 47 60

CERTIFICATE OF CAPABILITY


DISCIPLINE: JUMPING One Certificate per discipline (Jumping)

The National Federation of: ______The undersigned acting as President: ______

hereby declares that the hereunder mentioned competitors and horses have the experience and qualifications required to take part in Jumping in the 2015 PanAmerican Games, Toronto (CAN) for which they have been entered and that their performances entirely satisfy the standards as laid down by the appropriate FEI Regulations. Please find enclosed the record of results sheet confirming their qualifications.

The maximum number of competitors/horses allowed to be listed on these forms is double the number permitted to participate in the 2015 PanAmerican Games, Toronto (CAN) NFs are kindly requested to email or fax to submit the number of forms necessary to include the number of participants entitled to be nominated. Note: Incomplete forms will not be accepted.

COMPETITORS / HORSES
SURNAMES & FIRST NAMES (capital letters) / FEI REGISTRATION NUMBER / NAMES / PASSPORT N° AND / OR FEI REGISTRATION N° / YEAR OF BIRTH / SEX / COLOUR / BREED / COUNTRY OF BIRTH
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COMPETITORS / HORSES
SURNAMES & FIRST NAMES (capital letters) / FEI REGISTRATION NUMBER / NAMES / PASSPORT N° AND / OR FEI REGISTRATION N° / YEAR OF BIRTH / SEX / COLOUR / BREED / COUNTRY OF BIRTH
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Date: ……………..….. Signature: ………………………………… SEAL OF NF

FEDERATION EQUESTRE INTERNATIONALE Certificate of Capability

2015 PanAmerican Games, Toronto (CAN) , 10-25 July 2015

JUMPING

NAME OF NATIONAL FEDERATION:
Name & First Name(s) of Competitor:
Date of birth of competitor:
Competitor FEI Registration No:
Name of horse & FEI Registration number:
Age of horse:

One Record of Results form per athlete / horse to be completed and annexed to the Certificate of Capability.

Athletes and horses must obtain the qualification for the 2015 PanAmerican Games, Toronto (CAN) at events between 1 January 2014 and 15 June 2015. All athletes and horses, not necessarily as a combination, must obtain a Certificate of Capability by obtaining a result of not more than eight penalties in the first round of a Table A competition (Art. 238 or 273) with a minimum height of 1.50m at a CSI(-W) or CSIO(-W) Outdoor Event or a Special Qualifying Outdoor competition.

Date / Event / Category / Competition / Result

The undersigned hereby declare that the above information is correct.

Place & Date: ………………………………….. Competitor: …………………………………………..

Place & Date: ………………………………….. President of NF: ……………………………………..

Seal of the NF: