Declaration

Declaration:

I agree to become a member of the Fortuna Ltd Syndicate I am purchasing shares in and I:

1. Acknowledge receipt of the Disclosure Statement together with the accompanying Syndicate Agreement (“the Agreement”) and
2. Confirm that the Disclosure Statement and the Agreement have been read and understood by me; and
3. Agree to be bound by the terms set out in the Disclosure Statement and the Agreement; and
4. Grant the powers and authorities given to the Manager and the Promoter under the Disclosure Statement and the Agreement including the granting of the Power to the Manager and the Promoter to sign all documents required by any Thoroughbred Racing Authority or Jurisdiction on my behalf; and
5. Declare that I have attained the age of 18 years, that I am not for any reason prohibited from owning a racehorse or prohibited from admission to a racecourse and I am not a person to whom the provisions of rule 411(b) of the Rules of New Zealand Thoroughbred Racing apply.