2016 Official Prize List with entry form

May 6, 2016 Opening Date:
June 6, 2016 Closing Date – In secretary’s Hand or by electronic entry
USEF/USDF #682 USEF Level 2
AQHA Approved
Foothills Equestrian Nature Center 3381 Hunting Country Rd, Tryon, NC 28782
NCDCTA
SUMMER HIGHLAND FLING DRESSAGE
Saturday & Sunday, 25-26, 2016
2016 Great American Insurance Group / USDF Regional Qualifier,
2016 CBLM Qualifier
USDF/Dover Adult Amateur Medal Program.
AQHA Approved – Earn AQHA Dressage Points+
Get All Show Information at www.ncdcta.org/SHF.html
Entry Secretary/Manager
Sandy Donovan , Dressage Services
PO Box 980
Southern Pines, NC 28388
E-mail: [email protected]
901-218-0613 (M)
Asst. Mgr/ Secretary
Olga Wagner
Co-Secretary: Lisa Harders
Competition Licensee
NCDCTA: Lynn Kerin, President
www.ncdcta.org
NightWatch / Braiding:
Amy Struzzieri 845-220-7206
[email protected]
Technical Delegate:
Joe Coleman “r” KS
JUDGES: Dolly Hannon (S) CO,
Marlene Schneider (S) MN
Others TBA
Farrier on Call: Number at show office
Photographer:
WNC Photography/[email protected]
EMT: Wade Harden
Videographer: Del Greenwell
Veterinarian on Call:
Tryon Equine 828-894-6064
Safety Officer: Sandy Donovan
ON LINE ENTRIES are through:
www.horseshowoffice.com. There is no
charge for this service.
EVERY CLASS OFFERED HEREIN WHICH IS COVERED BY THE RULES AND SPECIFICATIONS OF
THE CURRENT FEDERATION RULE BOOK WILL BE CONDUCTED AND JUDGED IN ACCORDANCE
THEREWITH.
All Classes are run in their entirety; pinned by Division
Note: No memberships or Horse ID are required for Intro and Opportunity Classes. Opportunity Classes
are also exempt from the $16 USEF drug fee.
BLM= Colonel Bengt Ljunquist Memorial Championship qualifying class. WWW.CBLM.ORG
Q=Qualifying class for Great American Insurance Group/USDF Regional Championships. State
qualifying on entry and add $10.
J=Juniors/Young Riders-list birth date on entry; A=Amateur-enclose copy of USEF Amateur card with
entry or will be considered open. O=Open
All classes will be run in their entirety and pinned AA, Jr/YR and Open. Classes may be split if entries
warrant. Please include rider status after class number.
**Freestyle TOC = Please state level on entry. Training Level Freestyle is NOT a Qualifying test.
*Test of Choice—to include FEI classes not offered above
***Class 287 Measured Ponies may enter and ride any regular (USDF, USEF, FEI) test.
Competitors in Opportunity Classes may not Cross Enter into Recognized Classes
Classes will all be held in outdoor arenas weather permitting.*
CLASS LIST
SAT
21
22
23
201
202
202N
203
203N
205
211
212
213
215
221
222
223
SUN
31
32
33
301
302
203N
303
303N
311
312
313
321
322
323
CLASS
USDF Intro Test A
USDF Intro Test B
USDF Intro Test C
Training Test 1
Training Test 2 BLM
Training Test 2 Opportunity
Training Test 3 GAIG-Q
Training Test 3 Opportunity
Training Level Rider Test
First Test 1
First Test 2 BLM
First Test 3 GAIG-Q,
First Level Rider Test
Second Test 1
Second Test 2 BLM
Second Test 3 GAIG-Q
(Class 223 is the USDF/Dover Medal AA Class)
225
231
232
233
241
242
243
251
252
253
231
332
333
341
342
343
351
352
353
Second Level Rider Test
Third Test 1
Third Test 2 BLM
Third Test 3 GAIG-Q
Fourth Test 1
Fourth Test 2, BLM
Fourth Test 3 GAIG-Q
PSG- GAIG-Q, BLM
Intermediare I GAIG-Q, BLM
FEI Intermediare II, GAIG-Q, BLM
SAT
254
260
261
262
263
264
SUN
354
255
256
360
361
362
363
364
CLASS
FEI Grand Prix GAIG-Q, BLM
FEI Young Rider Team Test Q
FEI Junior Rider Team Test Q
USEF 4 Year Old Test Final
FEI 5 Year Old Test Final
FEI 6 Year Old Test Final
USEF Developing PSG
USEF Developing GP
271
371
USDF Freestyle TOC, Q (State
272
372
FEI Freestyle TOC, Q (State level on
280
380
FEI TOC (not previously listed. No
freestyles)
level. Training is not a qualifier)
entry)
281
381
FEI Para-Equestrian TOC (State
282
382
FEI Para Equestrian MFS TOC
385
287
294
295
296
297
level on entry –Standard arena)
(State Level on Entry – Standard Arena)
TOC Pony (State level on entry)
NDPC Pony Cup TOC
391
Dressage Seat Equitation (Jr/YR)
392
Dressage Seat Equitation (Adult)
Materiale
Division
394
Three Year Old Fillies
395
Three Year Old Colts/Geldings
396
Four and Five Year Old Mares
397
Four/Five Year Old Stallions/
Geldings
FEES
Intro/Materiale/DSE/Opportunity
USEF Training – Fourth & Rider
FEI & Test of Choice
and Young Horse, etc (requiring 2 judges)
Musical Freestyles
$ 40
$ 50
$ 60
GAIG/USDF Qualifying add
Office fee
USEF fee per horse
$ 10
$ 25
$ 16
Guest Horse (Plus Office fee & Stall)
Late fee
Add/change fee/per class
$ 35
$ 35
$ 10
Non-compete/weekend
USEF Show Pass (non-member)
USDF non-member
USDF Affidavit
$ 30
$ 25
$ 5
per rider, owner, trainer, coach
Stall Fri noon – Sun PM
$115
including Tacks
RV hookup/per night
Stall Single night (2 bales)
Additional stall or tack/nights (arrive early or stay over
Additional Bedding/Bale
$
$
$
$
Includes water and electric
Day Parking
$ 35
(D & M: $8, USEF: $8)
(All stalls include 2 bales – Fri noon – Sun pm)
$ 60
40
70
35
8
per entry
Exempt: changes due to scheduling conflict
per rider, owner
per rider, owner
Order with Entry. Limited shavings available on grounds.
(per day per horse not stabled on grounds—including schooling day)
LEVELS: Intro – Grand Prix. All tests will be current editions. 20 X 60 m rings. Intro and Opportunity
classes are exempt from all horse ID and membership requirements. Opportunity classes also exempt
from $16 USEF fee.
AWARDS: Trophy and six ribbons.
All Classes will be scheduled as “Open” classes and ribbons will be pinned as Open, JR/YR and AA.
Master’s High Score Award – for entries with combined horse + rider age exceeding 65 years.
High point ribbons JR/YR, AA, Open & Masters. High scores will apply to Friday and Saturday Classes
only. USDF/Dover AA Medal will be for Saturday, DSE awards and more. See Website or contact
secretary for more. Special National Dressage Pony Cup Ribbons will be awarded for Class 287.
ENTRIES: Each Mailed Entry Must Have Hard Copies of All Required Documentation Attached. Include
LEGIBLE e-mail address on entry. ON LINE ENTRIES are through: www.horseshowoffice.com. There
is no charge for this service.
Make checks payable to “DRESSAGE SERVICES” and mail with hand written entry and current negative
coggins to Entry Secretary Sandy Donovan. Full refund if scratch is received by closing date less $25
office fee. After closing date: Q fees, USEF fees, and extra bedding refunded (once all indebtedness is satisfied),
for notified scratches through the end of the competition. Once competition finishes any unrefunded USEF or USDF
monies will be sent to the Federation. No class or stabling refunds after closing date, including classes cancelled
due to weather, terrorism, or acts of God. No refunds after closing date or after start of competition.
Post entries will be placed on a waiting list to fill scratches. Express deliveries can be sent to the physical
address Sandy Donovan, 195 Woodbine Way, Carthage, NC 28327 . Be sure to specify “NO Signature
Required” in case the secretary is away at time of delivery.
Guest horses are welcome but must send in a completed entry form with plus the $25 office fees, $35
Guest Horse Fee, submit a current coggins, and pay either stabling or day parking.
Bounced check policy: $25 fee; waitlisted until cashier’s check received.
Music for freestyles must be provided by the competitor to announcer at least two hours prior to the start
of the freestyle class. Freestyle entries must include a copy of a test scoring over 60% at the highest test
of the level. Arrange with the announcer to schedule a sound check before your ride.
TIMES: Official times available Friday at the secretary’s stand. Unofficial times and stabling will be emailed
to competitors and posted on website www.ncdcta.org/SHF.html. the Tuesday before the show.
STABLING: 302 Permanent stalls (10’ x 10’) with doors in shed row barns. Initial bedding = 2 bags for all
stalls including Tack stalls. Additional bedding is available for advance purchase – pre-order on stabling
form and pay with entry. Very limited shavings at show grounds
ACCOMMODATIONS: Days Inn, Columbus, NC 828-894-3303; Melrose Inn 828-859-0234; Red Horse
Inn, Landrum, SC 864-895-4968; Howard Johnson, Spartanburg, SC 864-576-0042
http://www.fence.org/equestrian-center/where-to-stay gives many local B&B opportunities to get you off the
beaten hotel/motel track.
DIRECTIONS: – www.fence.org, do not use mapquest or GPS (not listed)
From I-26 take the first SC exit #1 (Landrum Hwy 14). Go 1.4 mile; turn right on Bomar Ave. Turn right on
Prince Rd, go 1.5 miles and just prior to the interstate bridge turn left on Hunting Country Rd. Go 1 mile.
Turn left into Equestrian facility after crossing narrow creek bridge.
ARENAS - Two irrigated 20 x 60 arenas and one covered 20 x 60 arenas and warm–up areas with allweather footing.
HOSPITALITY: Good food available on the grounds during the day. Enjoy the cold drinks and snacks on
the Show Office Porch as you check in on Friday. Explore www.fence.org to learn more about this unique
facility and the Tryon Area.
PONY MEASUREMENT: Will be available on grounds. If you want your pony measured at the show you
must contact Sandy Donovan ([email protected]) in advance to arrange a time. Tentative time
will be Saturday morning at 9:00. The Vet must be present with the TD, so scheduling is important.
Competitors will be responsible for paying for vet visit fee if one is charged.
OTHER: Entries accepted on a first come basis by postmark and/or date stamp on on-line entry.
Management reserves the right to combine or divide classes, add or substitute judges, or make changes as
required by circumstances. All dogs must be leashed. No dogs allowed in the covered arena.
ADULT DRESSAGE EQUITATION DIVISION AND JR/YR DRESSAGE EQUITATION DIVISION
Offered at Training, First and Second Levels. Equitation Division is made up of 2 classes: The Dressage
Seat Equititation and Rider Test. Three entries at a level to fill the Division (allows for a separate DSE
class) - less than 3 at a level will be combined with the next level. Scores from the Rider Test and the DSE
will be totaled to find the Division Champion and Reserve. Special ribbons and Championship Prize for
each Division. USEF AA status not required, but by entering the Equitation Division, competitors declare
themselves as Amateurs according to USEF GR 808.
NCDCTA 70% Club -- Become a member of the club! Earn TWO 70%+ scores at any USEF/NCDCTA
recognized show. Club members will receive Membership Pins to proudly display their accomplishments
and recognition on the NCDCTA website and Newsletter. The most number of 70%+ scores in 3 divisions
(Jr, AA, Open) will receive year-end awards and further recognition. Join NCDCTA and become a member
of this prestigious club! See www.NCDCTA.org for full details.
The Fine Print:
 DSE, MFS, Young Horse, rider Tests – any out of the mainstream tests do not count for the 70%
Club.
 NCDCTA membership is required – but membership can be obtained on the weekend/day of the
show where the scores are earned. In other words, a competitor, seeing that they have earned
two 70% scores may go online at www.ncdcta.org and join NCDCTA during the show weekend
and those scores will earn them membership in the NCDCTA 70% Club (along with the other
benefits of the NCDCTA membership).
 Horses do NOT have to be registered with NCDCTA
 Owners do NOT have to be members of NCDCTA
 NCDCTA 70% Club Pins will be mailed to Club Members as soon as their scores are earned –
pins will be mailed to the address given with their NCDCTA membership.
 In the case of a tie for year-end prizes, the highest single score will break the tie. If the highest
single score of the year is also tied, both competitors will receive recognition and the prize.
 See www.ncdcta.org/70percent.php for details of the program, recognition of all members of the
Club and score tracking. Your show(s) are also recognized on this page – with links to your own
show websites and contact information.
 Questions about the program should be directed to: [email protected]
NCDCTA Junior Scholarships to NCDCTA Shows!
In order to encourage juniors of all levels to take advantage of our state's competitive dressage
environment, NCDCTA is pleased to offer scholarships to up to four junior riders (riders 18 and
under as of December 31, 2016) at each of its five shows in 2016
Each scholarship will cover the cost of four classes, one stall, and a shared tack stall. This
application, due by the show's opening date, will be reviewed by a committee of NCDCTA board
members. Applicants do not need to be NCDCTA members. Scholarship criteria include
enthusiasm, thoughtfulness in application, and dedication to competition as part of ongoing
education in dressage. Recipients will be responsible for the cost of classes beyond four, as well
as the office fee, the USEF drug fee, and any other applicable fees, including but not limited to
the USDF/GAIG qualifying fee and non-member fees. Decisions and entry procedures will be
announced before the show's closing date.
NCDCTA 2016 Shows:

NCDCTA Capital Dressage Classic – June 3-4-5, 2016 - Raleigh, NC
o Application Deadline - Opening Date: April 1, 2016
o Entries Recieved by - Closing Date: May 13, 2016
o Show Website: : www.EquestrianSecretarial Services.com
o Online Application: http://www.ncdcta.org/scholarships.php

NCDCTA Summer Highland Fling - June 25-26, 2016 - Tryon,NC
o Application Deadline - Opening Date: May 6, 2016
o Entries Recieved by - Closing Date: June 6, 2016
o Show Website: www.ncdcta.org/SHF.html
Online Application: http://www.ncdcta.org/scholarships.php




NCDCTA Labor of Love - August 20-21, 2016 - Pinehurst, NC
o Application Deadline - Opening Date: July 10, 2016
o Entries Recieved by - Closing Date: August 1, 2016
o Show Website: : www.EquestrianSecretarial Services.com
Online Application: http://www.ncdcta.org/scholarships.php

Great American Insurance Group/United States Dressage Federation Region 1
Dressage Championships and NCDCTA Autumn Leaves Dressage
o September 15-18, 2016 Carolina Horse Park, Raeford, NC
o Application Deadline - Opening Date:July 25, 2016
o Entries Recieved by - Closing Date: August 22, 2016
o Show Website: : www.EquestrianSecretarial Services.com
o Online Application http://www.ncdcta.org/scholarships.php

NCDCTA Harvest Moon (2016 NCDCTA Dressage Championships) –
o October 29-30 Carolina Horse Park, Raeford, NC
o Application Deadline - Opening Date: September 1, 2016
o Entries Recieved by - Closing Date: October 10, 2016
o Show Website: : www.EquestrianSecretarial Services.com
o Online Application http://www.ncdcta.org/scholarships.php
ENTRY DOCUMENTATION REQUIREMENTS
 Current USEF membership (or n/m fees) for Rider, Owner and Trainer, Coach
 Current USDF membership (or n/m fees, number) for Rider and Owner. Rider’s USDF
membership may be either Participating or Group, Owner’s USDF membership may be
Participating, Group or Business; if Rider/Owner’s USDF # is a non- member ID #, the USDF
non-member fee must be paid.
 USDF Horse ID.
 Current (1 Yr) negative coggins.
 For Adult Amateur classes - USEF membership card must declare Amateur.
 Juniors and Young Riders must include birthdate.
 Freestyle entries - copy of a 60% + at the highest test of the MFS level or higher.
FOR GAIG / USDF QUALIFYING CLASSES ALSO INCLUDE:
 Check "Qualifying" and add $10 per Qualifying class.
 Copies of USEF and USDF Horse Registrations (not HID #s).
 Rider must have current Participating USDF membership; Owner must have current Participating
or Business USDF membership.
 Rider and Owner must have current USEF membership.
ALL ENTRIES must have THREE signatures - Rider, Owner and Trainer.
Legal Guardian must sign for riders under 18 yrs. Trainer blank must be signed by person
over 18 who assumes responsibility for horse at the show. (Parents who sign as trainer are
exempt from membership requirements).
Headgear:
From the time horses are officially admitted to the competition grounds by competition
management, anyone mounted on a horse at any time on the competition grounds, including noncompeting riders, riders on non-competing horses, and those competing in all classes and tests, including
Para-Equestrian tests, must wear protective headgear as defined by this rule and otherwise in compliance
with GR801. Any rider violating this rule at any time must immediately be prohibited from further riding until
such headgear is properly in place. Protective headgear is defined as a riding helmet which meets or
exceeds ASTM (American Society for Testing and Materials)/SEI (Safety Equipment Institute) standards for
equestrian use and carries the SEI tag. The harness must be secured and properly fitted. Unless jackets
are waived, while in the competition ring, exhibitors wearing protective headgear must wear a short, dark
jacket, dark tailcoat (only permitted for tests above Fourth Level), or Armed Services or police uniform (if
eligible), dark hat covers (where applicable) and must otherwise conform to DR120 (see GR801).
USEF MEMBERSHIP STATEMENT
Life, senior active and junior active members shall be eligible to participate in all classes at
Regular Competitions, Eventing Competitions at the Preliminary Level or above and
Combined Driving Competitions at the Advanced Level, Dressage, Reining and Vaulting
Competitions and Endurance Rides. A nonmember may participate as a handler, rider,
driver, owner, lessee, agent, coach or trainer at Regular Competitions, Eventing
Competitions, Dressage Competitions, Reining Competitions and Combined Driving
Competitions upon payment of a $30 Show Pass fee. Participants in the following classes
are exempted from the Requirements of this rule:
1) leadline; 2) exhibitions; 3) games and races; 4) classes for 4-H members; 5) walk trot and
academy classes (academy classes are classes limited to horses used regularly in a lesson
program); 6) USDF introductory level tests, pas de deux and quadrille classes; 7) NRHA
Endorsed Reining Competitions. 8) Opportunity classes, 9) citizens of other nations who
have proof, in English, of current membership in good standing of their own National
Federation, 10) USEA beginner novice division; and 11) assistant handlers in Dressage
Sport Horse Breeding classes
All questions not covered in these rules and regulations shall be decided by the show
management whose decision shall be final. Every horse entered for competition will comply with
the rules of the horse show management, but management will, in no case, be responsible for any
loss or damage that may occur, and it shall be condition of entry that each exhibitor shall hold
this horse show and the officials and employees of the show blameless for any loss or accident to
his horse, employees, equipment, which may occur from sickness, fire or otherwise. The
management reserves the right to refuse, accept conditionally, or to cancel any entries, disqualify
any riders or exhibitors, prohibit entries and cancel award prizes without claims for damages; to
cancel or combine unfilled classes, or to reschedule classes after due notice to exhibitors; to
change rings or rotate judges. Exhibitors are notified that any act of discourtesy or disobedience
to the judges or officials, on the part of the owner, manager, rider, or groom shall disqualify the
horse, and the owner shall forfeit his entry fee and other fees. Show management reserves to
itself the power to prohibit any person from attending or showing a horse in the ring and to
remove any groom or horse from the show without being liable for compensation. In accordance
with the 1989 Federal Waste Tracking Act, which restricts the disposal of medical waste, biohazardous medical waste containers will be provided in the stable area. All exhibitors and their
agents are responsible for the proper disposal of this waste. No person will be allowed in the
show ring during the time of judging except the exhibitor and those having official or requested
duties to perform. It is the tradition of the show that riders be correctly attired for the
class in question, that attendants be neatly dressed and the horses properly presented.
Management may in its discretion bar any person from entering the ring if not suitable presented
to appear before an audience.
Minors who do not have a valid driver’s license which allows them to operate a motorized
vehicle in the state in which they reside will not be permitted to operate a motorized vehicle of
any kind including, but not limited to, golf carts, motorcycles, scooters, or farm utility vehicles
on the competition grounds of licensed competitions. Minors who have a valid temporary license
may operate the above described motorized vehicles as long as they are accompanied by an adult
with a valid driver’s license. Violations of this rule will be cause for sanctions against the
parent(s), guardian(s), and/or trainer(s) who are responsible for the child committing the offense.
Penalties may include exclusion of the child, parent(s), guardian(s), and/or trainer(s) from the
competition grounds for the remainder of the competition and charges being filed against any of
the above individuals in accordance with Rule 6. Wheelchairs and other mobility assistance
devices for individuals with disabilities are exempt from this rule.
Federation Entry Agreement
By entering a Federation-licensed Competition and signing this entry blank as the Owner,
Lessee, Trainer, Manager, Agent, Coach, Driver, Rider, Handler, Vaulter or Longeur and on
behalf of myself and my principals, representatives, employees and agents, I agree that I am
subject to the Bylaws and Rules of The United States Equestrian Federation, Inc. (the
“Federation”) and the local rules of NCDCTA Southern Highland Fling Dressage and
PRELUDE. I agree to be bound by the Bylaws and Rules of the Federation and of the
competition. I will accept as final the decision of the Hearing Committee on any question arising
under the Rules, and agree to release and hold harmless the competition, the Federation, their
officials, directors and employees for any action taken under the Rules. I represent that I am
eligible to enter and/or participate under the Rules, and every horse I am entering is eligible as
entered.
I also agree that as a condition of and in consideration of acceptance of entry, the Federation
and/or the Competition may use or assign photographs, videos, audios, cable - casts, broadcasts,
internet, film, new media or other likenesses of me and my horse taken during the course of the
competition for the promotion, coverage or benefit of the competition, sport, or the Federation.
Those likenesses shall not be used to advertise a product and they may not be used in such a way
as to jeopardize amateur status. I hereby expressly and irrevocably waive and release any rights
in connection with such use, including any claim to compensation, invasion of privacy, right of
publicity, or to misappropriation. The construction and application of Federation rules are
governed by the laws of the State of New York, and any action instituted against the Federation
must be filed in New York State. See GR908.4
2016 ENTRY FORM
DRESSAGE COMPETITIONS
OFFICIAL USE
Due
COMPETITION
Duplicate copies of Entry Form. One horse per entry form. Name
Non compete horses must complete entry. Signatures required.
Date
Send to (Entry) Secretary. Form Date: February 1, 2016
Entry Complete Date
RIDER
OWNER
Street
Street
T/St/Zip
T/St/Zip
Phone
DOB (JrYR)
Email
Status
Phone
Citizenship
TRAINER
Email
PHONETIC
Emergency: Name / Phone
For Breed Show in Hand indicate Handler as Rider - If Unknown indicate Owner - Status: Open / JrYR / AA
HORSE
Pronunciation of difficult name(s)
Previous Name
Reg #
Breed
Sex
Color
Height
Coggins
Sire
Sire: Breed / Reg #
Sire: Owner
Dam
Dam: Breed / Reg #
Dam: Owner
Dam’s Sire
Country Birth
Year Birth
For Sale
Breeder
Coggins is required ~ Include Breed Papers with Entry for eligibility to breed specific special awards ~ Indicate USA, Born in The USA High Score Award
NUMBER
RIDER
OR NON MEMBER FEE
NUMBER
USEF / USDF MEMBERSHIP NUMBERS / FEES
OWNER
TRAINER
COACH ON GROUNDS
OR NON MEMBER FEE
USEF
$30 $ 0
$30 $ 0
USDF
$25 $ 0
$25 $ 0
NUMBER
OR NON MEMBER FEE
NUMBER
OR NON MEMBER FEE
$30 $ 0
NUMBER
HORSE
Req only for Qu
alifying
and Champ classes
$30 $ 0
Not Required
Not Required
$0
Include copy of all USEF and USDF membership cards or pay one Non Member Fee per person per show ~ Pay $5 Affidavit Fee for each missing copy of USDF Rider / Owner / Horse membership card
Missing card
Missing card
Missing card
Not Required
Not Required
USDF
$5 $ 0
$5 $ 0
$5 $ 0
Affidavit
Affidavit
Affidavit
MISCELLANEOUS FEES
FEI FIELDS
FEI Rider #
FEI Horse #
FEI Passport #
CDI competitors must indicate Rider Cizenship above, fill out these three FEI fields, and pay $35 IHP Fee
CLASS ENTRY FEES
NUMBER
Post Entry
Class Change
NonCompete
CDI IHP $35
RV/Camper
Paddock
Other Fee
Other Fee
DESCRIPTION
ENTRY FEE
ADDITIONAL
FULL PAYMENT MUST BE INCLUDED WITH ENTRY
TOTAL USEF / USDF FEES
$0
TOTAL CLASS ENTRY FEES
$0
TOTAL MISCELLANEOUS FEES
$0
TOTAL STABLING FEES
$0
OFFICE FEE
DRUG FEE
(CDI)
(See Prize List)
$16 ($8 Drugs/Meds / $8 USEF)
$28 ($20 Drugs/Meds / $8 USEF)
FORM TOTAL
$0
$0
TOTAL PAID
Notes
Additional Fee for $10 USDF Qualifying Fee ~ GADS Challenge $30, etc
STABLING
Horse Name
STABLING NIGHTS
Mon
Tues
Notes
Rider
Wed
Thurs
Notes
Stabling Group
Fri
Sat
Horse Sex
Stall(s)
.
Horse Stall
Lodging/Phone
Tack Stall must be same nights as Horse Stall ~
Tack Stall
Sun
Depart Day/Time
Arrive Day/Time
STABLING FEE TOTALS
Stalls
# Stalls
x Fee
= Total
$0
Shavings
# Bags
x Fee
= Total
$0
Stall Deposit # Stalls
x Fee
= Total
$0
Form Date: February 1, 2016
USDF CLAUSE
I hereby agree to release, indemnify and hold harmless USDF, its instructors, officers, directors, agents and volunteers from and against any and all loss, liability or damage arising from or because of, or in connection with, participation in this competition or related activities. I hereby agree to release, indemnify and hold harmless the show
management, show committee and members, officers, directors, agents and volunteers from and against any and all loss, liability or damage arising from or because of,
or in connection with, participation in this competition or related activities.
Under NC,VA,SC,GA AL and TN law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities
resulting exclusively from the inherent risks of equine activities. (N.C. Gen. Stat. §99E-1-3, VA Code Ann. § 1-796.130-133, S.C. Code Ann. § 47-9-710-730, § 12-4, GA
Code Ann, Code of Ala. § 6-5-337 (1994) and Tenn. Code Ann. § 44-20-101-105 respectively).
USEF MEMBERSHIP STATEMENT
Life, senior active and junior active members shall be eligible to participate in all classes at Regular Competitions, Eventing Competitions at the Preliminary
Level or above and Combined Driving Competitions at the Advanced Level, Dressage, Reining and Vaulting Competitions and Endurance Rides. A non-member may participate as a handler, rider, driver, owner, lessee, agent, coach or trainer at Regular Competitions, Eventing Competitions, Dressage Competitions,
Reining Competitions and Combined Driving Competitions upon payment of a $30 Show Pass fee. Participants in the following classes are exempted from the
Requirements of this rule: 1) leadline; 2) exhibitions; 3) games and races; 4) classes for 4-H members; 5) walk trot and academy classes (academy classes
are classes limited to horses used regularly in a lesson program); 6) USDF introductory level tests, pas de deux and quadrille classes; 7) NRHA Endorsed
Reining Competitions. 8) Opportunity classes, 9) citizens of other nations who have proof, in English, of current membership in good standing of their own
National Federation, 10) USEA beginner novice division; and 11) assistant handlers in Dressage Sport Horse Breeding classes.(GR901.9)
USEF FEDERATION ENTRY AGREEMENT
By entering a Federation-licensed Competition and signing this entry blank as the Owner, Lessee, Trainer, Manager, Agent, Coach, Driver, Rider, Handler, Vaulter or
Longeur and on behalf of myself and my principals, representatives, employees and agents, I agree that I am subject to the Bylaws and Rules of The United States
Equestrian Federation, Inc. (the “Federation”) and the local rules of the competition. I agree to be bound by the Bylaws and Rules of the Federation and of the competition. I will accept as final the decision of the Hearing Committee on any question arising under the Rules, and agree to release and hold harmless the competition,
the Federation, their officials, directors and employees for any action taken under the Rules. I represent that I am eligible to enter and/or participate under the Rules,
and every horse I am entering is eligible as entered.
I also agree that as a condition of and in consideration of acceptance of entry, the Federation and/or the Competition may use or assign photographs, videos, audios,
cablecasts, broadcasts, internet, film, new media or other likenesses of me and my horse taken during the course of the competition for the promotion, coverage or
benefit of the competition, sport, or the Federation. Those likenesses shall not be used to advertise a product and they may not be used in such a way as to jeopardize amateur status. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of
privacy, right of publicity, or to misappropriation.
The construction and application of Federation rules are governed by the laws of the State of New York, and any action instituted against the Federation must be filed in
New York State. See GR908.4. (GR906.4)
USEF RELEASE, ASSUMPTION OF RISK, WAIVER AND INDEMNIFICATION
This document waives important legal rights. Read it carefully before signing.
I AGREE in consideration for my participation in this Competition to the following:
I AGREE that “the Federation” and “Competition” as used herein includes the Licensee and Competition Management, as well as all of their officials, officers, directors,
employees, agents, personnel, volunteers and Federation affiliates.
I AGREE that I choose to participate voluntarily in the Competition with my horse, as a rider, driver, handler, vaulter, longeur, lessee, owner, agent, coach, trainer, or as
parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sports and the Competition involve inherent dangerous risks of accident, loss, and
serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death. (“Harm”).
I AGREE to hold harmless and release the Federation and the Competition from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm of any nature
caused by me or my horse to others, even if the Harm arises or results, directly or indirectly, from the negligence of the Federation or the Competition.
I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of the Federation or the Competition.
I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the Federation and the Competition and to hold them harmless with respect to claims for Harm
to me or my horse, and for claims made by others for any Harm caused by me or my horse while at the Competition. I have read the Federation Rules about protective
equipment, including GR801 and, if applicable, EV114, and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that the Federation
strongly encourages me to do so while WARNING that no protective equipment can guard against all injuries. If I am a parent or guardian of a junior exhibitor, I consent to
the child’s participation and AGREE to all of the above provisions and AGREE to assume all of the obligations of this Release on the child’s behalf. I represent that I have the
requisite training, coaching and abilities to safely compete in this competition.
I AGREE that if I am injured at this competition, the medical personnel treating my injuries may provide information on my injury and treatment to the Federation on the
official USEF accident/injury report form.
BY SIGNING BELOW, I AGREE to be bound by all applicable Federation Rules and all terms and provisions of this entry blank and all terms and provisions of this Prize
List. If I am signing and submitting this Agreement electronically, I acknowledge that my electronic signature shall have the same validity, force and effect as if I affixed
my signature by my own hand. (GR908.6)
SIGNATURES ARE MANDATORY
Entry will not be accepted without mandatory signatures, full payment, legible
proof of Coggins and other prize list requirements.
SIGNATURES ACKNOWLEDGE ACCEPTANCE OF PRIZE LIST REFUND POLICY
RIDER / DRIVER / HANDLER / VAULTER / LONGEUR
Mandatory
OWNER / AGENT
Mandatory
TRAINER
Mandatory
COACH
Mandatory for person on grounds who coaches Rider / Handler
PARENT / GUARDIAN
Required if Rider / Driver / Handler / Vaulter / Longeur is a minor
Is Rider / Driver / Vaulter a U.S. citizen?
CREDIT CARD INFORMATION
Mastercard
Visa
ENTRY FORM NOTES
Copies/scans are acceptable. The word “same” and ditto marks will be rejected. Trainer
is person responsible for condition of horse and must be on grounds during show. Any
person on grounds who coaches Rider / Handler must sign this form as Coach.
Signature
Print Name
Signature
Print Name
Signature
Print Name
Signature
Print Name
Signature
Print Name
Yes
No
(Check Prize list to be sure this Competition accepts credit card payments ~ )
Print name
Number
of Cardholder
Billing Street
Expiration
MM/YY
Security
Code
Town / St / Zip
AMOUNT
Signature
PREVIOUS COMPETITION SCORES FOR QUALIFICATION / ANNOUNCER
Competition
Date
Level / %
Competition
Date
Level / %
USDF Membership Benefits: USDF is dedicated to education, the recognition of achievement, and promotion of dressage. For details
on member benefits, including educational programs, awards, and other opportunities, refer to the USDF Member Guide or the USDF
website at www.usdf.org.
This
competition
is recognized
by USDF
for 2016
Membership Requirements for USEF-licensed/USDF-recognized Competitions: Owners and riders, including foreign riders and
owners who are not residents of the US, wishing to participate in a USEF-licensed/USDF-recognized competition as a rider or
owner/lessee, must have either a USDF Group Membership (GM), Participating Membership (PM), or have a USDF Non-Member (NM) identification number and pay
the USDF Non-Member (NM) fee. (Note: USDF Business Members can own horses but cannot compete as riders with their USDF Business Membership.)
Individuals cannot compete at a USEF-licensed/USDF-recognized competition with a USDF Education Membership.
Horses competing at USEF-licensed/USDF-recognized competitions must have either a USDF Horse Identification (HID) number or a USDF Lifetime Horse
Registration (LHR). Proper credentials or verification certificates must be presented to the competition secretary.
Riders and owners wishing to participate in a USEF-licensed/USDF-recognized competition, and not able to present the competition secretary with verification of a
USDF membership or NM identification, and USDF LHR or USDF HID, must complete a USDF Competition Affidavit Form and pay the $5 affidavit filing fee. A copy
of a completed affidavit form from another competition may also be used for verification purposes for up to 60 days. (Exception: Affidavits cannot be used at Great
American Insurance Group/USDF Regional Dressage Championships.)
Exceptions:

Horses competing only in Individual Breed Classes (IBCs) at DSHB competitions, sires and dams of horses in DSHB group classes, where those sires or
dams are not actually competing in the same competition, horses competing only in breed restricted dressage or DSHB classes at Regular Competitions
(e.g. all Arabian, all Friesian, or all Morgan classes), or in USDF Introductory Level tests, pas de deux or quadrille, are exempt from this requirement. Also
exempt are horses ridden in leadline, exhibitions, games and races, classes for 4-H members, walk-trot, academy and opportunity classes.

Riders and owners/lessees competing only in classes which are exempt from the USDF HID requirements are also exempt from the USDF NM
identification number and NM fee requirements. Also exempt are handlers of horses competing in DSHB In-Hand or Group classes.
Memberships Defined
Participating Membership (PM): A membership issued to an individual directly by USDF. The membership year is December 1 through November 30. PMs are
available for 1-year ($75), 5-years ($300), or life ($1,500). A USDF Youth Participating Membership (YPM) is available for individuals who have not reached their 21st
birthday by December 1 of the current membership year ($60). A PM allows the member to compete at USEF-licensed/USDF-recognized competitions and to
participate as a rider and/or owner/lessee for all Adequan®/USDF Year-End Awards, Great American Insurance Group/USDF Breeders Championship Series Finals
and the Great American Insurance Group/USDF Regional Dressage Championship program.
Group Membership (GM): A membership issued to an individual by USDF when the member name and dues are submitted to USDF through an affiliate Group
Member Organization (GMO). The GM year begins December 1 and ends November 30. A GM allows the member to compete at USEF-licensed/USDF-recognized
competitions and participate in the USDF Rider Awards program.
Business Membership (BM): A membership that runs December 1 through November 30 and is issued to a business or organization directly by USDF. The USDF
BM ($200) offers a wider variety of advertising benefits. BMs satisfy requirements of horse ownership only.
Education Membership (EM): A membership issued to an individual directly by USDF. This online education only membership expires 12 months after the date
joined. This membership type does NOT allow an individual to compete at a USEF-licensed/USDF-recognized competition.
Non-Member (NM) Identification Number: For each USDF NM owner/lessee and USDF NM rider there will be a USDF NM fee of $25 per competition that must be
collected by the show secretary and submitted to USDF, along with the USDF Report of Fees document and the $5 affidavit fee and Competition Affidavit Form if the
person cannot provide a copy of their USDF NM card. Owners/lessees or riders exempt from the NM number requirements are also exempt from paying the USDF
NM fee. If there are multiple owners of a horse and all are NMs, only one of the owners must pay the NM fee. If the horse has at least one owner who is a current
USDF PM, GM, or BM there is no NM fee assessed. Competition management will be invoiced for all applicable USDF NM fees not received with the USDF post
competition paperwork, along with a report listing all USDF NMs. Competition management is then required to submit the NM fees within 30 days to the USDF. An
individual with a USDF NM identification number is not eligible for any USDF membership benefits. Once a USDF NM number has been assigned, a USDF NM card
can be obtained from the USDF website.
Horse Identification (HID) Number: A one-time tracking number for horses ($25). Scores earned by a horse with an HID number will be recorded, but will NOT be
counted towards Adequan®/USDF Year-End Awards. A horse with an HID number is not eligible to compete in Great American Insurance Group/USDF Regional
qualifying or championship classes or Great American Insurance Group/USDF Breeders Championship Series Finals. An HID number can be upgraded to a Lifetime
Horse Registration (LHR) for a fee of $70. If a horse has a USDF LHR it does not need an HID number. An HID number is a one-time fee that does not need to be
renewed.
Lifetime Horse Registration (LHR): A horse with an LHR ($95) is eligible for Adequan®/USDF Year-End Awards, and eligible to compete at Great American
Insurance Group/USDF Breeders Championship Series Finals and Great American Insurance Group/USDF Regional qualifying and championship classes, assuming
requirements for the owner and rider are met. If a horse has an LHR it does not need an HID number. An LHR does not need to be renewed.
How to Join USDF
Applications for USDF Participating Membership (PM), Business Membership (BM), Horse Identification (HID) number, and Lifetime Horse Registration (LHR) may
be found in the following locations:

On the USDF website: www.usdf.org. You can submit the application online or download the form and fax or mail it to the USDF office.

In the show office at USEF-licensed/USDF-recognized competitions classified by USEF as Dressage Competitions, and Regular Competitions which are
open to all breeds.

By calling or writing the USDF office at (859) 971-2277, 4051 Iron Works Parkway, Lexington, KY 40511
The effective date of membership is the date the form and correct fees are received in the USDF office or, if applying at a competition, the date accepted by the
competition secretary, provided the application is signed and dated by the competition secretary, member, and/or horse owner on that same day.
04/15
2016 Great American Insurance Group/USDF Regional Dressage
Championships
A single Regional Dressage Championship program organized by the United States Dressage Federation (USDF),
and recognized by the United States Equestrian Federation, Inc. (USEF), will be held in each of the nine USDF
regions. In addition, Alaska and Hawaii may each hold state championships if an official request from a Group
Member Organization (GMO) is received by April 1 of the prior year. The Regional Championship Program Rules
can be found on the USDF website at www.usdf.org. Please refer to the 2016 USDF Member Guide for the
comprehensive list of rules and requirements for this program.
Membership/Registration Requirements for Qualifying and Championships
Rider:
 Must have a USDF Participating* Membership (PM) at the time qualifying scores are earned and at the time of the
championships.
 Must have a USEF membership (Junior Active, Senior Active, or Life) at the time the qualifying scores are earned and at the
time of the championships.
Horse:
 Must have a USDF Lifetime Horse Registration (LHR) at the time qualifying scores are earned and at the time of the
championships.
 Must have a USEF (Annual or Lifetime) Membership recorded at the time qualifying scores are earned and at the time of
the championships.
 USDF horse registration and USEF horse/recording must be in the name(s) of the current owner(s) or lessee(s) of record.
 A horse is not required to have breed registry papers.
Owner:
 Must have a USDF membership (PM* or Business Member (BM)) at the time the qualifying scores are earned and at the
time of the championships.
 Must have a USEF membership (Junior Active, Senior Active, or Life) at the time qualifying scores are earned and at the time
of the championships.
* PMs are USDF members who join USDF directly. USDF Group Members (GM) are ineligible.
Minimum Qualifying Scores. One set of nationally-standardized qualifying scores has been established for all USEF/USDF Regional
Championships, for levels through Grand Prix, in three divisions: open, adult amateur and junior/young rider. FEI Junior and FEI
Young Rider classes have only one respective division. Freestyles have only open divisions.
The minimum percentages are as follows:
Training Level (Test 3)
First Level (Test 3)
Second Level (Test 3)
Third Level (Test 3)
Fourth Level (Test 3)
FEI Junior (Team Test)
FEI Young Rider (Team Test)
Prix St. Georges
Intermediate I
Intermediate II
Grand Prix
OPEN
68%
66%
64%
62%
62%
—
—
60%
60%
60%
60%
AA
63%
62%
61%
60%
60%
—
—
60%
60%
60%
60%
JR/YR
63%
62%
61%
60%
60%
60%
60%
60%
60%
60%
60%
FREESTYLE
First Level
Second Level
Third Level
Fourth Level
Intermediate I
Grand Prix
OPEN
63%
63%
63%
63%
63%
63%
AA
—
—
—
—
—
__
JR/YR
—
—
—
—
—
__
Rev May 2015
USEF Competition Name:USEF#:
Competition Division(s) and Rating(s):
TRACK POINTS,
CLIMB THE STANDINGS,
AND EARN YEAR-END AWARDS!
Make your results count toward the USEF Horse of the Year Awards
and Silver Stirrup Awards Programs with an annual or lifetime horse
recording. Call or email today to speak with a customer care
representative about how to get started.
859 258 2472 // [email protected]