Entry Form - American Saddlebred Association of Arizona

Transcription

Entry Form - American Saddlebred Association of Arizona
PLEASE TYPE OR CLEARLY PRINT. ONLY ONE OWNER PER ENTRY FORM. All entries must be complete, including all required paperwork, and contain the correct fees. Enclose copies of
Saddlebred Registration Papers (both sides), copies of applicable membership cards, and check.
OWNER Legal Owner (printed exactly as it appears on horse registration papers or contract),
Signature of Owner or Agent, Street or PO Box of Owner, City of Owner State, Zip
Code, Phone Number of Owner, Email address, ASHA# if applicable
COMPLETE BOTH SIDES OF THIS FORM
2015 Southwest Cactus Classic
Multi-Breed Horse Show
TRAINER Printed Name of Trainer, Signature of Trainer (If no
Trainer, Owner Must Sign – Mandatory), Street or PO Box of
Owner, City of Trainer, State, Zip Code, Phone Number of
Trainer, Email address, ASHA # (if applicable)
May 2 - 3, 2015
WestWorld of Scottsdale, Scottsdale, Arizona
Arenas 3 and 4
Send completed entries to:
Joe Husband
3646 W Colter ST, Phoenix, AZ 85019
Email: [email protected]
Please make checks payable to ASAA, Inc.
Each person signing this form acknowledges that he/she has read the front and reverse side of this official entry form and agrees to the applicable terms, conditions, waivers, releases,
indemnifications and consent as set forth therein. Each person agrees that information is accurate to the best of his/her knowledge.
Name of Horse and ASB Breed Reg. No. if applicable
Name of Rider / Driver / Handler ASHA# if applicable
Date of Birth
if Jr.
Exhibitor
Class #
Class #
Class #
Class #
Entry
Fees $
Name of Horse and ASB Breed Reg. No. if applicable
Name of Rider / Driver / Handler ASHA# if applicable
Date of Birth
if Jr.
Exhibitor
Class #
Class #
Class #
Class #
Entry
Fees $
Name of Horse and ASB Breed Reg. No. if applicable
Name of Rider / Driver / Handler ASHA# if applicable
Date of Birth
if Jr.
Exhibitor
Class #
Class #
Class #
Class #
Entry
Fees $
Name of Horse and ASB Breed Reg. No. if applicable
Name of Rider / Driver / Handler ASHA# if applicable
Date of Birth
if Jr.
Exhibitor
Class #
Class #
Class #
Class #
Entry
Fees $
SPONSORSHIP: PLEASE HELP SUPPORT YOUR HORSE SHOW BY SPONSORING CLASSES! Your name will be announced as a class sponsor for as little as $25 per class! Please indicate the total amount of your
sponsorship below and list the classes you would like to sponsor here:
ENTRY DEADLINE APRIL 27 2015
Payment by Credit Card
□ Visa
□ MasterCard
□ Discover
Card#__________________________________________________
Expiration Date: ___________________CVC Verification_________
(last 3 numbers on back of card)
Name on Card:__________________________________________
Billing Address: __________________________________________
Signature: _____________________________________________
(Qualifiers, Academy, Equitation, ASAA Medal: $25 per class; Stake: $30 per class)
Make All Checks Payable to:
American Saddlebred Association of
Arizona (ASAA)
Mail Entries to: Mr. Joe Husband
3646 W Colter ST, Phoenix, AZ 85019
Email: [email protected]
For Office Use Only
Amount Paid ____________ Check # ________
For #’s ____________________________________
Receipt _____________
□ Registration Papers □ Open Check □ Breed Membership Cards
Total Entry Fees from above: ................................$ _______________
Please stable me with: List trainer AND barn name.
__________________________________________
__________________________________________
__________________________________________
Other Fees
Post Entry Fee, Per Horse @ $25...................……............$ ________
Office Fee, Per Owner @$15............................……..........$ ________
Grounds Fee @ $25 per horse/per day (waived if stall is used)..$ ________
Horse Stalls (2 pm Friday to 4pm Sun; Bedding not included) # _____@$85each
……………………………………………………….………$ _________
Tack/Feed Rooms #________-_@ $85 each …….........$ _________
Early Arrival Days #_____@ $25 per stall (Horse and Tack) $ _________
ASB Affiliation Fee, Per Horse @ $20 ...........................$ _________
TOTAL ENCLOSED........................................…............$ __________
CHECKS MADE PAYABLE TO ASAA, INC. ALL ACCOUNTS REQUIRE OPEN CHECK OR $200 CASH DEPOSIT TO SHOW.
SOUTHWEST CLASSIC MULTI-BREED HORSE SHOW ENTRY AGREEMENT — ASSUMPTION OF RISK, RELEASE AND INDEMNIFICATION
THIS DOCUMENT WAIVES IMPORTANT LEGAL RIGHTS — READ CAREFULLY BEFORE SIGNING
FOR USE WITH SOUTHWEST CLASSIC MULTI-BREED HORSE SHOW ENTRY FORM
In consideration for American Saddlebred Association of Arizona conducting the Southwest Classic Multi-Breed Horse Show (hereinafter the “Competition”) permitting me to participate in this Competition, and by signing the entry
blank, I agree as follows: I AGREE that I choose to participate voluntarily in the Competition, as a rider, driver, handler, lessee, owner, agent, coach, trainer, invitee, junior exhibitor, or as a parent or guardian of a junior exhibitor.
I AM FULLY AWARE AND ACKNOWLEDGE THAT HORSE SPORTS AND PARTICIPATION IN THIS COMPETITION INVOLVE SERIOUS RISK OF HARM INCLUDING, BUT NOT LIMITED TO, RISKS OF ACCIDENT, SERIOUS BODILY INJURY,
INCLUDING DEATH, BROKEN BONES, HEAD INJURIES, TRAUMA, PAIN, AND SUFFERING, AND PROPERTY DAMAGE, INCLUDING, BUT NOT LIMITED TO DAMAGE ARISING FROM FIRE, THEFT AND VANDALISM (hereinafter “HARM”). I
EXPRESSLY ASSUME ALL RISKS OF HARM TO ME, MY HORSE OR MY PROPERTY.
I REPRESENT that I have the requisite training, coaching, and abilities to safely participate in the COMPETITION.
I AGREE to release the Competition, its owners, officer, directors, agents, personnel, volunteers, employees, invitees, affiliated organizations and insurers (hereinafter “RELEASED PARTIES”), from all claims for money damages or
otherwise for any HARM to me, my agents, employees, associates, or my property or animals even if the HARM resulted directly or indirectly from the negligence of the RELEASED PARTIES. I, on behalf of myself, my heirs, representatives and
assigns hereby WAIVE my substantial rights to assert any causes of action, claims or demands of any nature, including, but not limited to claims for negligence and wrongful death, that I, or others on my behalf, may now or in the future have
against the RELEASED PARTIES.
I AGREE to indemnify and hold harmless (that is pay all losses, damages, attorneys fees and costs of) the Released Parties from and against any and all claims, demands, penalties, actions, losses, costs, damages, injuries, liabilities and
obligations (including attorneys fees) of whatsoever kind and nature, which may be asserted against or incurred by any of them as a result of (1) my participation in the Competition or (2) any act, failure to act, or neglect (a) by me, my
agents, employees, riders, handlers, trainers, coaches, drivers, contractors or invitees, or (b) by any animal owned or exhibited by me or in my custody or control.
I AGREE that the Competition has the sole right to control, sell, supervise or give away (or assign to others the right to do so) the exclusive rights to broadcast, televise, reproduce, transmit and disseminate all or part of this event, and I
agree that the Competition may use or assign, in any way the Competition sees fi t, photographs, films, videos, audios, cablecasts, or other likenesses of me and my horse taken during the course of the Competition for the promotion, coverage
or benefit of the Competition. Those likenesses shall not be used to advertise a product and they may not be used in such a way which implies endorsement of any company, product, product category or service. 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.
By signing below as a parent or guardian of a junior exhibitor, I consent to the child’s participation and agree to all of the above provisions, and further agree to assume all of the obligations of this Agreement personally and on
behalf of the child. This Agreement is governed by the Laws of the State of Arizona and is intended to be interpreted as broadly as possible. I agree that exclusive jurisdiction and venue (place) for any legal action against the Competition
shall be in the State of Arizona. If any part of this agreement is determined to be unenforceable, all other parts shall remain in effect.
BY SIGNING BELOW, I AGREE to be bound by all applicable rules and all terms and provisions of this entry blank.
SHOW RULES:
The Southwest Classic Multi-Breed Horse Show (hereinafter Southwest Classic) reserves the right to refuse service to anyone for any reason; to accept, reject, or cancel any entry; and, to limit entries.
1
Southwest Classic reserves the right to add, cancel, or consolidate classes; and/or cancel shows at any time and for any reason
any Southwest
Southwest Classic reserves the final and absolute right to interpret all rules and regulations, arbitrarily settle and determine all matters, questions and differences in regard to or arising out of or connected to
Classic Multi-Breed Horse Show, and the right to amend or to add to these rules as it is determined necessary. Any exhibitor who violates these rules will forfeit all entry fees, privileges, premiums and awards, and Southwest Classic shall have
the full power to exclude the violator from further participation in the show and/or future Southwest Classic Multi-Breed Horse Shows.
2
The show shall be conducted in accordance with general rules of the current USEF or IJA 2008 Rule Book depending on the breed, to the extent that said rules do not conflict with a specific Southwest Classic rule, which shall
govern. Every class offered herein which is covered by the rules and specifications of the current USEF Rule Book will be conducted and judged in accordance therewith.
3
The decisions of the judges are final. Southwest Classic accepts no responsibility for decisions of the judges. Judges have the discretion to excuse any horse that appears sore or lame.
4
Exhibitors are hereby notified that any unethical, discourteous, or unsafe act by them, their riders, drivers, handlers, grooms, trainers, invitees or agents shall disqualify their entry and the owner shall forfeit any fees or charges
as well as prize money which he or she may have won at that show. WITHOUT BEING HELD LIABLE FOR DAMAGE OF ANY KIND, Southwest Classic shall have the full power to exclude the offending individual(s) from further participation in the
show and/or future Southwest Classic shows, and to have the individual(s) removed from the grounds. This shall be accepted as a condition of entry.
5
No competition numbers shall be released by the Show Office until the Entry Form is complete and all necessary paperwork and full payment has been received. A signed open check or $200 cash deposit MUST be left with the
Show Office for fees accrued during the show. Please remember to close out your account before you leave. You may pay by cash or check. There will be a $50 service fee on returned checks.
6
All adds, scratches, and changes must be made at the show office at least one hour prior to the effective add, scratch or change.
7
To be eligible for a Championship class, the horse must have entered, shown, and been judged in any class in its division or any class specified as a prerequisite. To be shown and judged in any class in which animals compete
together, an animal must perform in all required gaits both ways of the ring in the original workout and must remain in the ring up to the point of the judge excusing it.
8
Southwest Classic reserves the right to use all photographs and video taken during the show. Exhibitor hereby agrees to Southwest Classic’s use of his or her and animal images for publicity purposes.
9
All signs and facility rules must be followed at all times! Dogs must be on a leash at all times.
Arizona Revised Statutes §12-553 Limited liability of equine owners and owners of equine facilities; exception; definitions
A. An equine owner or an agent of an equine owner who regardless of consideration allows another person to take control of an equine is not liable for an injury to or the death of the person if:
1.
The person has taken control of the equine from the owner or agent when the injury or death occurs.
2.
The person or the parent or legal guardian of the person if the person is under eighteen years of age has signed a release before taking control of the equine.
3.
The owner or agent has properly installed suitable tack or equipment or the person has personally tacked the equine with tack the person owned, leased or borrowed. If the person has personally tacked the equine, the person assumes full responsibility for the suitability, installation
and condition of the tack.
The owner or agent assigns the person to a suitable equine based on a reasonable interpretation of the person's representation of his skills, health and experience with and knowledge of equines.
B. Subsection A does not apply to an equine owner or agent of the equine owner who is grossly negligent or commits willful, wanton or intentional acts or omissions.
C. An owner, lessor or agent of any riding stable, rodeo ground, training or boarding stable or other private property that is used by a rider or handler of an equine with or without the owner's permission is not liable for injury to or death of the equine or the rider or handler.
D. Subsection C does not apply to an owner, lessor or agent of any riding stable, rodeo ground, training or boarding stable or other private property that is used by a rider or handler of an equine if either of the following applies:
1
The owner, lessor or agent knows or should know that a hazardous condition exists and the owner, lessor or agent fails to disclose the hazardous condition to a rider or handler of an equine.
2
The owner, lessor or agent is grossly negligent or commits willful, wanton or intentional acts or omissions.
E. As used in this section:
1. "Equine" means a horse, pony, mule, donkey or ass.
2. "Release" means a document that a person signs before taking control of an equine from the owner or owner's agent and that acknowledges that the person is aware of the inherent risks associated with equine activities, is willing and able to accept full responsibility for his own safety and welfare and releases the
equine owner or agent from liability unless the equine owner or agent is grossly negligent or commits willful, wanton or intentional acts or omissions.