Saskatoon Classic Bronze Entry Form

Transcription

Saskatoon Classic Bronze Entry Form
Saskatoon Classic Bronze Entry Form
Bridle #
September 4-6, 2015
Paid:_____________
A Bronze Level Equine Canada Show – SHF Heritage Series & Prairie Cup Circuit Show
Ebon Stables – Saskatoon SK
Chq #:___________
Mail Entries to: Ebon Stables
Fax Entries to: 306-477-0199
c/o Victoria Kendall
Email inquiries: [email protected]
Box 27, RR#5
Entry inquiries: 306-241-2579
Saskatoon, SK S7K 3J8
Entry Deadline is Aug 28, 2015 – please use separate form per horse
Horse Information
Show Fees
Horse Name:
Age:
Total Entry Fees:
Breed:
TIP#:
Pony: L__ M__ S__
Stable with:
Stall Fee: _______x$80.00/stall
Shavings Pre-Order: _______ bags x $8.00/bag
Trainer:
Hunter Warm Up Rounds - $15.00
Owner of Horse:
Owner EC #
EC membership Level:
Owner address:
$30.00
Paramedic Fee
$10.00
Drug Levy Fee
Early Bird entered in draw for stabling (received by Aug 21)
$25.00 Late Fee (if received after Aug 28)
Rider Information
Name:
$3.50
Power Hook Up - $25.00
EC:
SHF#
Subtotal
SHJA#
GST 5%
Date of Birth if Junior:
Saturday Supper Tickets:_______x$15.00/ticket
Street Address:
Payable to Ebon Stables
Total Show Fees
*Separate Chq*
Stall Cleaning and Bridle # Refund
City, Province:
Postal Code:
Phone:
Cell/Alternate Phone #:
Email:
Emergency Contact Name & Phone #:
Make Prize money payable to: ____Owner
____Rider
Entry Fees
Div
Office Fee
Class Numbers
Entry Fee
This Document will affect your legal rights and liabilities. Please read carefully:
I __________________________________ acknowledge that the sport of horses
is a risk sport and that I am participating at my own risk and in full knowledge of
the hazards which are inherent in this sport. I further acknowledge that inherent
risks in riding and working around horses, which include bodily injury to both
horse and rider which can result from normal use, competition, or schooling. It is
hereby also understood that no helmet or protective equipment can protect
against all foreseeable injury. I hereby certify that every horse and rider is
eligible as entered and agreed for myself and my representatives to be bound by
the Constitution and Rules of Equine Canada and the Saskatoon Classic Show’s
Prize List. In consideration of being allowed to participate in this event, I hereby
assume all risk and I hereby release and absolve Equine Canada, SHF, SHJA, Ebon
Stables, Holliston & Associates, and their directors, officers, employees,
volunteers, and their representatives for all responsibility, liability or claims of
any nature and kind which I may have arising from my participation in this
activity, including but not limited to bodily injury or death to myself or my
horse(s) and damage to property arising from any cause whatsoever, including
the negligence of one or more of the individuals and organizations referred to
herein. All persons mounted on a horse on the competition grounds are required
to wear properly fitted ASTM or BSI approved helmet with safety harness
correctly fastened (se EC Article G102) In the event that ___________________
participates in an Equine Canada sanctioned competition where protective
headgear is required for juniors, he/she will wear properly fitted and fastened
approved headgear at all times while riding or driving at the event location. It is
understood that juniors not meeting this requirement will not be allowed to
compete at these competitions. (A802.6) I hereby declare that in signing this
document that I have read and fully understand and agree to the terms and
conditions stated herein and that it is binding upon my executors, heirs and
assigns.
Signature of Rider or Legal Guardian if rider is a Junior
Signature of Owner
Total Entry Fees
$40.00
Date