Saskatoon Classic Gold Entry Form
Transcription
Saskatoon Classic Gold Entry Form
Saskatoon Classic Gold Entry Form Bridle # September 7, 2015 Paid:_____________ A GOLD 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 Early Bird Entry Aug 21, 2015 – entered in draw for stall fees Horse Information Show Fees Horse Name: Total Entry Fees: Passport #: Age: Breed: TIP#: Stall Fee (waived if entered in Bronze): Tack Stall (if available, waived if pd for in Bronze): $80.00/stall Pony: L__ M__ S__ Stable with: Trainer: Owner of Horse: Owner EC # Shavings Pre-Order: _______ bags x $8.00/bag Office Fee (waived if entered in Bronze) Owner address: Rider Information Paramedic Fee $5.00 Drug Levy Fee $7.00 $20.00 Power Hook Up - $25.00 Level: Pony Club: SHF# SHJA# Subtotal Date of Birth if Junior: GST 5% Payable to Ebon Stables Street Address: *Separate Chq* City, Province: Postal Code: Email: Emergency Contact Name & Phone #: Make Prize money payable to: ____Owner Total Show Fees Stall Cleaning and Bridle # Refund $40.00 This Document will affect your legal rights and liabilities. Please read carefully: Phone: Cell/Alternate Phone #: ____Rider Entry Fees Div $30.00 Jump Canada Levy Name: EC#: x$80.00/stall Class Numbers Entry Fee 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, Saskatoon Riding Club, 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 Total Entry Fees Signature of Owner Date