Entry Form - MC Equestrian
Transcription
Entry Form - MC Equestrian
Teesdale Stables, MC Equestrian, Paramount Equestrian Novice Rider’s Development Circuit MC Equestrian Centre Tournament June 27, 2015 Riders Name: __________________________________________________________________________ Address: __________________________________________________City/Town:__________________ Postal Code:_____________________________ Phone Number: ________________________________ Email: __________________________________ Horse Name: __________________________________ Name of Riding Stable: _________________________ Trainer Name: ___________________________ Please circle classes entered (Maximum 5 classes, One Division only per rider) Division A 10 years & Under Division 9:00am 1 X - Rail Hunter 2 X - Rail Hunter 3 Walk / Trot Equitation 10 year & under or (one Equitation Class only) 4 5 6 Division B 7 8 9 10 11 Division C 12 13 14 15 16 Division D 17 18 19 20 21 Division E 22 23 24 25 26 Walk / Trot / Canter Equitation 10 & under 18" Hunter 18" Hunter X-Rail and 18” Open Division (all ages) X - Rail Hunter X - Rail Hunter 18" Hunter 18" Hunter Walk / Trot / Canter Equitation 18” and 2’0” Open Division (all ages) 18" Hunter 18" Hunter 2’0” Hunter 2’0” Hunter Walk / Trot / Canter Equitation 2’0” and 2’3” Open Division (all ages) 2’0" Hunter 2’0" Hunter 2'3" Hunter 2'3" Hunter Walk / Trot / Canter Equitation 2’3” and 2’6” Open Division (all ages) 2’3" Hunter 2’3" Hunter 2'6" Hunter 2'6" Hunter Walk / Trot / Canter Equitation Prizes and Tournament Features: A $20 Equi-Products gift certificate will be awarded to a participant of each over-fences class. The winner will be drawn from all participants in that class. Prizes will be awarded to 8th place in each flat class. No. of Classes__________ x $20.00 = $ ________ Administration Fee $ 20.00 Paramedic Fee $ 20.00 G.S.T.@ 5% $ ________ TOTAL $ ________ Please charge my VISA MASTERCARD card (circle one) Name of Cardholder_______________________________ Card #_______________________________ Exp. Date ___________ Faxed entry accepted with Credit Card Fax # (403) 851-1397 or Cheque Payable to: MC Equestrian Centre. For further information contact: Hannah Friedenberg, 403 932 3341 Email: [email protected] I hereby certify that neither MC Equestrian Centre(a div. of CKR Farms Ltd.), nor the organizing committee, or owners of MC Equestrian Centre(a div. of CKR Farms Ltd.), nor any of their staff or agents shall be in any way liable for any accident, injury, damage, loss or for any other matter that may happen from any cause or circumstance whatsoever, to exhibitors, competitors or members or their agents or to anyone on the tournament grounds or to any animal or article exhibited or to any property brought on the tournament grounds or for any other loss, claim, matter, circumstance or event whatever in connection with or arising out of, or attributable to their tournament or any journey to or from the tournament. It is to be understood and agreed that under no circumstances shall MC Equestrian Centre(a div. of CKR Farms Ltd.), its owners, agents, or employees negligence, and you agree to indemnify and save harmless MC Equestrian Centre(a div. of CKR Farms Ltd.), its owners, agents and employees from and against any and all liability arising out of such loss, damages, claims or costs. Date: _____________________ Signature:__________________________ if rider is under the age of 18 years, this form must be signed by a parent or legal guardian (Trainer signature is not valid)