Arrival
Date Departure
Date No. Stoney Ridge Stables May 26 &27 Mail entries and make
checks payable to: Stoney Ridge Stables
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Horse’s Name |
Horse’s USEF # |
Color |
Sex |
Height |
Year Foaled |
Breed/Country of Origin |
SirexDam/Sire
of Dam |
Measurement Card |
A-O Age |
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CHECK BOXES FOR HUNTER AND JUMPER SECTIONS |
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Very Green Hunter |
Pregreen Hunter |
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Junior Hunter |
Amateur Owner |
Low Adult Hunter |
Adult Amateur Hunter |
Childrens Pony Hunter |
Pony Small |
Pony Medium |
Pony Large |
Green Pony Hunter |
14
under Childrens
Hunter |
15-17 Childrens Hunter |
Low Childrens Hunter |
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1 |
2 |
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S |
L |
Y |
O |
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Y |
O |
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C |
A |
J |
A |
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Limit Rider |
Short Stirrup |
Individual
Classes & Equitation |
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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 U.S. 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,
cable-casts, 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 Federation 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 [Stoney Ridge Stables]
to the following: 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 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 caused by me or my horse to
others, even if the Harm resulted, 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 at the Competition. I have read the Federation Rules about protective
equipment, including GR318 and EV113, 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 AGREE that “the Federation” and
“Competition” as used above includes all of their officials, officers,
directors, employees, agents, personnel, volunteers and affiliated organizations.
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. I represent
that I have the requisite training, coaching and abilities to safely compete
in this competition. BY SIGNING BELOW, I AGREE to be bound by all
applicable Federation Rules and all terms and provisions of this entry blank. |
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Owner
USEF#_______________________________________ Owner______________________________________________ Street
Address_______________________________________ City/State/ZIP________________________________________ Phone
/Fax#________________________________________ SS#/TIN#___________________________________________ Name
Associated with SS/TIN__________________________ Owner/Agent
Signature______________________________
Rider
#1____________________________________________ DOB_______________________________________________ USEF#__________________ASPCA#____________________ Street
Address_______________________________________ City/State/ZIP________________________________________ Rider/Agent
Signature_______________________________ |
Trainer
USEF#_______________________________________ Trainer_____________________________________________ Street
Address_______________________________________ City/State/ZIP________________________________________ Phone#/Fax#________________________________________ Trainer
Signature___________________________________ Coach__________________________Coach
USEF#________ Coach
Signature____________________________________ Rider
#2____________________________________________ DOB_______________________________________________ USEF#
____________________ASPCA#_________________ Street
Address_______________________________________ City/State/ZIP________________________________________ Rider/Agent
Signature_______________________________ |
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TOTAL ENTRY
FEE |
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STALLS: WEEKEND: $70 |
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NON-SHOWING HORSE $50.00 |
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USEF/USHJA NON-MEMBER FEES. USHJA: $20.00 USEF ADULT: $20.00 + $5.00 discipline fee
($25.00) USEF JUNIORS: $20.00 |
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AFFIDAVIT FEE. USEF and/or USHJA: $5.00 |
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USEF DRUG TESTING FEE PER HORSE (D & M:
$7.00; USEF: $5.00) |
$12.00 |
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GROUNDS FEE |
$15.00 |
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Total
Amount Due |
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Amount
Enclosed |
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Balance
Due |
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RCVD. CHK. # |
CHK. # |
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