Entry Form for Schooling Shows

Dressage at Pacific Equestrian Center

Entry Form for Schooling Shows

Mail entries to: PEC Schooling Entry, 10992 Wilton Road, Wilton, CA 95693

Show Secretary: Mari Naten Barn : 916-687-8035 Cell: 916-798-5844 Fax: 916-687-8041

Email:

Date of Show: ______(closing date Wednesday 7pm prior)

Horse Information / Rider Information
Name / Name
Breed / Address
Sex / City
Color / State, Zip
Phone
Cell
Email
Status / Am/Jr/O
Owner Information / Trainer Information
(responsible for horse on grounds)
Name / Name
Address / Address
City / City
State, Zip / State, Zip
Phone / Phone
Cell / Cell
Email / Email
Entries / Stabling
Class # / Class Description / Fees $
Subtotal Class Fees
Drug/Office Fee / $15.00
Stable Fee
Late Fee ($10 per class)
Incomplete Entry ($10)
WDAA High Point recording fee ($2.00)
Total
/ Stall Fee / $35 x (days) =
Arrival / Date: Time:
Departure / Date: Time:
Emergency / Name:
Number:
Trainer Incentive:
1 free stall if 3 students enter with min. 2 classes each – (list students)
Credit card payment - Visa or MasterCard
#______3 digit code______
Exp date ______
Name on card______

Release of Liability: I hereby acknowledge that I have voluntarily requested participation for myself or my minor child in equestrian activities at Pacific Equestrian Center. I am aware that dressage, jumping and all other forms of horseback riding activities are dangerous and I am voluntarily participating with the knowledge of the danger involved and hereby agree to accept any and all risks of injury or death. I hereby release and hold harmless Pacific Equestrian Center, its employees, independent contractors, volunteers and agree neither I nor my heirs and assignees will make a claim against, sue, attach the property of, or prosecute any of them for injury to myself, my horse, my property or to anyone else for damage resulting from the negligence or other acts or omissions however caused, as a result of my engaging in any equestrian or related activity while at Pacific Equestrian Center. I have carefully read this agreement and release, and fully understand its contents. I am aware that this is a release of liability and a contract between Pacific Equestrian Center and myself. I also acknowledge that there are no warranties implied concerning the facilities, the event or the activities at Pacific Equestrian Centers. I further acknowledge that I am signing this contract of my own free will.

Signature of Horse Owner:______Date:______

Signature of Rider:______Date:______

Signature of Parent if Rider is a Minor:______Date:______