Jump Show Entry Form

May 19, 2012 8:00 am Office Opens

Jumping Classes Begin at 9:00 am

Judge: Marla Foreman

Name of rider:______Name of Horse

E-mail:______@______

Home phone number: (____)______Cell: ( )______

Address:______State: ______Zip Code:______

$5 a ride for members$6 a ride for non membersNumber of rides:______Total Owed:$

Circle the class(es) below you are registering for:

  1. Ground poles 17 & Under
  2. Ground poles 18 and over
  3. Cross Rail and ground poles (18 inches) 17 & Under
  4. Cross Rail and ground poles (18 inches) 18 & Over
  5. 2’(Cross Rails and verticals) 17 & Under
  6. 2’(Cross Rails and verticals) 18 & Over
  7. 2’-3”( Cross Rails, verticals and oxers) 17 & Under
  8. 2’-3”( Cross Rails, verticals and oxers) 18 & Over
  9. 2’-6”( Cross Rails, verticals and oxers) 17 & Under
  10. 2’-6”( Cross Rails, verticals and oxers) 18 & Over
  11. 2’-9”( Cross Rails, verticals and oxers) 17 & Under
  12. 2’-9”( Cross Rails, verticals and oxers) 18 & Over
  13. 3’ ( Cross Rails, verticals and oxers)
  14. 3’-3”( Cross Rails, verticals and oxers)
  15. 3’-6”( Cross Rails, verticals and oxers)

Classes with less than three participants will be cancelled
Must have a separate entry form per rider/horse combination.
Paid: Cash Check Check #: Number:

Release

Be sure to sign both sections

This entry constitutes an agreement and affirmation, that all participants (which include without limitation the owner, lessee, trainer, manager, agents, coach, rider, handler, and the horse), their principals, representatives, and agents:

  1. Shall be subject to the rules of this competition;
  2. Represent that the horse and rider are eligible as entered.
  3. Will accept as final the decision of the show committee on any question arising, and agree to hold harmless the officials and directors for any action taken;
  4. Agree that they participate voluntarily and are fully aware that horse sports and this competition involve inherent risk of injury or death. By participating they expressly hold harmless the Richland Riders Club and any and all of its directors or agents, from and against all claims of loss or injury resulting directly or indirectly from negligent acts or omissions of said officials of the competition.

Signature of Competitor:

Signature of parent or guardian for minor to show:

PHOTO RELEASE

I agree that as a condition and in consideration of (acceptance of entry in this event) (and/or admission to the grounds of the Richland Rider’s Club), and/or its assigns may for commercial purposes use, publish, copyright, or assign photographs, videos, audios, cablecasts, or other likenesses of me and my horse taken while on the grounds. I hereby expressly and irrevocably waive and release any rights of publicity, or misappropriation. If the person entered/admitted is under 18 I certify that I am his or her parent or legal guardian and I give my consent to the same on his or her behalf.

Please check one:

Yes, I agree to the above

No, I do not agree to the above

Signature: Date:

Please Print Name:

(Must be signed by a Parent or Guardian if rider is under the age of 18)