THE BATHURST AGRICULTURAL HORSE SHOW

THU 5 - SUN 8 APRIL

JUMPING ENTRY FORM – UNAFILLIATED COMPETITIONS

ONE ENTRY FORM PER HORSE & RIDER COMBINATION

ENTRIES CLOSE 15 MARCH 2018 NB: Overall entries restricted to 110 for horses that require stables

KEY INFO: / HORSE SICKNESS:
Show Dates / Thu 5th – Sun 8th April 2018 / Date / Batch No.:
Payment / Bathurst Show No 2 Account, FNB Port Alfred, Branch 210917 Acc 62090310906 / (i) / (i)
(ii) / (ii)
Email: / / EQUINE FLU
Only scanned and signed email entries accepted with proof of payment / Date / Batch No.:
(i) / (i)
Queries / Candy Marshall 0833883644 or email above / (ii) / (ii)
NAME OF HORSE: / NAME OF COMPETITOR:
OWNER: / INDICATE / ADULT JUNIOR PONYRIDER
STALLION MARE GELDING / By signing I hereby accept and agree to abide by all the rules set out in the schedule
The owner/competitor undertakes to not bring any horse to the show which has an infectious disease, whether notifiable or not, or which horse the competitor could reasonably be expected to know has an infectious disease. The competitor undertakes to withdraw the horse from the show (with forfeiture of entry fee) if subsequent to entry it should develop, or circumstances arise which the competitor can reasonably be expected to know the horse has developed, or may develop, any such disease or the ability to spread such disease. I declare that the vaccination details entered are valid and were administered by a registered veterinarian.
The sponsors, BRC, BAS, the organizing body and officials appointed by those bodies, shall in no way be held responsible for any damage, loss or injury sustained by the owners, competitors, grooms, and members of the public or any other persons on their property at the Bathurst Showgrounds for the duration of the show, or any damage or loss which only eventuates after the show, but may somehow be linked to it.
SPECIAL STABLING REQUIREMENTS:
DATE OF ARRIVAL IF KNOWN:
NO OF GROOMS ATTENDING:
CLASS NO. / CLASS NAME / AMOUNT
PUISSANCE
MINI DERBY 55CM(open to 50CM-70CM)
MINI DERBY 75CM (open to 70CM-90CM)
MINI DERBY 95CM (open to 90CM-1.0M)
MINI DERBY 1.15M (open to 1.0-1.3M)
SUB TOTAL
STABLING* / OPEN R200 WOOD R300 BRICK R400 / NAME OF RESPONSIBLE PERSON OVER 18:
COMPETITORS LEVY* R150 PER HORSE
TEL:
GRAND TOTAL / EMAIL:
* These do not need to be duplicated on every discipline form
SIGNATURE OF RESPONSIBLE PERSON OVER 18
FOR OFFICE USE
Date Received / Correct Entry Fee
Correct Information / Confirmed Receipt