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Hot Daze Horse Show & Mo Hot Daze Horse Show

ENTRY FORM

Checks payable to: Britannia Farm 26901 West Brooks Rd. Waller, TX 77484

August 21 & 22, 2010 Entries received after 6 pm Thursday will pay $10 late fee. Mail or fax to 936-372-9499 before 6:00 p.m. Thursday.

OWNER

COGGINS Acc. #: _________________ Date: _________ Lab:______________

D

E

F

G

______STALLS @ $50.00 ______DAY STALL @ $40/day

___________________________________

____________________________ ______ NON—SHOWING FEE @ $30/day

Name

Name

___________________________________

___________________________________

Address

Address

___________________________________

___________________________________ OFFICE FEE @ $10 per entry

City, State, Zip

City, State, Zip

Age

H

I

J

K

L

M

N

RIDER GHHJA #: ___________________

O

Pre Non Walk Pre Grn Sm Med Lg Limit Jr/Ad Low Opn Sch Beg Nov Grn Pro Trot Beg Grass Pony Pony Pony Hntr Hntr Hntr Hntr Hntr Hntr Hntr

P

Q

____GROUND FEE @ $20/day ______SHAVINGS

GHHJA N/M FEE @ $10

R

TOTAL

S

Sch Jr/Ad Open Ity Bity Jmpr Jmpr Jmpr Jmpr

SAT

CLASS FEES LATE FEE

*** NO FAXED ENTRIES AFTER THURSDAY ***

MARK DIVISIONS ENTERED FOR EACH DAY C

______STALLS @ $70.00

RIDER

Horse GHHJA #: ___________________ OWNER GHHJA #: _________________

B

ENTRY FEES

NO FAXED ENTRIES AFTER THURSDAY—Bring entry to show on Friday Entries received by 5:00 pm Wednesday receive $10 credit on account

NAME OF HORSE

A

NUMBER (office use only)

INDIVIDUAL CLASSES

EQUITATION CLASSES

SAT SUN

SUN THIS ENTRY IS AN AGREEMENT THAT THE PERSON ENTERED, ALONG WITH THE OWNER, LESSEES, TRANER, MANAGER, COACH AND HORSE: (1) THAT EVERY HORSE AND RIDER IS ELIGIBLE AS ENTERED; (2) THAT THE OWNER AND ANY OF HIS/HER REPRESENTATIVES WILL AGREE TO THE FINAL DECISIONS MADE BY THE MANAGEMENT AND HOLD THE COMPETITION OF THE GHHJA, PAULINE COOK; DBA BRITANNIA FARM, GREAT SOUTHWEST EQUESTRIAN CENTER L.P., LUCIA HANSEN, MAURENE MOFFETT, THEIR OFFICIALS, THE MANAGEMENT EMPLOYEES AND AGENTS HARMLESS FOR ANY INJURY OR LOSS SUFFERED DURING OR IN CONJUNCTION WITH THE COMPETITION, WHETHER OR NOT SUCH INJURY OR LOSS RESULTED, DIRECTLY OR INDIRECTLY, FROM THE NEGLIGENT ACTS OR OMISSIONS OF SAID OFFICIALS, EMPLOYEES, AGENTS, THE MANAGEMENT, GHHJA, PAULINE COOK; DBA BRITANNIA FARM, GREAT SOUTHWEST EQUESTRIAN CENTER L.P. LUCIA HANSEN, MAURENE MOFFETT, . WARNING, UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE), AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE HEATHOF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES.

PERMISSION FOR A MINOR TO SHOW: MUST be signed if rider is under 18 years of age. Numbers will not be issued until this form is signed!

PLEASE STABLE WITH: Notice: Stalls will not be held unless check accompanies entry. Trainer’s Name ____________________________________________________ Trainer’s Signature __________________________________________________ Trainer’s GHHJA Number ____________________________________________ Where a minor exhibitor has no trainer, parent or guardian must sign and assume responsibility.

I hereby consent to the entry of my child _____________________________________ in this show and certify that I have read the foregoing representations and statement, and that I hereby agree and accept responsibility there under for the participation of said minor.

Exhibitor Signature _________________________________________________

_____________________________________________________________ Signature of Parent/Guardian/Trainer

Emergency Contact / Cell Phone No.___________________________

(Must be signed by exhibitor, owner or his agent.)


http://www.gswec.com/downloads/2010PrizeLists/HotDaze%20MoHotDaze%20Aug%202010%20entry