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NUMBER (office use only)

ENTRY FORM

Great Southwest Equestrian Center Open Horse Show

Checks payable to: GSEC 2501 South Mason Rd., Ste. 100 Katy, TX 77450 Fax # 281-578-6651

Entries received before Wednesday 09/14/2011 will receive a $10 credit. Entries received after Friday, 09/16/2011 will pay

Date: _________ Lab:______________ Horses GSEC number_____________

Zero In Reining $50.00

$10.00 late fee. PAYMENT IS NOT REQUIRED UNTIL BACK NUMBER IS PICKED UP FROM SHOW SECRETARY

NAME OF HORSE

COGGINS Acc. #: _________________

ENTRY FEES

September 17, 2011

OWNER

______STALLS @ $30.00 Includes one bag of shavings

______GROUNDS FEE $30.00

RIDER

______CLASSES @ $10.00

___________________________________

____________________________ ______

Name

Name

___________________________________

___________________________________ NON—SHOWING FEE @ $20.00

Address

Age

Address

ALL DAY FEE @ $50.00 MUST ALSO PAY GROUNDS/ STALL FEE

___________________________________

___________________________________

City, State, Zip

City, State, Zip

OFFICE FEE @ $10 per entry

Email______________________________

Phone number ______________________

ANNUAL (ONE TIME) GSEC ASSOCIATIONFEE @ $20

___ADDITIONAL SHAVINGS $11.00

CLASSES

RV HOOKUP @ $30.00/ NIGHT LATE FEE @ $10.00

EARLY DISCOUNT $10.00 TOTAL THIS ENTRY IS AN AGREEMENT THAT THE PERSON ENTERED, ALONG WITH THE OWNER, LESSEES, TRAiNER, 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 GREAT SOUTHWEST SHOWS OPEN SERIES, GREAT SOUTHWEST EQUESTRIAN CENTER L.P., 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, GSEC, GREAT SOUTHWEST EQUESTRIAN CENTER L.P.. 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:

PLEASE STABLE WITH:

Trainer’s Name ____________________________________________________

Trainer’s Signature __________________________________________________ Where a minor exhibitor has no trainer, parent or guardian must sign and assume responsibility

MUST be signed if rider is under 18 years of age. Numbers will not be issued until this form is signed! 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 thereunder for the participation of said minor. _____________________________________________________________ Signature of Parent/Guardian/Trainer

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

Emergency Contact / Cell Phone No .___________________________



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