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Rider’s Name: _____________________________________________________________
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Full Address: _____________________________________________________________
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Phone #: (_____) _____-_______ Rider’s Age: ______ D.O.B. (if under 18) ___/___/___
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Horse’s Name: ____________________________________________________________
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Check One: Saturday ENGLISH _____ Sunday WESTERN _____
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- CURRENT PROOF OF RABIES VACCINE AND NEGATIVE COGGINS REQUIRED FOR EVERY
HORSE ENTERED IN THE SHOW.
- NO HORSES TO BE RIDDEN IN ANY AREA OTHER THAN WARM-UP RING AND SHOW RING.
- ONLY HORSE WITH RIDER ALLOWED IN THE WARM-UP RING. (FOR EVERYONE’S SAFETY!)
- Pre-Entry deadline is Monday, October 1, 2012.
- No refunds given!
- Pre-Entry fee is $8.00 per class.
- Post-Entry fee is $9.00 per class.
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List Class Numbers: ________________________________________________________
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________________________________________________________________________
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Total Number of Classes: ___________________________________________________
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________________________________________________________________________
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Amount Enclosed: $__________
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| Send to: |
Anita Vedovelli
195 Torrington Road
Goshen, CT. 06756 |
or |
call:
email: |
(860) 491-9819
abdove@sbcglobal.net |
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I HEREBY ENTER THE ABOVE NAMED RIDER AND HORSE AT MY OWN RISK. I AGREE TO INDEMNIFY AND HOLD
HARMLESS THE HARWINTON AGRICULTURAL SOCIETY, HORSE SHOW COMMITTEE, AND HORSE SHOW OFFICIALS FROM
ANY AND ALL LEGAL PROCEEDINGS, AND LIABILITIES ARISING FROM ANY ACCIDENT, ILLNESS, LOSS, DAMAGE,
OR DEATH OF PERSONS, HORSE, OR PROPERTY THAT I SEND TO THIS SHOW. SIGNED ENTRY FORM SHALL BE
DEEMED ACCEPTANCE OF ALL SHOW RULES AS STATED.
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__________________________________________________________________________________
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Exhibitor Signature (or Guardian if under 18)
Date
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