Windy Hollow Hunt Dressage Show I June 5 & 6, 2015 Windy Hollow Hunt Dressage II June 7, 2015

May 5, 2015 Opening Date June I & II - USEF/USDF #6760/328076 (Level 3) Closing Date: May 23, 2015 Windy Hollow Hunt Dressage Show I – June 5 & 6, 2...
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May 5, 2015 Opening Date June I & II - USEF/USDF #6760/328076 (Level 3)

Closing Date: May 23, 2015

Windy Hollow Hunt Dressage Show I – June 5 & 6, 2015 Windy Hollow Hunt Dressage II – June 7, 2015

Sussex County Fair Grounds – 37 Plains Rd, Augusta, NJ 07822 Judges: Pam Wooding S NJ Dinah Babcock S TX

Technical Delegate: Victoria Mozykowski, r, FL EMT: Peggy Warnet

Official Qualifying Competitions for GAIG/USDF 2015 Regional Championships & CBLM CHAMPIONSHIPS OFFICIAL QUALIFYING COMPETITION FOR THE 2015 ADEQUAN FEI NORTH AMERICAN JUNIOR AND YOUNG RIDER CHAMPIONSHIPS PRESENTED BY GOTHAM NORTH OFFICIAL QUALIFYING COMPETITION FOR THE 2015 MARKEL/USEF YOUNG & DEVELOPING HORSE DRESSAGE CHAMPIONSHIPS Official Qualifying Competition for 2015 USEF Pony Rider Dressage National Championships:2015 AGCO/USEF Junior and Young Rider Dressage National Championships:and the 2015 USEF Young Adult Brentina Cup Dressage National Championships presented by Dressage Today

Managers: Sally Wiley 973-764-0925 [email protected]

Show Secretary: Lori Kaminski 410 Charter Hall Rd, Perryville, MD 21903 302-545-8855 – [email protected] Organizing Committee Chairs: Dr. Lisa Toaldo & Noreen Gratzel

CLASSES - Go to www.windyhollowhunt.org for Updates Note: June I & II are two separate shows. Please use separate entry blanks & fees for each show.

LEVELS: USDF Intro through FEI Grand Prix, including USEF Rider Tests, Freestyles, Junior, YR, plus USEF Opportunity classes, Dressage Seat Equitation and Para-Equestrian. Adult Amateur and Junior/Young Rider divisions are offered for each test when three or more entries for that test are received. Pony only classes for Adults and Juniors. USEF Pony Card required. USEF TEST OF CHOICE CLASSES: Note that any test offered on a particular day as Great American Insurance Group/USDF Qualifying, is not also eligible as qualifying in a test of choice class on the same day. FREESTYLES: Freestyle class entries require copies of qualifying tests at that level to be submitted at time of entry. Riders should submit music to the announcer’s booth the morning of their ride. Music should be labeled with instructions and horse/rider names. OPPORTUNITY CLASSES: Held in accordance with USEF GR331. Scores from these classes will not be included for high point or yearend awards. Horses entered only in these classes are exempt from USEF/USDF fees, including the Equine Drugs and Medication fee, but they are still subject to and must comply with the Drugs and Medication rules and may be selected for drug testing. Horses entered only in these classes are not required to have a USEF/USDF number but are to list the numbers if the horse has been registered with either federation. Riders who enter only Opportunity Classes are exempt from USEF/USDF membership requirements and are not required to pay a non-member fee, but are required to list membership numbers if the participant is a member. Riders and horses may also enter Introductory Classes with the same exemptions. Cross entry to other classes is allowed, but then all applicable fees and membership requirements apply. AWARDS: Ribbons - First through Sixth place. First place in a class of three or more riders receives a trophy or award. High Score Trophies for Open, AA, Jr/YR, FEI and Musical Freestyles and Pony only (Opportunity, Introductory, Test of Choice, and Dressage Seat Equitation classes do not count). USDF/Dover Adult Amateur Medal awarded at both shows to the Adult Amateur rider with the highest score in Classes 223A (Saturday) and 323A (Sunday). American Morgan Horse Association Open High Point Award recognizing the highest scoring Morgan; awarded at both shows. Opportunity and Intro classes will be grouped and pinned as one. Must submit breed papers and proof of membership in the breed association for this award. American Warmblood Society High Score Award recognizing the highest scoring AWB; awarded at both shows. Must submit breed papers for this award. American Trakehner Association High Score Award recognizing the highest scoring Trakehner; awarded at both shows. Must submit breed papers and proof of membership in the breed association. American Hanoverian Society High Score Award recognizing the highest scoring Hanoverian of the week-end. Must have American or German Hanoverian papers or an AHS Certificate of Pedigree. Thoroughbred Incentive Program Classes sponsored by the Jockey Club, offered per weekend. Must have a T.I.P. registration (it’s free). For more information and to register go to http://tjctip.com. Fresian High score Award sponsored by FHANA- highest scoring Fresian for weekend, some restrictions apply, check WHH website for further details, must submit Breed papers and membership. Trainer Award – details to follow on the WHH web site. Plus, we offer a complimentary tack stall to trainers who bring five or more competing horses, according to availability. Pony Club – Highest scoring Pony clubber per show. Must be a current member or show proof of past membership.

ENTRY FEES: $45 $50 $65 $65 $45 $50 $45 $30 $10 $30 $16 $80 $30 $50 $10 $20 $35

Training-Second Level Third -Fourth USDF Freestyle Classes All FEI Classes Para Equestrian classes Jr,Yr and Pony classes Rider Tests Dressage Equitation, Opportunity & Introductory Classes GAIG/USDF Qualifying add to class fee where appropriate (BLM Qualifying no extra charge) Office Fee per Show USEF Drug Fee per Show – Opportunity & Introductory classes are exempt Non-competing Horse Fee (includes office fee) USEF Pass Fee (formerly Non-member Fee) per Show (includes rider/owner/trainer) Post Entry Fee (entries received after closing date) Incomplete Entry Fee (for missing coggins, proof of USEF/USDF registrations, emergency contact) Change Fee (for class changes and horse/rider substitutions once show has started) Returned Check Fee (if not rectified within 10 days the matter will be turned over to USEF for disciplinary action

$25 USDF non –member fee

Note: June I & II are two separate shows. Please use separate entry blanks & fees for each show. Make checks payable to Windy Hollow Hunt and mail to:

Lori Kaminski – 410 Charter Hall Road, Perryville, MD 21903 [email protected] Visa and MasterCard also accepted. Include card information on entry form in specified area. On-line entries can be accessed through www.windyhollowhunt.org NO REFUNDS after the closing date (GR 311.1.7 exception “act of God” in which classes are canceled, only those class fees will be refunded). Refunds before closing date will be issued for amount paid minus the $30 office fee. Returned checks will incur a $35 fee; if not rectified within 10 days the matter will be turned over to USEF for disciplinary action. ENTRY REQUIREMENTS: Entries must include current coggins within one year. All horses minimally must have a USDF HID number for regular classes. Entries for GAIG/USDF Qualifying must include proof of full USEF Annual or Lifetime recording and USDF Lifetime registration for horse. Rider and owner must be current USEF/USDF Participating/Business members. Go to www.eqverification.org to print out all USEF/USDF registrations on one page. Incomplete entries (missing coggins, proof of USEF/USDF registrations, emergency contact) subject to $10 incomplete entry fee. RIDE TIMES: Tentative ride times and stabling will be available online at www.windyhollowhunt.org the Wednesday night prior to the show. STABLING: See note below. Permanent 10X10 stalls with solid doors on grounds. $195 for noon Thursday through end of show Sunday; $95 day only based on availability only. Includes 2 bags initial bedding. Additional bedding available for $9.00/bag. Tack stalls are available at the same rates (limited availablity.) We will again be offering a complimentary tack stall to trainers who bring five or more competing horses. FOOTING: Four 20 X 60 meter sand mix competition arenas. Same footing in the two warm-up rings. Grass warm-up also available.

CONCESSIONS: Food concessions available on show grounds. HOTEL ACCOMMODATIONS: Holiday Inn Express, 973-940-8888. Mention code WHH for discount. Limited rooms available. Crystal Springs Resort,973-827-5996. RV/CAMPER HOOK UPS: RV hook ups/camping - $150/weekend. Shower facilities available on grounds. Please indicate on entry. DIRECTIONS: From NW I-84 (NY & PA): Take Milford Exit, Rt. 6 east to Rt. 209 wouth. Cross bridge to NJ at Milford. Take Rt. 206 south ten miles to Plains Rd on left (follow signs). From NE (NY & CT): Take I-84 west to Exit 3W/Middletown (before overpass)/Rt. 6. Turn left at light and follow Rt. 6 to Slate Hill/Rt. 284 (left turn), then south through towns of Westtown & Unionville to Sussex. Turn right at light onto Rt. 23; immediate left to light and straight onto Rt.639 (past airport) to Rt. 565. Watch for signs to fairgrounds (about 5 miles). Second sign (Linn Smith Rd) better for trailers. Turn left at end and fairgrounds are ½ mile on left. For further information check www.newjerseystatefair.org. MANAGEMENT: Show management reserves the right to refuse, accept conditionally, and/or cancel award of prizes without claims for damages, and to change the order of classes or cancel or combine classes at its discretion if entries deem necessary. Management also reserves the right to substitute judges if necessary. OTHER: Farrier – John Nurge, 973-219-2254 or 908-850-0194; on call. Video/Photographs – Susan Stickle Photography Protective Headgear must be worn at all times when mounted per USEF rule DR120.6 Dogs must be leashed at all times. Fines will be assessed for unleashed dogs. Veterinary East Coast Equine-(908-852-1300); on call Pony measurement- upon request,see website for times, an alternative time, if necessary,must be requested in writing to management from the owner or agent five days prior to the start of the competition with a fee of $100.00.

CLASS LIST (Friday & Saturday = Show 1; Sunday = Show 2) FRI

SAT SUN FEE CLASS NAME

100A 100B 100C 100D 101 102 103 RT1 111 112 113 RT2 121 122 123 --RT3 131 132

200A 200B 200C 200D 201 202 203 RT11 211 212 213 RT22 221 222 223 223A RT33 231 232

300A $30 300B $30 300C $30 300D $30 301 $45 302 $45 303 $45 RT111 $45 311 $45 312 $45 313 $45 RT222 $45 321 $45 322 $45 323 $45 323A $45 RT333 $45 331 $50 332 $50

USDF Introductory Walk-Trot A USDF Introductory Walk-Trot B USDF Introductory C Dressage Seat Equitation Training Level Test 1 - Open, AA, Jr/YR Training Level Test 2 - Open, AA, Jr/YR, BLM Qual. Training Level Test 3 - Open, AA, Jr/YR, GAIG/USDF Qual. USEF Training Level Rider Test First Level Test 1 - Open, AA, Jr/YR First Level Test 2 - Open, AA, Jr/YR, BLM Qual. First Level Test 3 - Open, AA, Jr/YR, GAIG/USDF Qual. USEF First Level Rider Test Second Level Test 1 - Open, AA, Jr/YR Second Level Test 2 - Open, AA, Jr/YR, BLM Qual. Second Level Test 3 - Open, Jr/YR, GAIG/USDF Qual. Second Level Test 3 - AA Dover Medal, GAIG/USDF Qual. USEF Second Level Rider Test Third Level Test 1 - Open, AA, Jr/YR Third Level Test 2 - Open, AA, Jr/YR, BLM Qual.

Opportunity Classes Friday OP1 $30—First Level Test 1 OP2 $30--First Level Test 2 Saturday OP3 $30—First Level Test 2 OP4 $30--First Level Test 3 Sunday OP5 $30—First Level Test 1 OP6 $30—First Level Test 3 No USEF/USDF horse/ owner/ rider registrations or USEF drug fee required.

133 141 142 143 151 161 162 171 172 181 182 183 184 191 292 193 194

195 195A 196A 196B 197 197A 198 199

199E 400 401 402

233 241 242 243 251 261 262 271 272 281 282 283 284 ------293

333 341 342 343 351 361 362 371 372 381 382 383 384 ----393

294 394 601 602 295 395 295A 395A 296 396A 700 396 297 397 297A 397A 298 398 299 299A 299B 299C 299D 299E 500 501 502

399 399A 399B 399C 399D 399E

$50 $50 $50 $50 $65 $65 $65 $65 $65 $65 $65 $65 $65 $65 $65 $65 $65

Third Level Test 3 - Open, AA, Jr/YR GAIG/USDF Qual. Fourth Level Test 1 - Open, AA, Jr/YR Fourth Level Test 2 - Open, AA, Jr/YR, BLM Qual. Fourth Level Test 3 - Open, AA, Jr/YR, GAIG/USDF Qual. Prix St. Georges - Open, AA, Jr/YR, GAIG/USDF Qual., BLM Qual. Intermediaire 1 - Open, AA, Jr/YR, GAIG/USDF Qual., BLM Qual. Intermediaire 2 - Open, AA, Jr/YR, GAIG/USDF Qual., BLM Qual. FEI Grand Prix - Open, AA, Jr/YR, GAIG/USDF Qual., BLM Qual. FEI Grand Prix Special - Open, AA, Jr/YR USDF Musical Freestyle - Open, AA, Jr/YR, GAIG/USDF Qual., BLM Qual. FEI Musical Freestyle - Open, AA, Jr/YR, GAIG/USDF Qual., BLM Qual. Musical Freestyle Quadrille TOC Pas de Deux TOC FEI Junior Team Test– ( NAJYRC/GAIG/USDF/USEF Qual.) FEI Young Rider Team Test– ( NAJYRC/GAIG/USDF Qual. ) FEI Test of Choice - Open FEI Young Horse - FEI 5 & 6 y.o. Preliminary

$65 $65 $45 $65 $45 $45 $45 $45 $45

FEI Young Horse – FEI 5 yo Final (USEF Qualifier-Saturday only) FEI Young Horse- FEI 6 yo Final (USEF Qualifier Saturday only) Paraequestrian Test of Choice – State which Test Paraequestrian Freestyle Test of Choice – State which Test USEF Developing PSG USEF Qual. Saturday only USEF Developing GP – USEF Qual. Saturday only All Pony Test of Choice – Adult/Open –State which Test (see website for requirements) All Pony Test of Choice – Junior – State which Test (see website for requirements) USEF Young Horse Test for 4 Year Olds ( Markel/USEF Qualifier SAT only )

$65 $65 $65 $65 $65 $65 $65 $65 $65

FEI Pony Test of Choice – State which Test FEI Junior Individual Test - NJYRC and USEF Qual. Sunday are NOT Qual FEI Junior Freestyle Test - NJYRC and USEF QUAL Sunday are NOT Qual FEI YR Individual Test Test- NAJYRC and USEF Qual. Sunday are NOT Qual FEI Young Rider Musical Freestyle- NAJYRC AND USEF qual. Sunday are NOT Qual FEI YR Grand Prix 16-25 Test – USEF QUAL. SAT ONLY Brentina’s Cup USEF FEI Pony Team USEF – Saturday Qualifier only FEI Pony Individal USEF- Saturday Qualifier only

Note: Show I (Friday/Saturday) and Show II (Sunday) are separate shows. Please use separate entry blanks and fees for each show and include the day and date. Only one set of supporting paperwork and one check is necessary. Please indicate your status on entry blank (OPEN, AA, or JR/YR), and if you’re qualifying for GAIG/USDF 2015 Regional Championships in appropriate classes.

Every class offered herein which is covered by the rules and specifications of the current USEF Rule Book will be conducted and judged in accordance therewith.

USEF MEMBERSHIP STATEMENT Life, senior active and junior active members shall be eligible to participate in all classes at Regular Competitions, Eventing Competitions at the Preliminary Level or above and Combined Driving Competitions at the Advanced Level, Dressage, Reining and Vaulting Competitions and Endurance Rides. A nonmember may participate as a handler, rider, driver, owner, lessee, agent, coach or trainer at Regular Competitions, Eventing Competitions, Dressage Competitions, Reining Competitions and Combined Driving Competitions upon payment of a $30 show pass fee. Participants in the following classes are exempted from the Requirements of this rule: 1) leadline; 2) exhibitions; 3) games and races; 4) classes for 4-H members; 5) walk trot and academy classes (academy classes are classes limited to horses used regularly in a lesson program); 6) USDF introductory level tests, pas de deux and quadrille classes; 7) NRHA Endorsed Reining Competitions. 8) Opportunity classes, 9) citizens of other nations who have proof, in English, of current membership in good standing of their own National Federation, 10) USEA beginnernovice division; and 11) assistant handlers in Dressage Sport Horse Breeding classes. Motorized Vehicle Statement In accordance with GR1301.7: Minors who do not have a valid driver's license which allows them to operate a motorized vehicle in the state in which they reside will not be permitted to operate a motorized vehicle of any kind, including, but not limited to, golf carts, motorcycles, scooters, or farm utility vehicles, on the competition grounds of licensed competitions. Minors who have a valid temporary license may operate the above described motorized vehicles as long as they are accompanied by an adult with a valid driver's license. Violations of this rule will be cause for sanctions against the parent(s), guardian(s) and/or trainer(s) who are responsible for the child committing the offense. Penalties may include exclusion of the child, parent(s), guardian(s), and/or trainer(s) from the competition grounds for the remainder of the competition and charges being filed against any of the above individuals in accordance with Chapter 6. Wheelchairs and other mobility assistance devices for individuals with disabilities are exempt from this rule.

2015

Official Use Only

BRIDLE #

COMPETITION NAME____________________________________ COMPETITION DATES NAME OF HORSE

PREVIOUS NAME (IF ANY)

_________________ BREED

SEX

DAM’S SIRE

HEIGHT

COLOR COGGINS DATE (ENCLOSED

COUNTRY OF BIRTH

YEAR OF BIRTH

USEF#

COPY)

SIRE

BREEDER

RIDER/HANDLER ________________________________________

USDF#

DAM

FEI/PASSPORT #

CLASS NO.

FOR SALE

DIVISION

GROOM

CLASS DESCRIPTION

QUAL Y/N

FEES

USEF#______________ USDF#____________ FEI/LOCAL#___________

ADDRESS ________________________________________________ CITY/ST/ZIP______________________________________________ CELL PHONE__________________J R/YOUNG RIDER BIRTHDAY________ EMAIL ADDRESS____________________________________________ RIDER CITIZENSHIP (IF NOT USA )_________________________________ RIDER STATUS (CIRCLE ONE):

JR/YG

AA

OPEN

OWNER ________________________________________________ USEF#______________ USDF#____________ LOCAL#

_____________

ADDRESS ________________________________________________ CITY/ST/ZIP ______________________________________________ CELL PHONE______________________________________________ EMAIL ADDRESS____________________________________________

SUBTOTAL CLASS FEES AND QUALIFYING FEES USEF Show Pass FEES $30 PER NON-MEMBER USDF NON MEMBER FEE $25 PER NON-MEMBER OFFICE FEE AND/OR BRIDLE # FEE USEF HORSE FEES $8 USEF FEE + $8 DRUG FEE = $16.00

OWNER CITIZENSHIP (IF NOT USA )________________________________

CDI HORSE FEES TRAINER _______________________________________________ USEF#______________ USDF#____________ LOCAL#

_____________

$8 USEF FEE + $ 20 DRUG FEE = $28.00

IHP DISCIPLINE FEE ($35

IF REQUIRED)

ADDRESS ________________________________________________

STABLING FEES _____ STALL @ $_____/STALL

CITY/ST/ZIP ______________________________________________

TACK STALLS

_____ STALL @ $_____/STALL

CELL PHONE______________________________________________

BEDDING

____ BALES @ $_____/BALE

EMAIL ADDRESS____________________________________________

NON COMPETING HORSE FEE

COACH ________________________________________________

SPONSORSHIP

USEF#______________ USDF#____________ LOCAL#

_____________

GROUNDS FEE OR OTHER FEES ___________

ADDRESS ________________________________________________

OTHER_____________________________

CITY/ST/ZIP ______________________________________________

LATE/CHANGE/BANK CHARGES FOR CC

TOTAL FEES

Please Fill Out Both Sides of This Form. Reverse side MUST be SIGNED.

Stabling Information & Special Requests: Please list only ONE name (either individual or barn) for entire group (so we can get everyone together) Group/Self

Tue

Wed

Thu

Fri

Sat

Sun

Mon

Stalls Tack Stalls

Stable Group: _______________________________________________ Contact: ______________________________

US Equestrian Federation, Inc. Entry Agreement I have read the United States Equestrian Federation, Inc. (the “Federation”) Entry Agreement (GR906.4) as printed in the Prize List for [insert name here] (“Competition”) and agree to all of its provisions. I understand and agree that by entering this Competition, I am subject to Federation Rules, the Prize List, and local rules of the competition. I agree to waive the right to the use of my photos from the competition, and agree that any actions against the Federation must be brought in New York State.

Federation Release, Assumption of Risk, Waiver and Indemnification This document waives important legal rights. Read it carefully before signing. I AGREE in consideration for my participation in this Competition to the following: I AGREE that “the Federation” and “Competition” as used herein includes the Licensee and Competition Management, as well as all of their officials, officers, directors, employees, agents, personnel, volunteers and Federation affiliates. I AGREE that I choose to participate voluntarily in the Competition with my horse, as a rider, driver, handler, vaulter, longeur, lessee, owner, agent, coach, trainer, or as parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sports and the Competition involve inherent dangerous risks of accident, loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death. (“Harm”). I AGREE to hold harmless and release the Federation and the Competition from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm of any nature caused by me or my horse to others, even if the Harm arises or results, directly or indirectly, from the negligence of the Federation or the Competition. I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of the Federation or the Competition. I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the Federation and the Competition and to hold them harmless with respect to claims for Harm to me or my horse, and for claims made by others for any Harm caused by me or my horse while at the Competition. I have read the Federation Rules about protective equipment, including GR801 and, if applicable, EV114, and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that the Federation strongly encourages me to do so while WARNING that no protective equipment can guard against all injuries. If I am a parent or guardian of a junior exhibitor, I consent to the child’s participation and AGREE to all of the above provisions and AGREE to assume all of the obligations of this Release on the child’s behalf. I represent that I have the requisite training, coaching and abilities to safely compete in this competition. I AGREE that if I am injured at this competition, the medical personnel treating my injuries may provide information on my injury and treatment to the Federation on the official USEF accident/injury report form. BY SIGNING BELOW, I AGREE to be bound by all applicable Federation Rules and all terms and provisions of this entry blank and all terms and provisions of this Prize List. If I am signing and submitting this Agreement electronically, I acknowledge that my electronic signature shall have the same validity, force and effect as if I affixed my signature by my own hand. BOD 1/23/11 Effective 12/1/11

*RIDER/HANDLER (mandatory)

*OWNER / AGENT (mandatory)

*TRAINER (mandatory)

COACH (If applicable)

Signature:

Signature:

Signature (must be 18 or older):

Signature:

Print:

Print:

Print:

Print:

PARENT/GUARDIAN (Required if rider/handler is a minor, i.e. under 18) Signature:

(Home/Parent) Emergency Contact Is RIDER a U.S. citizen? (mandatory) Phone #

Print:

YES ________

NO ________

* No entry is valid without original signatures from the above individuals; Photocopied signatures or writing “same” are NOT acceptable. STABLING / CAMPER HOOK-UP RESERVATION FORM (Refer to Prize List for Specifications) ENTRY PREPARATION CHECKLIST Contact NAME and NUMBER for Rider Emergency: Contact NAME and NUMBER for Horse Emergency: Before Mailing, Be Sure You Have: ____________________/______________________

__________________/_______________________

___________________________________________ Name of Lodgings Where Rider or Responsible Party Will be Staying During the Competition

_________________________________________ Hotel Number at the Competition (For Emergency Contact Purposes)

Stall Occupant

Sex (S,M,G)

Check Stall Days/Nights Desired (see prize list directives) Mon Tues Wed Thurs Fri Sat Sun

Horse Name If accompanied by NON-COMPETING HORSE, must complete separate entry form and pay all applicable fees.

Tack

___ Supplied all Required Ass’n Numbers ___ Enclosed Copies of Applicable USEF and/or USDF Cards or Documents ___ Completed the Stabling / Camper

n/a

Approx. Time of Arrival: Special Requests*:

___Completed Both Sides of Entry Form ___All Original Required Signatures ___ Enclosed a Copy of the Current Negative Coggins (EIA) Certificate (Refer to Show Specifications for Date Validity Requirements. Copy must be legible.)

__________________

Approx. Time of Departure:

__________________

____________________________________________________________________

_______________________________________________________________________________________ *Provide name of individual with whom you desire to be stabled (if part of a group, make sure you all name the same person)

Stabling fees: ___________stalls for ___________nights @ $ _________ per night = __________________ Camper fees _____hook-ups @ $______ea (flat rate) OR _____nights @ $ _______ per night = _________ TOTAL STABLING / CAMPER HOOK-UP FEES: _________________

___ Enclosed a Check / Money Order for all Applicable Fees. ___Attached photocopy of Test(s) verifying USDF & FEI Freestyle Test eligibility (ex. for exempt classes) Mail this Entry Form, Supplemental Documents, and Fees to the Competition (Entry) Secretary Identified on the Prize List. EMERGENCY CELL CONTACT # OF SOMEONE WITH YOU /YOUR GROUP AT THIS SHOW WHO IS NOT LISTED ELSEWHERE ON THIS ENTRY FORM

________________________________

PLEASE SUBMIT ANY IMPORTANT INFORMATION FOR THE ANNOUNCER ON A SEPARATE SHEET