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WANHAM PLOWING MATCH GYMKHNA ENTRY FORM June 19, 2011 NAME & MAILING ADDRESS & PHONE #:_______________________________________________________ AGE AS OF JANUARY 1_________AGE GROUP (CIRCLE ONE) LEADLINE, PEEWEE(10 & -) ,JUNIOR(11-14), INTERMEDIATE(15-18), ADULT(19+) HORSE’S NAME________________________________ EVENT ENTRY FEE: PRIZE MONEY: AMOUNT: STAKES $2.00 FLAGS $2.00 POLES $2.00 KEYHOLE $2.00 JACKPOT KEYHOLE $5.00 1ST 50% /2nd 30% BARRELS $2.00 JACKPOT BARRELS (18+) $10.00 1ST $100.00 / 2ND 80% JACKPOT BARRELS (13-17) $5.00 1ST $100.00 / 2ND 80% JACKPOT BARRELS (-12) $5.00 1ST $100.00 / 2ND 80% JACKPOT EGG STOMP $5.00 1ST 50% / 2nd 30% ENTRY TOTAL PRIZE TOTAL **PLEASE MAKE CHEQUES PAYABLE TO C.O.C.O. PLOWING MATCH & AG. SOCIETY- THE WANHAM PLOWING MATCH & GYMKHANA ARE NOT RESPONSIBLE FOR ANY INJURIES WHICH OCCUR DURING THE EVENT OR WHILE ON THE GROUNDS. I UNDERSTAND & ACCEPT THESE TERMS: __________________________ SIGNATURE (PARENT/GUARDIAN IF PARTICIPANT IS UNDER 18) ACKNOWLEDGMENT OF RISK AND RELEASE OF LIABILITY For All Participants in the Province or Territory in which the Equine Activities are provided by the Host. WARNING: THIS AGREEMENT WILL AFFECT YOUR LEGAL RIGHTS. READ IT CAREFULLY! I acknowledge that the sport of horses is a high risk sport and that I am participating at my own risk and in full knowledge of the hazards and potential hazards in this sport. I further acknowledge the inherent risk in riding and working around horses, which risks include bodily injury to both horse and rider, which can result from normal use, competition or schooling. In consideration of being allowed to participate in this event, I hereby assume all risk and hereby absolve the C.O.C.O. Plowing Match and Agricultural Society also known as the Wanham Plowing Match, their directors, officers, volunteers, and representatives from any and all responsibility, liability or claims of any nature which I may have arising from my activities in this activity, including but not limited to bodily injury or death to myself or my horse(s) and damages to property arising from any cause whatever, including negligence of one or more individuals and organization referred to herein. I hereby declare that in signing this document, that I have read and fully understand and agree to the terms and conditions stated herein and that this is binding upon my executors, heirs or assigns. Signature of rider_____________________________ Date: _____________________ (If rider is under the age of 18, the parent or guardian must also sign) I acknowledge as Parent/Guardian of__________________________________ that I have read and fully understand and agree to the terms and conditions stated herein. Signature of Parent/Guardian____________________ Date: ____________________ WANHAM PLOWING MATCH GYMKHNA RULES AND REGULATIONS REGISTRATION 9:00-10:00 AM START TIME IS 10:00 A.M EVENT CASH PAYOUT - 1ST – 3RD PLACE AGE GROUP: (AS OF JANUARY 1ST OF THE CURRENT YEAR) LEADLINE – ANY AGE THAT HAS TO BE LEAD PEEWEES – 10 & UNDER JUNIOR – 11-14 INTERMEDIATE –15- 17 ADULT –18 & OVER- MENS & LADIES COMBINED IT IS RECOMMENDED THAT ALL HORSES HAVE A CURRENT NEGATIVE COGGINS TEST The C.O.C.O. Plowing Match & Ag. Society/ Horse Show accepts no liability for any loss, accident, damage or illness to spectators, horse, participants and their property during our event or while on the grounds. The Executive Committee reserves the right to decide any point not covered by the rules and to correct any error or make alternatives if necessary to the rules, prizes or programs. There shall be no refund of entry fees unless Veterinarian Certificate is presented to the Director or event has been cancelled. In the event of only one contestant, in any age group, they will be placed, according to their time in each event. Contestants shall be disqualified for abusing the horse or for misconduct, for the remainder of the show at which the infraction occurs. This ruling applies to arena and show grounds. Western attire must be worn: (cowboy boots, western shirts/blouses, hats, etc. Riders must ride in all Speed Events to participate in the Jackpot Events and to qualify for High Point Awards. Riders must ride with the same horse though-out the event. High Point Awards – most points accumulated in the Speed Events. No re-runs will be allowed on account of falling horses or faulty equipment. Bats can be no longer than thirty (30) inches long including two (2) inch long popper. In all events only one of the following may be used: Spurs, or Bat, or an Over and Under. BREAKING TIES: If the first rider out should disqualify, the second rider out must complete this tie breaking run. ***In every event each horse & rider must complete a left or right hand turn after crossing the finish line. ALL DECISIONS ARE FINAL!! THANK YOU FOR YOUR CO-OPERATION & LET’S HAVE FUN!!
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