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Visio-2009 TAP New Entry formvsd

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Visio-2009 TAP New Entry formvsd Powered By Docstoc
					                                      EMG                                                                                                                                                       PLEASE READ CAREFULLY
                                       200 Pine Ave                                  TRILLIUM AT PALGRAVE
                                      Caledon, ON,                                                May 29-31, 2009                                             Every entry at a recognized competition shall constitute an agreement and affirmation that all
                                      L7E 0M1                                          Entries Close MAY 22, 2009                                             participants (which include, without limitations, the owner, lessee, trainer, manager, agent,
                                      (905) 880-5344                        Please make cheques payable to Trillium @ Palgrave                                coach, driver, handler, and the horse), for themselves, their principals, representative,
                                       FAX (905) 880-4029          Stalls & Campers must be booked in writing on separate request forms.                      employees, and agents: (1) Shall be subject and bound by the constitution and rules of Equine
                                                                                                                                                              Canada and the local rules of the competition; (2) Represent that every horse, rider, driver,
                                                                                                                    Green Yr.         1st – 2nd – R           and handler is eligible as entered; (3) Agree that they participate voluntarily in the competition
     Passport #                                      Horse Name                                                                                               fully aware that horse sports and the competition involve inherent dangerous risk of serious
                                                                                                                    Pony Size         S – M – L
                                                                                                                                                              injury or death , and accept that no helmet or protective equipment can protect against all
 Owner EC #                                          Owner Name                                                                                               foreseeable injury, and by participation they expressively assume any and all risks of injury or
 Owner THJA#                                                                                                                                                  loss, and they agree to indemnify and hold EC, Equestrian Management Group Inc., the
                                                     Owner Address                                                             Phone #                        Trillium @ Palgrave and their officials, directors, employees and agents harmless from and
 Owner OEF#                                                                                                                    (  )                           against all claims including for any injury or loss resulted, directly or indirectly, from the
                                                                                                                                                              negligent acts or omissions of said officials, directors, employees or agents of Equestrian
 Rider 1 EC #                                        Rider # 1 Name                                                            Junior DOB                     Management Group Inc., EC or the Trillium @ Palgrave. Your signature below indicates
 Rider 1 THJA #                                                                                                                                               your acceptance of and compliance with the above statement.
                                                     Rider # 1 Address                                                         Phone #
 Rider 1 OEF#                                                                                                                  (  )                                            No entry will be accepted without proper signatures
 Rider 2 EC #                                        Rider # 2 Name                                                            Junior DOB                      I have read the above conditions of this entry and herby agree to all of the terms
 Rider 2 THJA #                                      Rider # 2 Address                                                         Phone #
 Rider 2 OEF#                                                                                                                  (  )                            Trainer/Person Responsible Signature________________________
                                                                                                                                                               (required for all Entries)
Core Hunter Divisions                               Hunter Classics                                         Equitation Classes                                                                       EC Sport License # __________________________
          Division Entry Only Put Rider # in Box            Class Entry Circle Class # Put Rider # in Box    Class Entry Circle Class # Put Rider # in Box

 1                                                                                                          C Equitation     Flat 36                           Parent/Guardian Signature__________________________________
      Small/Med Pony            $80                 Pony / Mini Hunter Classic 113 $35                                                       $20
                                                                                                                             O/F 37                            (required for all Junior Riders)
  2 Large Pony         $80                          2'6"/2'9" Open Hunter Classic     114 $35               B Equitation     Flat 38
                                                                                                                                             $20             Core Jumper Classes
  3 Childrens Hunter $80                                                                                                     O/F 39
                                                    Hi/Low Open Hunter Classic       115    $35                                                               Class Entry Circle Class # Put Rider # in Box
                                                                                                            A Equitation      Flat 40
 4 Hi/Low Hunter       $80                                                                                                                   $20             Child/Adult Jumper
                                                    Hack Classic                    117     $35                               O/F 41                                                   $40
 5 Adult Amateur       $80                                                                                                                                       50      51       52
                                                                                                            Adult Equitation Flat 42         $20
                                                    Hunter Hack                     118     $20
                                                                                                                                                             Child/Adult Mini Prix 116 $40                    Show Stall @ $120.00
 6 Modified Child      $80
                                                                                                             Trillium Medal Classes                          Trillium Jumper                                  RV Space @ $120.00
  7 Modified Adult     $80                          Hunter Warm Up Tickets                                                                                                             $40
                                                                                                            CE 2'3"/2'6" Pony Medal 43 $25                         57     58      59
                                                            Class Entry Circle Class # Put Rider # in Box
 8 Trillium Hunter     $80                                                                                                                                                                                    Add’l Hunter Warm Up Tickets
                                                    Friday Main Hunter 104 $15      CE 2'9" Pony Medal 44 $25                                                CE Trillium Jumper Medal $25                     @ $15.00 each
 9 Hack Division       $60                          Friday North Hunter 105 $15                                                                                                  49
                                                                                    CE Childs Medal    45 $25
 13 Short Stirrup      $80                          Friday South Hunter 106 $15                                                                              Non Core Jumper Classes                          Faxed in Entry @ 5.00
                                                                                    CE Adult Medal     46 $25                                                 Class Entry Circle Class # Put Rider # in Box
Non-Core Hunter Divisions                           Open Card Judged Hunter Warm Up                                                                                                                           Post Entry       @ $25.00
           Division Entry Only Put Rider # in Box           Class Entry Circle Class # Put Rider # in Box   CE Mod Child Medal 47 $25                         Training Jumper                                 After May 27, 2009
                                                                                                                                                                                        $40
17    Cross-Rail                $60                 Saturday Main Ring              107     $20             CE Mod Adult Medal 48 $25                        2'9"- 86 3' - 87 3'3" - 88
                                                                                                                                                                                                              Administration Fee                  $28.00
18    Child Pony Hi/Low         $80                 Saturday North Ring             108     $20              Lead Line                 60 $15                Jumper Schooling
                                                                                                                                                             2'9" Schooling           100      $25                             G.S.T. 5%
19    Novice Hi/Low             $80                 Saturday South Ring             109     $20              Walk Trot                 61 $15
20    Child Training                                                                                                                                         3' Schooling              101     $25
                                $80                 Sunday Main Ring                110     $20             Training Equit. Flat      89    $20
                                                                                                                                                                                                              E.C. Drug Fee                       $5.00
21    Adult Am Training                             Sunday North Ring               111     $20             Child Training Medal 90                          3'3" Schooling           102      $25
                                $80                                                                                                         $20
22     Modified Low             $80                 Sunday South Ring               112     $20             Adult Training Medal 91          $20             3'6" Schooling           103      $25            Grand Total

				
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