Docstoc

Grinnell Saddle Club Entry Form

Document Sample
Grinnell Saddle Club Entry Form Powered By Docstoc
					2010 Grinnell Saddle Club Entry Form                       JUNE 5-JUNE 26- SEP TEMBER 6                         Back #
ONE HORSE & RIDER COMBO PER CARD                                                                         (NUMBER STAYS WITH HORS E)
Exhibitor Name:

Horse's Name:                                                                       ONE EXHIBITOR PER CARD

Address:                                                                            ONE HORSE PER CARD



Circle the class #s for which you are registering:
                Pay           Pay           Pay           Pay         Pay           Pay           Pay           Pay
            1            7             14            20         ~27           35             41          47

           2             8             15            21         29            36             42          48

           3             9             16            22         30            ~37            43          49

           4             10            17            23         31            38             44          50

           5             12            18            24   trophy 33           39             45          51 _______

           6             13            19            25   trophy 34           40             46

                                                                                          Total Payback Won $
OFFICE USE ONLY

               _____ classes @ $6        $ ______                     Minus Entry Amt. Due GSC           $ -_________

           ~ _____ classes @ $10         $ ______                     Minus Stall and/or Camping fee     $ -_________

                  Entr y Amt. Due   $ _________                       Amt. Payable to (GSC / Exhibitor) $ __________
                               TABS ARE ENCOURAGED!!!                                                                         All Tabs
                                                                      Paid      CK #               Tab           CK #        Must Leave
Exhibitors must sign liability release                                                                                       Signed Check
Exhibitors are responsible for picking up their earnings before leaving the show-earnings not collected will be forfeited

2010 Grinnell Saddle Club Entry Form                       JUNE 5-JUNE 26- SEP TEMBER 6                         Back #
ONE HORSE & RIDER COMBO PER CARD                                                                         (NUMBER STAYS WITH HORS E)
Exhibitor Name:

Horse's Name:                                                                       ONE EXHIBITOR PER CARD

Address:                                                                            ONE HORSE PER CARD



Circle the class #s for which you are registering:
                Pay           Pay           Pay           Pay         Pay           Pay           Pay           Pay
            1            7             14            20         ~27           35             41          47

           2             8             15            21         29            36             42          48

           3             9             16            22         30            ~37            43          49

           4             10            17            23         31            38             44          50

           5             12            18            24   trophy 33           39             45          51 _______

           6             13            19            25   trophy 34           40             46

                                                                                          Total Payback Won $
OFFICE USE ONLY

               _____ classes @ $6        $ ______                     Minus Entry Amt. Due GSC           $ -_________

           ~ _____ classes @ $10         $ ______                     Minus Stall and/or Camping fee     $ -_________

                  Entr y Amt. Due   $ _________                       Amt. Payable to (GSC / Exhibitor) $ __________
                               TABS ARE ENCOURAGED!!!                                                                         All Tabs
                                                                      Paid      CK #               Tab           CK #        Must Leave
Exhibitors must sign liability release                                                                                       Signed Check
Exhibitors are responsible for picking up their earnings before leaving the show -earnings not collected will be forfeited
                                                                               Grinnell Saddle Club
                                                                                Release of Liability

            I, the undersigned, wish to participate in the Grinnell Saddle Club events listed on below. I understand that a number of inherent risks are associated with a
domesticated animal activity. A domesticated animal may behave in a manner that results in damages to property or an injury or death to a person. Risks associated with the
activity may include injuries caused by bucking, biting, stumbling, rearing, trampling, scratching, pecking, falling, or butting.
            The domesticated animal may act unpredictably to conditions, including, but not limited to, a sudden movement, loud noise, an unfamiliar environment, or the
introduction of unfamiliar persons, animals, or objects.
            The domesticated animal may also react in a dangerous manner when a condition or treatment is considered hazardous to the welfare of the animal; a collision occurs
with an object or animal; or a participate fails to exercise reasonable precautions, or use adequate control when engaging in a domesticated animal activity, including failing to
maintain reasonable control of the animal or failing to act in a manner consistent with the person’s abilities.
            In consideration of the Grinnell Saddle Club allowing my participating in any of the events listed below, I, on behalf of myself, and my heirs, administrators, personal
representatives, assigns and children and spouse, if any, do hereby agree to hold harmless, release and discharge the Grinnell Saddle Club and/or the Poweshiek County Fair
Association, which includes officers, directors, members, agents, representatives, affiliates and insurers, or and from all claims, demands, causes of action and legal liability
whether known or unknown, anticipated or unanticipated, due to the ordinary negligence of the Grinnell Saddle Club and/or the Poweshiek County Fair Association. I shall not
bring any claims, demands, legal actions or causes of action against the Grinnell Saddle Club and/or the Poweshiek County Fair Association for any damage or loss due to bodily
injury, death or property damage arising out of my participation in any of the events listed below.

                                                                                   WARNING
                                                                            Iowa’s Equine Warning Law

                                                                                                       O
UNDER IOWA LAW, A DOMENTICATED ANIMAL PRO FESSIONAL IS NO T LIABLE FOR DAMAGES SUFFERED BY, AN INJURY T , OR THE DEATH O F
A PARTICIPANT RESULTING FRO M THE INHERENT RISKS O F DOMESTICATED ANIMAL ACTIVITIES, PURSUANT TO IOWA CODE CHAPTER 673.
YO U ARE ASSUMING INHERENT RISKS O F PARTICIPATING IN THIS DO MESTICATED ANIMAL ACTIVITY.

_________________________________________________________                                             __________________
Signature of Participant                                                                              Date

_________________________________________________________                                             __________________
Signature of Parent or Guardian                                                                       Date
(If participant is a minor.)

Grinnell Saddle Club 2010 Event Schedule:               Saturday, June 5 @ 9:00 a.m.
                                                        Saturday, June 26 @ 9:00 a.m.
                                                        Saturday, July 10 @ 9:00 a.m.
                                                        Saturday, August 21 @ 9:00 a.m.
                                                        Monday, September 6 @ 9:00 a.m




                                                                               Grinnell Saddle Club
                                                                                Release of Liability

            I, the undersigned, wish to participate in the Grinnell Saddle Club events listed on below. I understand that a number of inherent risks are associated with a
domesticated animal act ivity. A domesticated animal may behave in a manner that results in damages to property or an injury or death to a person. Risks associated with the
activity may include injuries caused by bucking, biting, stumbling, rearing, trampling, scratching, pecking, falling, or butting.
            The domesticated animal may act unpredictably to conditions, including, but not limited to, a sudden movement, loud noise, an unfamiliar environment, or the
introduction of unfamiliar persons, animals, or objects.
            The domesticated animal may also react in a dangerous manner when a condition or treatment is considered hazardous to the welfare of the anima l; a collision occurs
with an object or animal; or a participate fails to exercise reasonable precautions, or use adequate control when engaging in a domesticated animal activity, including failing to
maintain reasonable control of the animal or failing to act in a manner consistent with the person’s abilities.
            In consideration of the Grinnell Saddle Club allowing my participating in any of the events listed below, I, on behalf of myself, and my heirs, administrators, personal
representatives, assigns and children and spouse, if any, do hereby agree to hold harmless, release and discharge the Grinnell Saddle Club and/or the Poweshiek County Fair
Association, which includes officers, directors, members, agents, representatives, affiliates and insurers, or and from all claims, demands, causes of action and legal liability
whether known or unknown, anticipated or unanticipated, due to the ordinary negligence of the Grinnell Saddle Club and/or the Poweshiek County Fair Association. I shall not
bring any claims, demands, legal actions or causes of action against the Grinnell Saddle Club and/or the Poweshiek County Fair Association for any damage or loss due to bodily
injury, death or property damage arising out of my participation in any of the events listed below.

                                                                                   WARNING
                                                                            Iowa’s Equine Warning Law

                                                                                                       O
UNDER IOWA LAW, A DOMENTICATED ANIMAL PRO FESSIONAL IS NO T LIABLE FOR DAMAGES SUFFERED BY, AN INJURY T , OR THE DEATH O F
A PARTICIPANT RESULTING FRO M THE INHERENT RISKS O F DOMESTICATED ANIMAL ACTIVITIES, PURSUANT TO IOWA CODE CHAPTER 673.
YO U ARE ASSUMING INHERENT RISKS O F PARTICIPATING IN THIS DO MESTICATED ANIMAL ACTIVITY.

_________________________________________________________                                             __________________
Signature of Participant                                                                              Date

_________________________________________________________                                             __________________
Signature of Parent or Guardian                                                                       Date
(If participant is a minor.)

Grinnell Saddle Club 2010 Event Schedule:               Saturday, June 5 @ 9:00 a.m.
                                                        Saturday, June 26 @ 9:00 a.m.
                                                        Saturday, July 10 @ 9:00 a.m.
                                                        Saturday, August 21 @ 9:00 a.m.
                                                        Monday, September 6 @ 9:00 a.m

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:39
posted:4/4/2011
language:English
pages:2