GALLOP ON THE GREENWAY ENTRY FORM

Document Sample
GALLOP ON THE GREENWAY ENTRY FORM Powered By Docstoc
					                                                                                        Print Form




         Gallop on the Greenway At the Florida Horse Park
       January 28, 29, 30, 2010 Sanctioned : AERC/ SEDRA/ FEI

Camp at Florida Horse Park (www.flhorsepark.com) and Cross Florida Greenway
Please do not tie anything to fences. Please scatter manure and fill holes. All Dog
s must be on Leashes. Animal control will make daily visits. Please make other
camping arrangements with FL Horse Park on line or at 352-307-6699

Terrain: Trails- 50% double tract and 50% single tract mostly light sand or grassy
with some roots Shoes recommend but not necessary One away vet check per
day, rest in camp. Management will take your vet check supplies to away vet
check, please make sure your items are marked with names, intitials, etc

Check in Starting at 1pm Wednesday 1/27/10 opening dinner Wed at 6pm.

Vet in will start daily about 3pm.

Awards-Completions, 1st place top ten and Best Conditioned

Meals-Wednesday night big dinner at 6pm. Thursday thru Saturday nights pot
luck before awards and meeting.

Entry: pre-entry by 1/25/10 Refunds if given notice by 1/25/10 less $20.00
Non-AERC fee of $15.00 per ride Negative Coggins at horse park Health
certificate required to enter Florida Sign in starts at 1pm on Wednesday 1/27/10

Directions at www.flhorsepark.com. Florida Horse Park, 11008 SE Hwy 475 Ocala,
Fl 34480.

Exit 341 off I-75 go east 2miles turn north (left) at red light onto Hwy 475 go about
3miles Horse Park on left signs will directly from entrance. .

                           www.fhorsepark.com
       Ride Manager Doug Shearer 352-816-2353 cell or liveoak@mfi.net

                    Make checks payable to Florida Horse Park
                     Mail to 11008 S Hwy 475 Ocala, Fl 34480
                    Or fax with credit card info to 352-307-6799
                     Or call horse park at 352-307-6699 ext 5
                      GALLOP ON THE GREENWAY ENTRY FORM

100 Mile AERC/FEI***- 75 Mile AERC/FEI***- 50 Mile AERC/FEI**- 25 Mile AERC
Name_________________________ AERC#____________USEF#____________
(Non-US riders must have letter of permission sent to management from your National
Federation)
Non US Rider National_______________Federation*____________RiderFEI*_____
Address_________________________________________________ Zip_________
Phone_______________ E-mail__________________________________________
Horse_________________ AERC#_____________ Horse Passport*_____________
Horse USEF#____________ Or FED*_____________Horse FEI#_______________
Breed___________________ Age______ Sex____ Country of Birth______________
Owner____________________________________________________________
Junior DOB ________________ Sponsor________________________________
(Must have permission to change. Must wear helmet & be over 7 years of age)


                      Weight Division (weight of rider plus tack): please circle
Featherweight,160Ibs or less Middleweight,186-210Ibs Lightweight,161-185Ibs Heavyweight,211+Ibs or
                                                         Junior
Thursday Jan 28 75miles/$125      50miles/$95     25miles/$70 FEI/AERC 75 miles/$ 240      FEI/AERC 50 miles/$ 190
Friday, Jan 29     75miles/$125   50miles/$95   25miles/$70       FEI/AERC75 miles/$ 240   FEI/AERC 50 miles/$ 190
Saturday, Jan 30         100miles/$150    75miles/$125     50miles/$95    25miles/$70
Saturday, Jan 30        FEI/AERC 100miles/ $360       FEI/AERC 75 miles/$ 240     FEI/AERC 50 miles/$ 190
**$35 High Performance fee and Drug testing fee are included in FEI entry fees.
                     GALLOP ON THE GREENWAY ENTRY FORM


Entry Fee                                                               __________
Non-AERC fee $15.00per event                                            ____________
Grounds fee per horse $15.00 X ________=                                 ____________
Stall fee ( not required ) $25.00/day x _______ =                        ____________
Extra Dinner fee on Wednesday night $10.00 x ___ =                       _________
                                    Total                                $ ___________


Check# ________ Check amt ________ Payable: Florida Horse Park, 11008 S Hwy
475,Ocala, FL 34480 E-mail: liveoak@mfi.net fax 352-307-6799


Credit card #___________________________ exp date ________3 digit code ____
Signature___________________________________________________________

WARNING: Under Florida Law an equine activity sponsor or equine professional is Not Liable for an
injury to, or the death of a participant in equine activities resulting from the inherent risk of equine ac-
tivities. As a participant in the Gallop on the Greenway, I agree to abide by SEDRA, SERA & AERC
rules. I understand the sport involves being in remote areas for extended periods of time, far from
communications, transportation, and medical facilities, that these areas may have natural and man
made hazards, which Ride Management cannot anticipate, identify, modify or eliminate, that horses
can be excitable, difficult to control & unpredictable and that accidents can happen to anyone at any
time. I accept responsibility for myself and the animal I ride. I hold Ride Management, all personnel and
the property owners including the FL Division of Forestry, blameless and free from all liability for injuries
or loss that might occur due to my participation in the Ride. This release is valid for my animals, per-
sonal belongings, family, or guests in my company. This release applies for the entire ride, arrival,
during, and until departure. I have read, understand, and accept this release.
FEI Riders and owners must also sign the FEI release waiver

Signature of Rider                                _____ ________________________________
HORSE OWNER (if different)                        _____________________________________
PARENT/GUARDIan (if under SPONSOR                 _____________________________________
Date________________________ Emergency Phone Number __________________________

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:8
posted:5/12/2011
language:English
pages:3