dressage entry form

ELYSIAN FIELDS EQUESTRIAN CENTER

2011 DRESSAGE SCHOOLING SHOW ENTRY FORM

Entry with payment and negative Coggins test due seven days prior to show date

Elysian Fields Equestrian Center and Dennis and Kerry Perry are not responsible for damage, injury, or loss to any person, animal or property of exhibitors or spectators. All competitors ride at their own risk. It shall be a condition of entrance to the grounds that this is agreed.

DATE OF SHOW: June 19 July 16/July 17 Sept. 25

The July show is two day show with two different judges. Please use separate entry for each day.

****$150.00 Sr. high point prize and $75.00 Jr. high point prize to the single high score for the two day July show. This is for Training Level and above for Sr. and Jr. rides. Must participate in both July shows to be eligible.****

Rider’s name_____________________________________

Age (if Jr. rider-13 and under)______

Address_____________________________________________________________

Phone____________________Email______________________________________

Rider’s signature_____________________________________________________

Horse’s Name_______________________________________________________

Owner’s name________________________

Owner’s signature_____________________

(if different than rider)

Parent/Guardian’s Signature____________________________________________

(If under 18)

CLASSES ENTERED (Please provide LEVEL AND TEST NUMBER-Intro tests A, B, and C, Training, 1st or 2nd level tests 1, 2 or 3.)

Fees: Tests $20.00 each X_________                                       =           $_________

Grounds Fee $ 5.00 per day -per horse rider comb.                 =           $5.00

Secretary’s Fee $ 3.00 per day- per horse rider comb.             =           $3.00

Stalls $15.00 per day                                                                         _________

Post entry stalls $20.00 ea. _________

Post entry fee@ $10.00 _________

TOTAL DU E : $

Use a separate entry for each show. Please enclose check in this amount made payable to Elysian Fields Equestrian Center. Send to 1345 Tallman Hollow Road, Montoursville, PA 17754. Refunds at the discretion of show secretary. Any questions, please call 570-435-5274 or email me at kpgiddyup@chilitech.net Ride times will be emailed the Thursday prior to the show. If you do not receive them please be sure to call.

Thanks for coming.