Greenville FFA Horse Show Pre-Registration Form

Greenville FFA Horse Show Pre-Registration Form

_____ Coggins ______Rabies ______Helmet ______Entry #

Name of Rider______Age ______

Complete Address______

______

Telephone Number ______

Name of Horse______

In consideration of the acceptance of the foregoing entry, it is understood and agreed that I/We are aware of the risks and exposures to personal injury involved through horsemanship activities and I/We hereby release the Greenville FFA and/or the Greenville Central School District and all officers and members thereof, from any and all claims for damages which may occur to me or my horse at any time hereafter. Neither myself, my heirs, representatives, nor dependents will charge said Association, its officers and members, or any of them with fault for any injury, loss or damage which may be suffered by me or them or any of them due to any manner, thing or condition, negligence or default whatsoever, and I hereby assume and accept the full risk and danger of any injury or damage to myself, family members, livestock and equipment while attending any event sponsored by this Organization. ASTM SEI HELMETS ARE REQUIRED FOR ALL RIDERS! Copies of Coggins and Rabies certificates must be included in pre-registration, and will be kept by the show secretary.

Rider Signature______

Owner Signature______

Parent/Guardian Signature______

Pre-Paid entries are $6.00 per class. Registration the day of show is $8.00 per class. Please make checks payable to Greenville FFA. Pre-paid entries must be received by Friday, July 5, 2013. Current copies of both Rabies and Negative Coggins must be sent with pre-entries. You MUST arrive 15 minutes before the scheduled start time of the show, or you will be charged a $2/class late fee!

To be eligible for the championship, you must enter four (4) of the classes for the division. Please CIRCLE the classes you are entering.

Pre Day Division Classes Entry of Show Amount

English Open Division / 1 / 3 / 6 / 9 / 14 / 17 / $6.00 / $8.00
English Junior Division / 2 / 4 / 7 / 10 / 13 / 16 / $6.00 / $8.00
English Walk-Trot / 2 / 5 / 8 / 11 / 12 / 15 / $6.00 / $8.00
Western Open Division / 20 / 23 / 27 / 31 / 37 / $6.00 / $8.00
Western Junior Division / 21 / 24 / 28 / 32 / 36 / $6.00 / $8.00
Western Walk-Jog / 21 / 25 / 29 / 33 / 34 / $6.00 / $8.00
Adult Walk Trot/Jog / 19 / 22 / 26 / 30 / 35 / $6.00 / $8.00
Gymkhana Division / 38 / 39 / 40 / 41 / $6.00 / $8.00
Lead Line / 18 / $6.00 / $8.00

Total Fees$______

Check # ______Total Paid$______

Initial ______

Mail to: Rachel Anderson, Horse Show Registration, Greenville High School, Route 81, Greenville, NY 12083