French Creek Pony Club Open Derby

Saturday August 19th 2017

Please join us for a fun day of dressage and jumping at beautiful

Polestar Farm – 15531 64th St., Lake Stevens, WA 98258

Jumping/cross country clinic with MeikaDecher on Sunday, August 20st!

for directions and clinic information

  • Grasshopper Jumps to 18” 2015 USDF Intro Test B
  • Hopeful Jumps to 2’ 2014 USEF BN Test B
  • Beginner Novice Jumps to 2’6” 2014 USEF BN Test B
  • Novice Jumps to 2’11” 2014 USEF Novice Test B
  • Training Jumps to 3’3” 2014 USEF Training Test B

7:00 AM Show office opens; warm-up arena open

8:30 AM Dressage tests begin; covered small arena (20mx40m) on hopeful If entries warrant, a 2nd dressage grass arena may be added for Intro and schooling tests.

10:00 AM Jumping begins with lowest heights; courses posted Saturday AM

The goal of this show is to provide a fun, low-stress, positive experience – perfect for new riders, green horses, or trying out a higher level.

Modified rules (same as 2014) allow you to continue with penalty points instead of elimination. For complete rules see our web page at frenchcreekpc.com

Ride times will be posted online and emailed by 8pm Aug 13 – please make sure your email address is legible!

Jump vests are suggested, but not required. Dress is appropriate schooling attire.

Ribbons 1st to 8th place; prizes for top scores

Limited day and overnight stalls. Free on-site camping (no hookups). No Dogs, please

Concessions on-site

Entries must be postmarked by August 13th

Discount for Pony Clubbers and Grasshopper division!

French Creek Pony Club Open Derby at Polestar Farm – August 19th, 2017

Visit frenchcreekpc.com for dressage tests, ride times, and rules

Rider Name: ______

Age: ______(as of 1/1/17)

Address: ______

Phone: ______

Email: ______

Required in order to email ride times and announcements

Horse Name: ______(one form per horse) USPC Member /Club Name of club:______

Derby only –dressage test and jump round

Derby and schooling at discounted rate - $20 dressage test /$20 XC round

I want to do schooling rounds only - $25 dressage test / $25 XC round; priority given to derby entrants

Derby Division – Grasshopper Division discounted entry fee of $60, max 2 divisions per horse

Division #1: Grasshopper Hopeful BN Novice Training

Division #2: Grasshopper Hopeful BN Novice Training Total:______($60/$75)

Dressage Schooling – Additional or Separate Tests; except for Intro, all tests are 2014 USEF, Test B, max 2 tests

Test #1: Intro-BBN-BNovice-BTraining-B

Test #2: Intro-BBN-BNovice-BTraining-B Total:______($20 if in conjunction w/ derby, $25 if only schooling)

XC Jump Schooling – Non-divisional or schooling rounds to be completed at the end of each division, max 3 rounds

Round #1 :18” 2’ 2’6” 2’11” 3’3”

Round #2 :18” 2’ 2’6” 2’11” 3’3” Total:______($20 if in conjunction w/ derby, $25 if only schooling)

Round #3: :18” 2’ 2’6” 2’11” 3’3”

Other fees:$25 Facility Fee (per horse): ______

$5 Discount for USPC Member:______

$15 Late Fee after Aug 13th:______

MAKE CHECKS PAYABLE TO FRENCH CREEK PONY Club (FCPC) TOTAL:______

***Submit separate check to Polestar for stall fees***

**Refunds after closing, less $20 admin fee, only with Vet/Dr. Certificate**

RELEASE: Whereas, the undersigned acknowledges the inherent risks involved in riding and working around horses, which risks include bodily injury from using, riding or being in close proximity to horses, among other risks, and that both horse and rider can be injured in normal use or in competition and schooling; In consideration, for the privilege of riding, and/or working around horses at Polestar Farm, the undersigned agree to hold harmless and indemnify Polestar Farm, all owners and employees and release them from liability or responsibility for accident, damage, injury, or illness to the undersigned or any horse owned by the undersigned or to any family member or spectator accompanying the undersigned on the premises of Polestar Farm.

Signature: ______Date: ______

Competitor or Parent/guardian if under 18 yrs.

Non-Pony Club competitors will need to sign the General Activity Release for USPC Non-Members

at the show office before picking up packets. Medical ID required for ALL riders.

Mail completed entries and checks to: Amy Blossom 23411 Sofie Rd Monroe, WA 98272

Due by August 13th!!!

STALL & CAMPING RESERVATION

FCPC DERBY AT POLESTAR FARM

AUGUST 19, 2017

A limited number of stalls are available, reserved for the time periods specified below. Bedding provided for inside stalls. Outside stalls are not covered, and have dirt/grass floors. If you are planning to stay overnight, get your stall payment in early as stall assignments are first come first served!

Rider Name: ______Horse Name:______

Stall with: ______

Inside Stalls – No doors, bring stall guard!

Friday overnight, inside barn ($25): Friday 4pm – end of derby on Saturday

Saturday overnight, inside barn ($25): Saturday end of derby - Sunday 4pm

Weekend, inside barn ($40): Friday 4pm - Sunday 4pm

Outside Stalls

Friday overnight, outside ($15): Friday 4pm – end of derby on Saturday

Saturday overnight, outside ($15): Saturday end of derby - Sunday 4pm

Weekend, outside ($25): Friday 4pm - Sunday 4pm

Please make check out to Polestar Farm for amount of stall fee(s)

CAMPING

Free on-site camping in parking field Friday & Saturday night; no hook-ups

Check which night(s): Friday Saturday

No arrivals prior to 4pm on Friday. The XC course and dressage arenas will be closed to all schooling on Friday.

Send this form in with your derby entry and payment.

No question to0 small!

Juliane Koss-206 250-6168/