Dressage/Jumper Entry Form

PRESTON ROSEDALE FARM

DRESSAGE/JUMPER ENTRY FORM

SEPTEMBER 18th, 2016

*Please note that classes 7, 27, and 28 are not ESD Sanctioned classes.

Please Make Cheques Payable to Preston Rosedale Farm. E transfers to

Class / Rider / Horse / Category of rider(PW,JR,AA,O) / Cost / Total + HST(0.13)
Class 1: Walk/Trot Equitation 20x40 / $25.00
Class 2:Walk Trot Green Horse Test B / $25.00
Class 3: Walk Trot Green Horse Test D / $25.00
Class 4: walk trot New Rider Test A / $25.00
Class 5: Walk Trot New Rider Test C / $25.00
Class 6: Special Request/Freestyle 20x40 / $25.00
*Class 7:
4 Games / $40.00
Class 8: EQUITATION OVER POLES / $10.00
Class 9: Beginner Jumper x’s / $10.00

Preston Rosedale Farm Waiver of Liability

WHEREAS, the undersigned, (“Releasor”) acknowledge(s) and understand(s) that horseback riding,

the care and handling of horses and all related activities are by their nature activities with unknown

and inherent risks thereby exposing the undersigned to possible serious personal injury and death due

to the nature of participating in the various equestrian activities at Preston Rosedale Farm.

FOR GOOD and VALUABLE CONSIDERATION, the receipt and sufficiency of which is

hereby acknowledged, the undersigned hereby release and forever discharge Preston Rosedale Farm,

(“Releasee”) and its principals shareholders, officers, directors, employees, volunteers, guest teachers

and demonstrators, their heirs, executors, administrators, personal representatives, successors and

assigns from any and all manner of actions, causes of action, suits, covenants, contracts, claims and

demands for damages, loss if injury, howsoever caused, including but not limited to direct, indirect or

consequential injuries and damages, which I ever had, now have, shall or may hereafter have not

limited to direct, indirect or consequential injuries and damages, which I ever had, now have shall or

may hereafter have or be sustained by me/we for or by reason of any cause, matter or thing as a result

of my attendance at or use of, facilities and premises at Preston Rosedale Farm.

AND FOR SAID CONSIDERATION I/we further agree not to make or take any proceedings

against any other person or corporation who might claim contribution or indemnity under the

provisions of the Negligence Act, R.S.O. 1990, and all amendments thereto from the person, persons

or corporation discharged by this release.

AND the Releasor hereby declares she/he fully understands the terms of this Release, and that

in addition to the aforesaid consideration, further acknowledges that the signing of this release is a

pre-condition of the undersigned being able to attend at and participate in horseback riding or any

related activity at Preston Rosedale Farm, and as such this release is accepted by her/him voluntarily

for the purpose of attending a seminar, workshop or any related activity and use of the facilities at

Preston Rosedale Farm. The undersigned further understands and acknowledges they have read and

received a copy of this release and that she/he has had an opportunity to consider same prior to signing

same and agreeing to attend any activity at Preston Rosedale Farm and that in the event that this form

of Release is not signed and acknowledged by said person or attendee, she/he shall not be permitted to

participate in any activity until this release is executed.

IN WITNESS THEREOF, I/we have hereunto set my/our hand, dated at the City /Town of

DATE:______, 2016

SIGNED, SEALED and DELIVERED

In the presence of :

x ______print witness name

x ______witness signature

(PrintAND signwitness’ name above)

(Signed by Parent if participant is a child under 18 years old)

X ______

(Signature of Parent)

______

(Name of Parent)

Phone and address of Releaser (18 year old or parent):

CONTACT EMAIL ADDRESS______

CONTACT PHONE NUMBER______

ALLERGIES/IMPORTANT INFORMATION______

Preston Rosedale Farm Entry Form Ring 2 Dressageand Jumper

*Please note that classes 7, 27, and 28 are not ESD Sanctioned

Name of Rider: / Coggins test:
Yes □
Name of Horse: / Rider DOB(Y/M/D): / OEF number:
Check which category which you will be eligible to compete in. / PW □ / JR □ / AA □ / O □
Address of rider:
Phone number: / Email:
*PLEASE ATTACH WAIVER*
RING 2
BELOW
Class 10: Training Equitation 20x60 / $25.00
Class 11: Training Level Test 1 20x60 / $25.00
Class 12: Training Level Test 2 20x60 / $25.00
Class 13: Training Level Test 3 20x60 / $25.00
Class 14: Special Requests/Freestyle / $25.00
Class 15: Prix Caprilli Test#2 / $25.00
Class 16: First Level Equitation / $25.00
Class 17: First Level test 1 20x60 / $25.00
Class 18: First Level test 2 20x60 / $25.00
Class 19: First level test 3 20x60 / $25.00
Class 20: Special Request/Freestyle / $25.00
Class 21: Prix Caprilli Test #4 / $25.00
Class 22: X’s jumper / $10.00
Class 23: 2’ jumper / $10.00
Class 24:2’3 jumper / $10.00
Class 25: 2’6 jumper / $10.00
Class 26: Wild Card most points wins. / $10.00
Class 27: Puissance / $10.00
Class 28: Teen/Adult fun game or 2! $10.00
TOTAL PLUS HST (MULTIPLY TOTAL X 1.13 FOR GRAND TOTAL)

PRESTON ROSEDALE FARM DRESSAGE AND JUMPER SHOW

September 18TH, 2016.

*Please note that classes 7, 27, and 28 are not ESD Sanctioned classes.

* HST must be added to your total. Cheques made payable to Preston Rosedale Farm, or e transferred to

Parking is well marked in the field east of the laneway. Only those who are working at the show, or handicapped may park in the main entrance driveway.

ABSOLUTELY NO DOGS (NOT EVEN IN YOUR VEHICLE) ARE PERMITTED ON THE PROPERTY.

$2500.00 in ribbons and prizes!

Grass warm up ring.

Arena warm up ring.

Fenced 20 x 40 Walk Trot Show Ring

Judged by MackaylaLeeworthy

Fenced 20 x 60 Competition Dressage Ring

Judged by Shannon Becvar

There will be a canteen for breakfast and lunch with proceeds donated to finding a cure for cancer.