MAIL ENTRYFORM WITH CURRENT COPY OF COGGINS AND CHECK BY CLOSING DATE (4 days before show)

CHECKS PAYABLE TO:

Apple Tree Farm
1530 Oak Ridge Club Road
Windsor, SC 29856

803-266-5870/603-345-0382 or e-mail


NAME______PHONE ( )______
STREET______E-MAIL______
TOWN______STATE______ZIP______AGE (IF JUNIOR)______
HORSE’S NAME______

EMERGENCY CONTACT PERSON & PHONE # FOR DAY OF EVENT

NAME______PHONE ( )______

Dates: Circle date Jan. 20 Jan. 30 Feb. 7 Feb. 12 Feb. 21 Feb. 27 March 6 March 14 March 24

Entry fees: $45/ division. $20 additional dressage test $10 additional jumping round

$30 dressage only $15 jumping only

Refunds: No Refunds after the closing date.

Prizes: Ribbons for each division.

______Starter: 2011 Intro level B Test, Jumps 12”

______Pre-Elementary: 2011 Intro level B Test, Jumps 18”

______Elementary: 2010 Beg. Novice Test A, Jumps 2’
______Advanced Elementary: 2010 Beg. Novice Test A, Jumps 2’3”

______Beginner Novice: 2010 Beg. Nov. Test A, Jumps 2’7”

______Novice : 2010 Novice Test A, Jumps 2’11”

______Training: 2010 Training A Test, Jumps 3’3”

______Prelim: 2010 Prelim A Test , Jumps 3’7”

______Interm: 2010 Inter. Test A, Jumps 3’9”

______Dressage only/SJ only indicate level

Time Start: Show starts at 9:00a.m. Divisions run from Amoeba to Interm. Times posted at: www.appletreefarm.org or call 803-266-5870.

I ENCLOSE A TOTAL OF $______FOR THE AFOREMENTIONED ENTRY.
I UNDERSTAND THAT THIS IS A HIGH RISK SPORT AND I AM PARTICIPATING AT MY OWN RISK. I AGREE for myself, and/or my child, my/our administrators and assigns, in consideration for my (and/or my child’s) participation, to assume this risk AND FURTHER DO HEREBY RELEASE AND HOLD HARMLESS AND INDEMNIFY THE AppleTree Farm, JUDGES, OFFICIALS, VOLUNTEERS, AGENTS, EMPLOYEES AND THE OWNERS OF THE PROPERTY WHERE THE EVENT IS TO BE HELD, FROM ALL LIABILITY AND claims including, but not limited to, claims for money or property, disability, covenants, actions, suits, causes or action, obligations, debts, costs, expenses, attorneys’ fees, judgments, orders and liabilities of whatsoever kind or nature in law, equity or otherwise, whether now known or unknown, suspected or unsuspected, and whether concealed or hidden, including but not limited to any state or federal statutory or common law claim or remedy of any kind whatsoever arising out of or in any way connected with any Harm to me or my horse and for any Harm caused by me or my horse to others, even if the Harm resulted, directly or indirectly, from negligence.

WARNING: Under South Carolina law, an equine professional is not liable for an injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities.

PARTICIPANT SIGNATURE ______DATE______

PARENT OR GUARDIAN ______DATE______

PARENT OR GUARDIAN MUST SIGN IF PARTICIPANT IS UNDER 18 YEARS OF AGE