ASHA

Horse/Rider Combination Entry Form

Fayette, AL – June 27, 2010

FILL OUT ONE FORM PER HORSE/RIDER COMBINATION !

Call Entry in to 205-399-6102 or 205-364-1019, or E-mail to & pay at event

No penalty Entry Deadline is 5:00 P.M., Monday, June 21st . Entries will be accepted until 8:00 A.M., Show Day

But…..

Entries received after Deadline will be charged a $30.00 Late Fee!

Absolutely no entries, changes, withdrawals or refunds after 8:00 A.M. on Show Day!

Name of Rider ______ASHA Mem # ______

Name of Horse ______ASHA CL # ______

Address ______

Phone ______Cell ______e-mail ______

ASHA ENTRY FEE SCHEDULE - Check Classes You Are Entering

Classes / Open / Non-Pro / Ltd Non-Pro / Green Horse / Collegiate / Novice / Youth
All 4 Classes (Includes Cattle Charge) / $160 ____ / $ 80 _____ / $ 80 _____ / $80 _____ / $75_____ / $ 80 ______ / $ 75 _____
Pleasure / $ 35 _____ / $ 15 _____ / $ 15 _____ / $15 _____ / $15 _____ / $ 15 ______ / $ 15 _____
Trail / $ 35 _____ / $ 15 _____ / $ 15 _____ / $15 _____ / $15 _____ / $ 15 ______ / $ 15 _____
Reining / $ 35_____ / $ 15 _____ / $ 15 _____ / $15 _____ / $15 _____ / $ 15 ______ / $ 15 _____
Working Cow
($30 Cattle Charge) / $ 65 _____ / $ 45_____ / $ 45_____ / $45 _____ / $45_____ / $ 45 ______ / $ 45 ______
Total Fees / $ ______ / $ ______ / $ ______ / $ ______ / $______ / $ ______ / $ ______

ASHA Entry Fees (From form above) ______

ASHA Membership, if needed ( ) $25.00 ______

ASHA Competitive License, if needed ( ) $15.00 ______

Office Charge ( X ) $15.00 $15.00

TOTAL

======

Paid by: Check ( )______Cash ( ) Received by: ______

By my signature below, I hereby acknowledge that I understand the risks involved in riding horses and/or cow work and voluntarily assume those risks. I agree that I will not hold the Alabama Stock Horse Association, the American Stock Horse Association, nor any of their directors, officers, employees, volunteers, or participants liable for any injury or property damage rising out of or caused by this show held June 27, 2010. I have read this release and understand its terms.

Participant’s Signature ______

(Parent, if participant is between 8 and 18)

WARNING!

UNDER ALABAMA LAW, AN EQUINE ACTIVITY SPONSOR OR 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, PURSUANT TO THE EQUINE ACTIVITIES LIABILITY PROTECTION ACT.