HORSE SHOW ENTRY BLANK (One Horse Per Blank)

Mail Entry form to:

Joyce Berger, Show Secretary

11012 Jeffries Road, Berlin Heights, OH 44814

HORSE SHOW ENTRY BLANK (one horse per blank)

Entry # / Class
Entered / Name of Horse / S, M, G / Reg. # / Age
Horse / Rider/Driver/Handler / Age / Fees
Amateur Number
Pony Measurement Card
4-H Membership / Owner or Authorized Agent (must sign) / Total Entry
Name / Stalls
Address / Grounds
City, State, Zip / Camper
Telephone
Signature / TOTAL
FEES

PERMISSION FOR MINOR TO SHOW

I hereby consent to the entry of my child

Child’s NameBirth Date

AddressTelephone No.

In this horse show and certify that I have read the foregoing representations and statements and that the same may be deemed a part hereof and hereby accept responsibility thereunder for the participation of said minor.

Signature of Parent or GuardianDate

Every Entry at a recognized competition shall constitute an agreement and affirmation that the person making it, owner, lessee, trainer, manager, agent, coach, driver, rider, and the horse (1) shall be subject to the Constitution and Rules of the Association and the local rules of the competition; (2) that every horse, rider and/or driver is eligible as entered; (3) that the owner and any of his representatives are bound by the Constitution and Rules and the Central Ohio Saddle Club and the competition and will accept as final the decision of any hearing committee on any question arising under said Rules and agree to hold the competition, the Central Ohio Saddle Club, their officials, directors and employees harmless for any action taken; (4) that the owner, rider/driver and any of their agents or representatives acknowledge that they participate voluntarily in the competition fully aware that horse sports and the competition involve inherent dangerous risk, and by participating they expressly assume any and all risks of injury or loss, and they agree to hold the Central Ohio Saddle Club, the competition, and their officials, directors, employees and agents harmless for any injury or loss suffered during or in connection with the competition, whether or not such injury or loss resulted, directly or indirectly, from the negligent acts or omissions of said officials, directors, employees or agents of the Central Ohio Saddle Club or competition. The construction or application of Central Ohio Saddle Club Rules is governed by the laws of the State of Ohio.