Indoor Radical Jumper Show Entry Form

Riders may enter as many levels as they wish. Prizes will be awarded to fifth place.

If riding an Oakhurst school horse, please name a second choice: ____________________________________________

If travelling/ competing with a Coach, Stable or Group please state:

Please note that there is a $20.00 stall day fee for horses coming in from outside of Oakhurst

Contact Information for duration of competition (if different from above – temporary address/cell phone etc):

RELEASE OF LIABILITY, WAIVER OF CLAIMS, ASSUMPTION OF RISKS AND INDEMNITY AGREEMENT. TERMS AND CONDITIONS- THIS SECTION MUST BE COMPLETED

THIS DOCUMENT WILL AFFECT YOUR LEGAL RIGHTS AND LIABILITIES- PLEASE READ CAREFULLY

I understand that it is my responsibility to ensure that I have entered the appropriate division. I accept all liability for entering the division as stated on this entry form.

I acknowledge that the sport of Horse Riding is a high-risk sport and that I am participating at my own risk and in full knowledge of the hazards and potential hazards which are inherent in this sport. I further acknowledge the inherent risk in riding and working around horses, which risks include bodily injury to both horse and rider which can result from normal use, competition or schooling.

In consideration of being allowed to participate in this event, I hereby assume all risk and I hereby release and absolve the organizing committee, volunteers, officers, directors, agents, representatives and employees, independent contractors and the owners and occupiers of the land upon which the competition is held from all responsibility, liability or claims of any nature and kind which I may have arising from my participation in this activity, including but not limited to bodily injury or death to myself or my horse(s) and damage to property arising from any cause whatever, including the negligence of one or more of the individuals and organizations referred to herein.

Approved headgear is required for juniors. It is agreed and understood that he/she will wear a properly fitted, ASTM/SEI or BSI approved helmet whenever mounted. It is understood that juniors not meeting this requirement will not be allowed to compete at these competitions.

I hereby declare that in making this entry that I have read and fully understand and agree to the terms and conditions stated herein and that it is binding upon my executors, heirs and assigns.

Date: __________________________________ Date: ____________________________________

(If the rider is under eighteen years, the parent/Guardian must also sign below)

I acknowledge as Parent/Guardian of __________________________________ that I have read and fully understand and agree to the

terms and conditions stated herein on behalf of _____________________________, and myself.

Parent/Guardian _______________________________ Date: _______________________________________

"I/we hereby confirm that there is liability coverage in force with respect to the ownership of the competing horse(s)"

Class # 1 X Poles (Optimum Time) $10 ($15 on an Oakhurst school horse)*

Class # 2 2’0” (Optimum Time) $10 ($15 on an Oakhurst school horse)*

Class # 3 Cross Country Equitation (2’0”) $10 ($15 on an Oakhurst school horse)*

Class # 4 2’3” (Optimum Time) $10 (15 on an Oakhurst school horse)*

Class # 5 2’6” (Optimum Time) $10 ($15 on an Oakhurst school horse)*

Class # 6 Cross Country Equitation (2’6”) $10 ($15 on an Oakhurst school horse)*

Class # 7 2’9” (Optimum Time) $10 ($15 on an Oakhurst school horse)*

Class # 8 3’0” (Optimum Time) $10 ($15 on an Oakhurst school horse)*

Class #9 Cross Country Equitation (3’0”) $10 ($15 on an Oakhurst school horse)*

Class # 10 3’3” (Optimum Time) $10 ($15 on an Oakhurst school horse)*

* Please note that Oakhurst school horses are only available to students in a lesson program at Oakhurst.

Card Number: __ __ __ __ - __ __ __ __ - __ __ __ __ - __ __ __ __ Expiry Date __ __ / __ __

ENTRY FORM