ENTRY FORM

 

CVMHA RELEASE FORM MUST BE SIGNED:

 

“Every entry shall constitute an agreement and affirmation that the person making it, owner, trainer, lesee, manager, agent, coach, driver, passenger, and the horse: 1) Shall be subject to the rules of the competition; 2) that every horse and exhibitor is eligible as entered: 3) that the owner and any of his/her representatives are bound by the constitution  and the rules of the AHSA and the competition and will accept as final the decision of the show committee on any question arising under the rules and agree to hold the CVMHA, the horse show, their officials, directors and club members harmless of any action taken; 4) that the owner and exhibitor 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 harmless of any injury or loss suffered during or in connection with the competition, whether or not officials, officers or members of the CVMHA or competition,” NY’s helmet law require helmets for all beginners riders.  Adults are encourages, but not required to wear ASTM headgear.

 

 

____________________________________                    __________________________________________

(owner/agent signature)                                                             (Signature of rider, driver, handler)

 

 

____________________________________                    _________________________________________

(Print name of owner/agent)                                                       (Signature of parent/guardian of owner, rider, driver

                                                                                                        or handler if under age 18)

_____________________________________

       (address of owner/agent)

 

_____________________________________                  _________________________________________

(city, state, zip code)                                                                   (signature of rider, driver, handler)

 

_____________________________________                  _________________________________________

(area code & phone number)                                                     (signature of parent/guardian of owner, rider, driver

                                                                                                        or handler if under age 18)

 

E-mail address________________________________

 

Name of Horse	Reg #	Color	Sex	Age	Height	Class #	Entry Fees
Sire	Reg #	Dam	Reg #
Rider/Driver		DOB if Jr. Exhibitor

 

 

 

Name of Horse	Reg #	Color	Sex	Age	Height	Class #	Entry Fees
Sire	Reg #	Dam	Reg #
Rider/Driver		DOB if Jr. Exhibitor

 

 

 

Name of Horse	Reg #	Color	Sex	Age	Height	Class #	Entry Fees
Sire	Reg #	Dam	Reg #
Rider/Driver		DOB if Jr. Exhibitor

 

-copy of Negative Coggins Test -Copy of Rabies Certificate -Checks or MO’s made out to CVMHA -All signatures, address & phone numbers -Copy of Registration papers if needed REMEMBER ALL COPIES BECOME PROPERTY OF THE CVMHA.  WE MUST HAVE THESE COMIES ON FILE TO COMPLETE THE ENTRY

 

                        FEES                                                               Please make checks payable to CVMHA

                                                                                                Mail entry and fees to:

HORSE #1 Total Entry Fee:                    $______                                                  Colleen C. Denton

                                                                                                                                41 Moss Road

HORSE #2 Total Entry Fee:                    $______                                                  Lewis, NY 12950

 

HORSE #3 Total Entry Fee:                    $______

                                                                                                SPECIAL REQUESTS: _____________________________________________

OFFICE & NUMBER FEES:                                                   

                # of horses ____x $5                $______          

 

HORSE STALLS ____x $20                    $______                 

 

TACK STALLS _____x $20                   $______                 

 

SHOWING OUT OF                                                                              

TRAILER ______x $10                          $______

                                                                                               

CAMPER_______x$35                           $______

                                                                                               

GRAND TOTAL                                     $_______

 

STALL CLEANING DEPOSIT SEPARATE CHECK               ________                HORSE STALLS X $10 EACH $_________________ made payable to cvmha.