Puckerbrush Farm Dressage Show

PUCKERBRUSH FARM DRESSAGE SHOW MDS/EMDA Pointed Shows 2017 Please check which show you are entering: 207-234-2147 PHONE ____ 4/2 Judge: Carol Poulin-Taylor ‘L’

____ 5/7 Judge: Jane Tremlett ‘L’ Please note that entries will not be accepted without shot records showing Rhino vaccine given at least 14 days prior but no later than 6 ____ 6/4 Judge: Sandra Beaulieu ‘L’ months prior to the show!!!

____ 7/2 Judge: Susanne Hamilton ‘R’ ______Class List______

_____ 9/3 Judge: Paula Foote ‘L’ 1. USDF Introductory Level Test A 2. USDF Introductory Level Test B 3. USDF Introductory Level Test C _____ 10/1 Judge: Chris Joost ‘L’ 4. USEF Training Level Test 1 5. USEF Training Level Test 2 ____ 11/5 Judge: Sandra Beaulieu ‘L’ 6. USEF Training Level Test 3 7. USEF Training Level Re-Ride Please mail entries, payment, shot 8. USEF First Level, Specify Test records and Coggins to: 9. USEF First Level Re-Ride 10. USEF Second Level – Specify Test 97 Miles Rd. 11. USEF Second Level Re-Ride Newburgh, ME 04444 12. USEF Third Level and Above– Specify Test 13. Musical Freestyle & Quadrille, Specify Test www.puckerbrushfarm.net [email protected]

NOTES: Puckerbrush Farm and show management reserve the right to combine, divide, or cancel classes as entries warrant. Puckerbrush Farm and show management reserve the right to add to or vary the list of judges. Any other changes deemed necessary will be at the discretion of show management. LEVELS: Introductory through Fourth Level and FEI. AWARDS: Ribbons to sixth place. Classes may be combined depending on entries. ENTRIES: $20.00 per class. NO TELEPHONE ENTRIES ACCEPTED. Make checks payable to Puckerbrush Farm. No refunds after closing date. Negative Coggins within one year and record of shots. TIMES: Times will be available on Thursday before show day on our website (www.puckerbrushfarm.net). FOOTING: 75 x 230 indoor arena. Small arena for Intro and Training. Standard arena for others. Warm-up in outdoor sand ring. STABLING: Limited number of stalls. $40 each. DIRECTIONS: From South: North on I-95, Exit 42 (Etna-Dixmont). Turn left on Rt. 143 towards Dixmont. Go approx. 5.5 miles to sharp corner – Rt. 143 goes right but you turn left onto Miles Rd. Go approx 2.5 miles and Puckerbrush is on the right. From North: South on I-95, Exit 43 (Carmel-Winterport). Turn left onto Rt. 69 towards Winterport. At blinking light, turn right onto Rt. 202/9. Go approx 4.7 miles and just over crest of hill turn right onto Miles Rd. Puckerbrush is .5 miles on left. FOOD: No Food available on grounds. DRESSAGE SHOW ENTRY FORM DATE ______

HORSE ______HEIGHT____ BREED ______

AGE______COLOR______SEX______

RIDER ______

JR/SR ______PHONE ______

ADDRESS ______EMAIL ______

OWNER OF HORSE (If different than rider)______

ADDRESS ______

Class Number Class Name Fee

Total______

THIS IS A RELEASE OF LIABLITY, PLEASE READ CAREFULLY BEFORE SIGNING. The undersigned owner, rider and signing parent or guardian hereby agrees:

I am fully aware that horse sports and competition involve inherent dangerous risk and I expressly assume any and all risks of injury or loss suffered during or in connection with the competition and I AGREE TO RELEASE the dressage club, or other organization sponsoring this competition, their officers, directors, employees, member or agents, and the owners and managers of the grounds where this event is held, from any loss, damage, liability or injury arising out of or resulting from this competition or rider’s participation or entry therein, whether or not such injury or loss resulted, directly or indirectly, FROM THE NEGLIGENT ACTS OR OMISSIONS of the management of the competition, their officers, directors, employees, member or agents, and the owners and managers of the grounds where this event is held. In the event of injury to rider, permission is hereby granted for emergency medical treatment for rider or rider’s animals. I further agree to INDEMNIFY, HOLD HARMLESS AND DEFEND THE DRESSAGE CLUB, OR OTHER ORGANIZATION sponsoring this competition, their officers, directors, employees, member or agents, and the owners and managers of the grounds where this event is held from and against ANY AND ALL CLAIMS FOR LOSS, DAMAGES, LIABILITY OR INJURY HOWEVER CAUSED, resulting directly or indirectly from rider’s entry or participation in this competition or from acts or omissions of rider or rider’s agents. I further agree to be subject to the rules of the dressage club or other organization sponsoring the competition.

RIDER SIGNATURE______DATE ______

______(PARENT/GUARDIAN SIGNATURE IF RIDER IS UNDER 18)

OWNER SIGNATURE ______DATE______