Prelude Circuit Entry Form

PRELUDE CIRCUIT ENTRY FORM Show Name: ______Date: ______Horse Name Rider Name

Address / Phone # Birthday (Junior)

RING ONE RING TWO Lead Line Division Hack Division 1. Best Turned Out 28. Road Hack 2. Lead Line Walk Only 29. Show Hack 3. Lead Line Walk/Trot 30. Pleasure Hack 4. Costume 31. Hunter Hack

Walk/Trot Division 2’3” Hunter Division 5. Best Turned Out 32. Warm Up 6. Walk/Trot Hack 33. Hunter Over Fences 7. Walk/Trot Equitation 34. Hunter Over Fences 8. Handy Hunter 35. Hunter Over Fences 36. Hunter Under Saddle Starter Division 9. Best Turned Out 2’6” Hunter Division 10. Equitation On The Flat 37. Warm Up 11. Hunter Under Saddle 38. Hunter Over Fences 12. Handy Hunter 39. Hunter Over Fences 40. Hunter Over Fences Junior Beginner Division 41. Hunter Under Saddle 13. Warm Up 14. Hunter Over Cross Rails 2’9” Hunter Division 15. Equitation Over Cross Rails 42. Warm Up 16. Hunter Under Saddle 43. Hunter Over Fences 17. Equitation On The Flat 44. Hunter Over Fences 45. Hunter Over Fences Adult Beginner Division 46. Hunter Under Saddle 18. Warm Up 19. Hunter Over Cross Rails 2’6” Jumper Division 20. Equitation Over Cross Rails 47. Clear Round 21. Hunter Under Saddle 48. Immediate Jump Off 22. Equitation On The Flat 49. Speed 50. Immediate Jump Off Novice 2’ Division 23. Warm Up 2’9” Jumper Division 24. Hunter Over Fences 51. Clear Round 25. Equitation Over Fences 52. Immediate Jump Off 26. Hunter Under Saddle 53. Speed 27. Equitation On The Flat 54. Immediate Jump Off

FEES Entry Fees: OFFICE USE ONLY Division - $40 Admin Fee: $10.00 Per Class - $10 Warm Up Per Round (Max 2) - $5 Grand Total: Payment: Entry #:

Every entry shall constitute an agreement and affirmation that all participants (which include, without limitations, the owner, lessee, trainer, manager, agent, coach, driver, handler, and the horse), for themselves, their principals, representative, employees, and agents:(1)Shall be subject and bound by the local rules of the competition;(2)Agree that they participate voluntarily in the competition fully aware that horse sports and the competition involve inherent dangerous risk of serious injury or death, and accept that no helmet or protective equipment can protect against all foreseeable injury, and by participation they expressively assume any and all risk of injury or loss and they agree to indemnify and hold all show facilities, the competition and their officials, directors, employees and agents harmless from and against all claims including for any injury or loss resulted, directly or indirectly, from the negligent acts or omissions of said officials, directors, employees or agents of the show facilities or the competition. Your signature below indicates your acceptance of and compliance with the above statement. You must be 18 years or older to sign.

______SIGNATURE (Parent or Guardian if Junior) Print Name