Interscholastic Equestrian Association, Inc

2009-2010 Membership Packet Checklist

Please refer to this checklist to ensure that your membership application packet is complete when submitted to the IEA membership office.

___ Team Application Form ___ Team Membership Dues ___ At least three Rider Applications for each type of team joining (i.e. Upper school hunt seat team) ___ Completed Rider Application Forms containing all necessary signatures ___ Completed Waivers containing all necessary signatures ___ Riders’ Dues ___ Coach's application ___ Completed Coach Application Form ___ Completed Waiver ___ Coach Dues ___ Proof of insurance ___ Show application ___ One (1) hosting date ___ Two (2) co-hosting dates (as defined in Rule 2.C.1.e) ___ Dates for all types of teams applied for. ___Coaches and team organizers have read and are familiar with the 2009-10 IEA Rulebook

Per IEA Rules 2.B.1 and 2.C.1.a, incomplete membership application packets may be returned to their sender.

DEADLINE FOR ALL MEMBERSHIPS = NOVEMBER 15, 2009! TEAM MEMBERSHIP APPLICATION For 2009-2010 Send to: IEA Membership Secretary 315 Chestnut St, Ashland MA 01721

[Please print legibly or type the information.]

NAME OF TEAM APPLICANT ______

Hunt Seat Upper School ____ Hunt Seat Middle School ____ Hunt Seat Upper & Middle School ____

Western Upper School _____ Western Middle School ____ Western Upper & Middle School _____ Any one team - $125; Any combination of two English, Western, Upper School or Middle School teams - $175. Any combination of three teams - $275; All four teams - $325

TEAM'S ADDRESS ______

City ______State ______Zip ______

TEAM'S TELEPHONE NUMBER (______) ______

TEAM COACH’S NAME ______

TEAM COACH”S EMAIL ADDRESS ______@______(REQUIRED)

Falsification of any membership, show, eligibility, or application form may be cause for immediate expulsion of the individual, coach, and/or team from the IEA, and any other penalty assigned by the IEA Rules.

The undersigned coach or other team representative has organized the above named equestrian team. The undersigned agrees that this team will accept, follow, and operate for the current school year under the Rules and Regulations of the Interscholastic Equestrian Association as amended from time to time.

______[Representative or Coach's Printed Name]

______[Representative’s Title or Position]

Date ______, 200______[Representative or Coach’s signature]

* * * * * * * * * * * * Please remit appropriate dues as listed above with this application form. * * * * * * * * * * * * * * * * *

The undersigned coach certifies that she/he has read and understands IEA Rules & Regulations, and affirms that she/he will abide by all IEA Rules ands Regulations as amended from time to time and all rules and regulations established by a sponsoring educational institution, if any.

Date ______, 200______[Coach’s signature]

______(Hosting Team) (Zone) (Region)

______(1st Co-Host) (2nd Co-Host)

Contact Information (Name, Address, Phone Number, Email) * Show Manager will be listed on website as primary contact unless otherwise noted *

Show Secretary: Show Manager: Other Contact: ______Show Information Show Date: (Please list 2 proposed dates) 1st Choice ______2nd Choice ______

Will show restrict entries to its Zone? (Y/N) ______Region? (Y/N)______

Anticipated entry limits (please describe) :______

Proposed Show Grounds:______

Competition Classification:

___ Middle School Hunt Seat Competition ___ Upper School Hunt Seat Competition Required Classes: Required Classes: Future Int. Eq o/f 2’ Varsity Open Eq o/f 2’6” Future Nov. o/f x-rails Varsity Int. Eq o/f 2’ Future Int. Eq on the Flat JV Nov. Eq o/f x-rails Future Nov. Eq on the Flat Varsity Open Eq on the Flat Future Beg Eq on the Flat Varsity Int. Eq on the Flat JV Nov. Eq on the Flat JV Beg. Eq on the Flat Additional Class Offered (optional): ___ Varsity Open Championship Class

___ Middle School Western Competition ___ Upper School Western Competition Required Classes: Required Classes: Future Int. Horsemanship Varsity Open Horsemanship Future Nov. Horsemanship Varsity Int. Horsemanship Future Beg Horsemanship JV Nov Horsemanship Future Int. Reining JV Beg. Horsemanship Varsity Open Reining Varsity Int. Reining By signing below, the management agrees to abide by all IEA rules and policies, and acknowledges liability for subsequent fines if these rules are not followed. In addition, the management certifies that the requested show date has been confirmed by the Zone Chairperson. Signature of Show Manager ______Date ______

Mail to: IEA 315 Chestnut St Ashland, MA 01721