Lesson Student Entry Form 2003

Lesson Student 2016 Winter Schooling Series Entry Form

CLOSING DATE FORENTRIES 6:00 PM ONE WEEK PRIOR TO SHOWS

WINDERMEREEQUESTRIANCENTER

ENTRY BLANK (ONE STUDENT PER ENTRY)

Entries will not be accepted without signatures where indicated. Each
signature indicates that the signatory has read and understands the COMPETITION AGREEMENT printed on this Entry Form.

MAIL ENTRY TO:WindermereEquestrianCenter

20615 Dunham Rd.

Clinton Township, MI 48038

586-465-2170

Entry Fee per class, for all but lead line and walk trot, $18.00

Lead Line and Walk/Trot (per class includes horse rental)$18.00

Lesson Horse Rental: 3 or more classes (per day)$30.00

2 classes or less (per day)$20.00

Medal Classes are $25 on MHJA Local Member Date ONLY$25.00

Coaching per day: Required for all students who are jumping

Optional morning schooling is included in this fee.$35.00

Coaching per day: Required for Students who are not jumping$25.00

.

• All competitors must wear headgear meeting ASTM/SEI standard with harness secured while mounted.

Permission for minor to show: I hereby consent to entry of my child:

Parent/Guardian Signature :

Every entry at a recognized competition shall constitute an agreement and affirmation that the person making it, owner, lessee, trainer, manager, agent, rider and the horse:
1) Shall be subject to the constitution and the rules of the Association and the local rules of the competition; 2) That every horse and rider is eligible as entered; 3) That the owner, rider and any of their agents acknowledge that they participate voluntarily in the competition fully aware that horse sports and the competition involve inherent dangerous risk of injury or loss, and they agree to hold the MHJA, Windermere Equestrian Center and their officials, directors, employees and agents harmless for any injury or loss suffered resulting directly or indirectly from negligent acts or omissions of said officials, directors, employees or agents of the MHJA or Windermere Equestrian Center.

WARNING! UNDER THE MICHIGAN EQUINE ACTIVITY LIABILITY ACT, AN EQUINE PROFESSIONAL IS NOT LIABLE FOR ANY INJURY TO OR THE DEATH OF A PARTICIPANT IN AN EQUINE ACTIVIY RESULTING FROM AN INHERENT RISK OF THE EQUINE ACTIVITY.

SHOW DATES: January/February/March/April/May

(CIRCLE ONE)

Name of Rider: ______

Address:

City/State/Zip:

Phone: Age:

Rider's Signature:

Classes for Rider (please list by number on prize list)

We make every effort to rotate students and to give everyone their favorite horse. Please remember how many students we have and understand that it is an impossible job to assign everyone their favorite horse.

Horse Choices:1.

2.

3.

4.

5.

Instructor's Signature of Approval:

Number of classes at $18.00

Lesson Horse Rental: $30 per day 3 or more classes

$20 per day 2 or less classes ______

Coaching per Day: # of days x ($25.00 or $35.00)

Late fee (if applicable): $25.00 ______

Total Due

RECEIVED CHECK NO. ______AMOUNT PAID

BALANCE DUE