| Donida Farm

Rider's Name

First Last

Horse's Name

Horse Owner's Name (if different from rider)

First Last

Horse is a

Mare
Gelding
Stallion

Address

Street Address City State ZIP Code

Email

Phone

Rider's Age*

17 or under
18 or over

Parent or Guardian Name*

First Last

Emergency Phone Number*

Release of Liability

Donida Farm, members of the show committee, staff and their associates will not be responsible for any loss or damage or injury to horses exhibited or for any article of any kind that may be lost or destroyed in any way injured. Each exhibitor will be responsible for any injury that may be associated with any person whom so ever by any horses owned by, exhibited by, or handled by him and shall indemnify the aforementioned individuals and organizations against all claims and demands of any kinds or nature that may grow out of and injury associated by any horses owned or exhibited by him or arise from the negligence of the person in charge of any such horse. The owner, driver, handler, and rider, and any other agents or representatives acknowledge that they participate voluntarily in the competition fully aware that horse sports and the competition involve inherent dangerous risk, and that by participating they expressly assume any risks of injury and loss, and they agree to hold the competition and its officials, directors, employees, or agents. All horses exhibited will be at the owners/lessee’s risk.

Rider signature (or Parent/Guardian Signature if under 18)*

Printing your full name in the box will act as a signature to indicate that you agree to the terms of the Release of Liability above.

Stabling and any group name

All horses must be stalled. No working out of trailers.

Stabling Options*

Day Stall
Overnight Stall
Donida Boarder

Day Stall

Saturday arrival / Saturday departure

Price: $25.00 Quantity:

Tack Stall

Price: $25.00 Quantity:

Overnight Stall

Friday after 2pm arrival / Saturday departure

Price: $35.00 Quantity:

Tack Stall

Price: $35.00 Quantity:

Stabling Group

Name of barn or group you wish to be stabled with. All riders must be pre-registered to be stabled with your group.

Class Registration

Classes may be combined, divided or cancelled upon manager’s decision. Riders may ride more than once in each class.

Rider Division*

Open
Adult Amateur
Junior (18 & under)

Dressage Classes

Classes

18. USEA Eventing Dressage TOC

Please indicate test.

19. USEA Eventing Dressage TOC (second ride)

Please indicate test.

20. USEF Western Dressage TOC

Please indicate test.

21. USEF Western Dressage TOC (second ride)

Please indicate test.

8. Intro Level Test of Choice

Please indicate test

Intro A
Intro B
Intro C

9. Intro Level Test of Choice (second ride)

Please indicate test

Intro A
Intro B
Intro C

10. Training Level Test of Choice

Please indicate test

Training Level Test 1
Training Level Test 2
Training Level Test 3

11. Training Level Test of Choice (second ride)

Please indicate test

Training Level Test 1
Training Level Test 2
Training Level Test 3

12. First Level Test of Choice

Please indicate test

First Level Test 1
First Level Test 2
First Level Test 3

13. First Level Test of Choice (second ride)

Please indicate test

First Level Test 1
First Level Test 2
First Level Test 3

14. Second Level TOC

Please indicate test

Second Level Test 1
Second Level Test 2
Second Level Test 3

15. Second Level TOC (second ride)

Please indicate test

Second Level Test 1
Second Level Test 2
Second Level Test 3

16. Third Level to Grand Prix TOC

Please indicate test

17. Third Level to Grand Prix TOC (second ride)

Please indicate test

1. Musical Freestyle Champion TOC

Please indicate level

22. NAWD Foundation 1, 2, or 3

Please indicate level

Foundation 1
Foundation 2
Foundation 3

23. NAWD Foundation 1, 2, or 3

Please indicate level

Foundation 1
Foundation 2
Foundation 3

25. NAWD Progression 1, 2, or 3

Please indicate level

Progression 1
Progression 2
Progression 3

24. NAWD Foundation 4, 5, or 6

Please indicate level

Foundation 4
Foundation 5
Foundation 6

3. Musical Pas De Deux

Name of second rider

4. Musical Theme Costume Class

Name(s) of other team members

Cash donation to be put towards class prizes name, company

Note to show secretary

Office Fee

Price: $10.00

Paypal Fee

Price: $3.50

Total

$0.00

December 6 & 7, 2014

Leave a reply Cancel reply

Dancing Under The Stars - Sept 28, 2019

Release of Liability

Stabling and any group name

Class Registration