*Current negative Coggins form MUST be presented for each horse/pony entered*

Rider Name

Junior Adult

Owner Name

Address

City  State AK AL AR AZ CA CO CT DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WI WV WY  Zip

Phone

Person Responsible for Payment

Email address

Classes Entered

The first 6 classes are judged 50% on equitation and 50% on jumper "style". There is a maximum time allowed, but it will be generous. These are for riders in their first year of showing jumpers.

1. Baby Beginning Jumpers - Cross Rails

2. Baby Beginning Jumpers - Cross Rails

3. Baby Beginning Jumpers - Cross Rails

4. Beginning Jumpers - 15" - 21" Verticals

5. Beginning Jumpers - 15" - 21" Verticals

6. Beginning Jumpers - 15" - 21" Verticals

The remaining classes will be run as regular Jumper classes.

7 . Puddle Jumpers - Power & Speed

8. Puddle Jumpers - Timed Jump-Off

9. Puddle Jumpers - Timed First Round

10. Intermediate Jumpers - Timed Jump-Off

11. Intermediate Jumpers - Timed First Round

12. Intermediate Jumpers - Power & Speed

13. Gambler's Choice 2'6"

14. Low Jumpers - Power & Speed

15. Low Jumpers - Timed First Round

16. Low Jumpers - Timed Jump - Off STAKES

17. High Jumpers - Power & Speed

18. High Jumpers - Timed First Round

19. High Jumpers - Timed Jump-Off STAKES

20. Gambler's Choice 3'

21. Chase Me Charlie (at a trot)

Entry Fees:

Classes are $12. Stakes, Chase Me Charlie and Gambler's Choice are $15. $10 office fee is waived by pre-registering before noon on Friday before show.

I AGREE in consideration for my participation in this competition to the following:

I AGREE that I choose to participate voluntarily in the competition with my horse, as rider, driver, handler, lessee, owner, agent, coach, trainer, or as parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sports and the Competition involve inherent dangerous risk of accident , loss and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death (“harm”).

I AGREE to release Keezlenutten Farm, LLC from all claims for money, damages or otherwise for any “harm” to me or my horse for any “harm” caused by me or my horse to others, even if the “harm” resulted, directly or indirectly, from the negligence of Stillmeadows Equestrian Center, LLC and the Competition.

I AGREE to indemnify (that is, to pay any losses, damages or costs incurred by) Keezlenutten Farm, LLC and the Competition and to hold them harmless with respect to claims for “harm” to me or my horse, and for claims made by others for any “harm” caused by me or my horse at the competition.

If I am a parent or guardian of a junior exhibitor, I consent to the child’s participation and AGREE to all of the above provisions and AGREE to assume all of the obligations of the Release on the Child’s behalf.

I AGREE that Keezlenutten Farm, LLC and the Competition as used above includes all of their officials, officers, directors, employees, agents, personnel, volunteers and affiliated organizations.