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Mid-Summer Masters Gold Entry Form
Bridle #
August 8-9, 2015
Paid:_____________
A GOLD Level Equine Canada Show – SHF Heritage Series & Prairie Cup Circuit Show
Ebon Stables – Saskatoon SK
Chq #:___________
Mail Entries to: Ebon Stables
Fax Entries to: 306-477-0199
c/o Victoria Kendall
Email inquiries: [email protected]
Box 27, RR#5
Entry inquiries: 306-241-2579
Saskatoon, SK S7K 3J8
Early Bird Entry July 24, 2015 – entered in draw for stall fees
Horse Information
Show Fees
Horse Name:
Total Entry Fees:
Passport #:
Age:
Breed:
TIP#:
Stall Fee (waived if entered in Bronze):
Tack Stall (if available, waived if pd for in Bronze): $80.00/stall
Pony: L__ M__ S__
Stable with:
Trainer:
Owner of Horse:
Owner EC #
Shavings Pre-Order: _______ bags x $8.00/bag
Office Fee (waived if entered in Bronze)
Owner address:
Rider Information
Paramedic Fee
$5.00
Drug Levy Fee
$7.00
$20.00
Power Hook Up - $25.00
Level:
Pony Club:
SHF#
SHJA#
Subtotal
Date of Birth if Junior:
GST 5%
Saturday Supper Tickets:_______x$15.00/ticket
Street Address:
Payable to Ebon Stables
City, Province:
*Separate Chq*
Postal Code:
Phone:
Email:
Emergency Contact Name & Phone #:
Make Prize money payable to: ____Owner
Total Show Fees
Stall Cleaning and Bridle # Refund
$40.00
This Document will affect your legal rights and liabilities. Please read carefully:
Cell/Alternate Phone #:
____Rider
Entry Fees
Div
$30.00
Jump Canada Levy
Name:
EC#:
x$80.00/stall
Class Numbers
Entry Fee
I _____________________________ acknowledge that the sport of horses is a
risk sport and that I am participating at my own risk and in full knowledge of the
hazards which are inherent in this sport. I further acknowledge that inherent
risks in riding and working around horses, which include bodily injury to both
horse and rider which can result from normal use, competition, or schooling. It is
hereby also understood that no helmet or protective equipment can protect
against all foreseeable injury. I hereby certify that every horse and rider is
eligible as entered and agreed for myself and my representatives to be bound by
the Constitution and Rules of Equine Canada and the Mid Summer Masters
Show’s Prize List. In consideration of being allowed to participate in this event, I
hereby assume all risk and I hereby release and absolve Equine Canada, SHF,
SHJA, Ebon Stables, Saskatoon Riding Club, and their directors, officers,
employees, volunteers, and their representatives for all responsibility, liability or
claims of any nature and kind which I may have arising from my participation in
this activity, including but not limited to bodily injury or death to myself or my
horse(s) and damage to property arising from any cause whatsoever, including
the negligence of one or more of the individuals and organizations referred to
herein. All persons mounted on a horse on the competition grounds are
required to wear properly fitted ASTM or BSI approved helmet with safety
harness correctly fastened (se EC Article G102). In the event that _____________
participates in an Equine Canada sanctioned competition where protective
headgear is required for juniors, he/she will wear properly fitted and fastened
approved headgear at all times while riding or driving at the event location. It is
understood that juniors not meeting this requirement will not be allowed to
compete at these competitions. (A802.6). I hereby declare that in signing this
document that I have read and fully understand and agree to the terms and
conditions stated herein and that it is binding upon my executors, heirs and
assigns.
Signature of Rider or Legal Guardian if rider is a Junior
Total Entry Fees
Signature of Owner
Date