! ! ! CLASS LIST: (Adult Amateur=AA; Junior=Jr; Open=O) 1. USDF Introductory Level- Test A (AA,Jr,O) 2. USDF Introductory Level- Test B (AA,Jr,O) 3. USDF Introductory Level- Test C (AA,Jr,O) 4. Training Level Test 1 (AA,Jr,O) 5. Training Level Test 2 (AA,Jr,O) 6. Training Level Test 3 (AA,Jr,O) 7. First Level Test 1 (AA,Jr,O) 8. First Level Test 2 (AA,Jr,O) 9. First Level Test 3 (AA,Jr,O) 10. Second Level Test 1 (AA,Jr,O) 11. Second Level Test 2 (AA,Jr,O) 12. Second Level Test 3 (AA,Jr,O) 13. Third Level - Indicate Tests of Choice (AA,Jr,O) 14. Fourth Level - Indicate Tests of Choice(AA,Jr,O) 15. Freestyle Test of Choice (AA,Jr,O) 16. Western Dressage Test of Choice (AA,Jr,O) Exhibition only ! CLASS FEES: USDF Introductory Class & Equitation Class - $20.00 Training through Fourth - $25.00 Western Dressage TOC - $25.00 No refunds after closing date unless requested with a vet certificate. No exceptions!! ! CLOSING DATE: Must be RECEIVED by OCT 18th SHOW RULES: !! and two rated shows RIDING TRAINING LEVEL THROUGH FOURTH LEVEL to qualify. Nonmembers are also eligible for all awards. Scores must meet the following minimum requirements: Training Level 60% First Level 58% Second - Fourth 55% In addition to each level award presented based on the criteria above, the following awards will also be presented: Annual Awards: Junior High Point Trophy: In addition to above criteria, rider must be a junior. Rae Lockwood Memorial Trophy: In addition to above criteria, rider must be an adult amateur. Intro High Point Trophy: Adult Amateur: In addition to the above criteria, horse and adult amateur rider combination cannot compete at any level higher than Intro C in the current ICC show year. Junior: In addition to the above criteria, horse and junior rider combination cannot compete at any level higher than Intro C in the current ICC show year. Second Career Trophy: In addition to the above criteria, horse must be an off the track thoroughbred with a Jockey Club tattoo as evidence of a prior racing career. Show Pony Trophy: In addition the the above criteria, the horse must be 14.2 hands or less. Coriander Memorial Trophy: In addition to the above criteria, the horse must be a registered Hanoverian. This dressage show is covered by all rules and specifications in the current USEF Rule Book. Any situation not covered by the USEF rules will be decided by the horse show management and such decisions are final. Entry blanks must be filled out completely with all signatures, membership numbers & copies of CDS cards, and fees. Incorrect and/or Incomplete forms will be charged a $5.00 office fee. Please check that all class numbers are correct. For insurance purposes, any horse brought on the show grounds must pay a $15.00 grounds fee. Any horse schooled in the warm-up area must instead pay a $15.00 schooling fee. All children must be supervised at all times. NO DOGS. All riders are required to wear headgear when mounted. Failure to enter the area at the specified time will result in elimination. Times will be telephoned. It is the exhibitors' responsibility to call if times are not received. Western Dressage High Point: Awarded to the horse and rider who ride in two rated and one schooling shows and receive the highest scores in western dressage. INLAND COMMUNITIES CHAPTER AWARDS: SHOW INFO: RUTH CORRAO HARRIS 951-315-0592 ! All awards will be presented to the horse and rider combination with the highest average percentage obtained from their best three scores (one schooling score and two rated scores).Horse and rider combination must participate in one schooling Perpetual Awards: Diane Prisco-Mink Perpetual Trophy: Awarded to the horse and rider combination with the highest average percentage at Training-Fourth level. Rider and horse combination must compete at both ICC rated shows. Holy Smoke Perpetual Trophy: Awarded to the horse and rider combination competing together for the first time at Training-Fourth level in an ICC show. Must also meet the above criteria. FHANA Friesian High Point Trophy: In addition to the above criteria, the horse must be a FHANA registered purebred Friesian. ! ICC LOGOWEAR: Polo shirts are available for sale at the show office. Support your chapter!! ! ICC Halloween Schooling Show - Saturday OCTOBER 25th Shadow Ridge Equestrian Center 7256 Weaver St Highland 92346 COMPLETE AND SIGN BOTH SIDES - ENCLOSE COPIES OF ALL CARDS MAIL TO: RUTH CORRAO HARRIS 29205 HIGHLAND BLVD MORENO VALLEY CA 92555 HORSE INFORMATION OWNER INFORMATION Name: _____________________________________________________________ Name: ________________________________________________________ Breed/Breed Registry Initials: _____________________________________ Address: ______________________________________________________ Sex: ___________ Height: ___________ Color: _____________ City: ______________________ State: _______ Zip: ________ Age: ________________________________________________ Phone: _____________________________________________ Sire: _______________________________________________ Fax: ________________________________________________ RIDER INFORMATION SUBTOTAL CLASS FEES MISCELLANEOUS ORGANIZATIONAL FEES EMAIL: _____________________________________________ Grounds Fee's (MANDATORY per horse) $ 15.00 OWNER CDS# ________________________________________ CDFA (Mandatory per horse) $ 5.00 CDS Travel grant (Mandatory per horse) $ 3.00 Name: ___________________________________________________________ Address: _______________________________________________________ CLASS NO / DESCRIPTION / FEE TRAINER INFORMATION Schooling Fee $15.00 (Non-competing horse) City: ___________________________ State: _______ Zip: ________ Phone: _____________________________________________ Name: ________________________________________________________ Fax: ________________________________________________ Address: ______________________________________________________ EMAIL: _____________________________________________ City: _____________________________State: _______ Zip: ________ CDS Junior Donation RIDER CDS# _________________________________________ Rider status (circle one): OPEN ADULT AMATEUR Phone: _____________________________________________ Region VII YR Donation Fax: ________________________________________________ Office fee for incomplete forms $10.00 JR/YR Adult amateurs - USEF Amateur Card is Mandatory JR/YR Date of Birth: __________________________________ EMAIL: _____________________________________________ Adult Riders, please indicate if over 50: ____YES ____NO TRAINER CDS# _______________________________________ TOTAL FEES ENCLOSED Make checks payable to ***Costumes are optional, but there will be a “Best Costume” award!! ICC-CDS ENTRIES CLOSE AND MUST BE RECEIVED BY: Saturday, OCTOBER 18th RIDE TIMES WILL NOT BE CALLED BUT POSTED ON WEBSITE & FACEBOOK Check here if you would like to request a ride time call JUDGE: RYAN BELL ! Entry Agreement By entering this Competition and signing this entry blank as the Owner, Lessee, Trainer, Manager, Agent, Coach, Driver, Rider, Handler, Vaulter or Longeur and on behalf of myself and my principals, representatives, employees and agents, I agree that I am subject to the Rules of USEF , California Dressage Society and the local rules of the Competition. I agree to release and hold harmless the competition, CDS, their officials, directors and employees for any action taken under the Rules. I represent that I am eligible to enter and/or participate under the Rules, and every horse I am entering is eligible as entered. I also agree that as a condition of and in consideration of acceptance of entry, USEF and/or the Competition may use or assign photographs, videos, audios, cable - casts, broadcasts, internet, film, new media or other likenesses of me and my horse taken during the course of the competition for the promotion, coverage or benefit of the competition, sport, or the Federation. Those likenesses shall not be used to advertise a product and they may not be used in such a way as to jeopardize amateur status. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropriation. Release, Assumption of Risk, Waiver, and Indemnification This document waives important legal rights. Read it carefully before signing. I AGREE in consideration for my participation in this Competition ICC RATED SHOW to the following: I AGREE that USEF, CDS and the “Competition” as used herein includes the Licensee and Competition Management, as well as all of their officials, officers, directors, employees, agents, personnel, volunteers and Federation affiliates. I AGREE that I choose to participate voluntarily in the Competition with my horse, as a rider, lessee, owner, agent, 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 risks of accident, loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death. I AGREE to hold harmless and release USEF, CDS and the Competition from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm of any nature caused by me or my horse to others, even if the Harm arises or results, directly or indirectly, from the negligence of the Federation or the Competition. I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of the Federation or the Competition. I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the Federation 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 while at the Competition. I have read the Federation Rules about protective equipment, including GR801 and, if applicable, EV114, and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that the Federation strongly encourages me to do so while WARNING that no protective equipment can guard against all injuries. 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 this Release on the child’s behalf I represent that I have the requisite training, coaching and abilities to safely compete in this competition. I AGREE that if I am injured at this competition, the medical personnel treating my injuries may provide information on my injury and treatment on the official USEF accident/injury report form. BY SIGNING BELOW, I AGREE to be bound by all applicable Rules and all terms and provisions of this entry blank and all terms and provisions of this Prize List. If I am signing and submitting this Agreement electronically, I acknowledge that my electronic signature shall have the same validity, force and effect as if I affixed my signature by my own hand. SIGN ALL THREE LINES, EVEN IF SAME PERSON - MANDATORY RIDER / DRIVER / HANDLER 1. Signature _________________________________Print Name _______________________________ RIDER 2. Signature _________________________________Print Name ________________________________OWNER 3. Signature _________________________________Print Name ________________________________TRAINER EMERGENCY CONTACT PHONE NUMBER MANDATORY ___________________________ SIGN IF APPLICABLE COACH Signature __________________________________________Print Name ________________________________________________PARENT / GUARDIAN Signature __________________________________________________ Required if Rider/Handler is a minor Print Name ________________________________________________