Rider - Black Jack Saddle Club
2015 Black Jack Saddle Club – Entry Form
Schooling Clinic/ Fun Show – April 18th, 2015
Rider: __________________________________________Rider Number: ___________Horse:_____________________________________
(Separate number for each rider/horse combo)
(Complete a separate form for each horse)
Are you a member of BJSC? (Please circle choice) Yes
No
IF no please provide the following:
Address: ____________________________________________________
Email: _____________________________________________
City/State/Zip: _______________________________________________
Phone: __________________________________________
Mark ‘X’ to enter class
SCHOOLING SHOW
1.
Showmanship – 18 & Over
2.
Showmanship – 17 & Under
15 min BREAK
3.
English Pleasure – 18 & Over
4.
English Pleasure – 17 & Under
5.
English Equitation – 18 & Over
6.
English Equitation – 17 & Under
15 min BREAK / TACK CHANGE – IF NEEDED
7.
Western Horsemanship – 18 & Over
8.
Western Horsemanship – 17 & Under
9.
Western Pleasure – 18 & Over
10. Western Pleasure – 17 & Under
LUNCH BREAK
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24
25.
26.
27.
28.
FUN SHOW
Musical Hoola Hoops 18 & Over
Musical Hoola Hoops 11 to 17
Musical Hoola Hoops 10 & Under
* Barrel Race 18 & Over
* Barrel Race 11 to 17
* Barrel Race 10 & under
** Dash Race 18 & Over
** Dash Race 11 to 17
**Dash Race 10 & Under
***Ribbon Race 18 & Over (Team of 2 riders)
***Ribbon Race 11 to 17 (Team of 2 riders)
***Ribbon Race 10 & Under (Team of 2 riders)
****Target Toss 18 & Over
****Target Toss 11 to 17
****Target Toss 10 & Under
SHORT BREAK – UNTACK HORSES
Ride a buck 18 & Over (Entry + $1.00, Winner takes all dollars)
Ride a buck 11 to 17 (Entry + $1.00, Winner takes all dollars)
Ride a buck 10 & Under (Entry + $1.00, Winner takes all dollars)
*Enter to get a time or put in an extra $5.00 to win Jackpot.
** Run around barrel at the end for fastest time.
***Team of 2, run around the barrel at the end each holding an end of a paper streamer without dropping or breaking the streamer.
****Toss a plastic egg at a target on the ground to see who gets the closest to the middle.
- Stallions are allowed to be shown by Adults 18 & Over as long as no problems arise
By participating you agree to HOLD HARMLESS the show management, Blackjack Saddle Club, its officers and the other
agents/employees associated with them & stable or arena owner regarding any loss, injury or damage to person, property or mount
which might occur as a result of your voluntary participation in equestrian competition and/or activities.
X: __________________________________________________________________
{Signature of participant (if under 18, guardian)}
_______________________________________
Date:
PAYMENT:
Schooling Show $25.00
Fun Show $5.00 a class or $25.00 for afternoon.
______________________ X $5.00 = $___________ + $3.00 =
# Classes Entered
Class Fee Subtotal
Office Fee
$_________________________
Total Due
Office Fee waived if Pre-registered before deadline for the show. $2.00 up-charge for classes added after the show starts.
NO REFUNDS for dropped classes. A class can be swapped for another.
Paid: Check #______________ or Cash
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