Fall Dressage Schooling Show

Fall Dressage Schooling Show

Please fill out the registration form carefully
Rider's Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
E-mail
example@example.com
Date of birth, if under 18

MonthDayYear
Date
Division*

Jr. Rider (under 18)Sr. Rider (18 & Up)
Name of Horse*
Breed of Horse, age, and sex*
Office*

Office Fee ($15.00)
Stabling/Jump Out*

One Day ($25.00) (Saturday)Over night ($30.00) (Friday Night)Jump Out ($10.00) (Saturday)
Please let us know what day you plan on arriving and a time. Also if you would like to stable with someone.
Camping

One Night With Electric ($25.00) Friday NightOne Night No Electric ($15.00) Friday Night
Each Test is $30.00 Fun Classes are Free
Level/Test Introductory

1. Introductory Test A-Jr2. Introductory Test B-Jr3. Introductory Test C-Jr4. Introductory Test A-Sr5. Introductory Test B-Sr6. Introductory Test C-Sr
Maiden

7. Training Level, Test 1- Maiden11. First Level, Test 1- Maiden
Training Level

8. Training Level, Test 19. Training Level, Test 210. Training Level, Test 3
First Level

12. First Level, Test 113. First Level, Test 214. First Level, Test 3
15. 2nd Level & Above - Test # (enter below):
16. Musical Freestyle (Training & Up) Level (enter below):
Western Dressage, Introductory

17. Introductory Level, Test 118. Introductory Level, Test 219. Introductory Level, Test 320. Introductory Level, Test 4
Western Dressage, Basic

21. Basic Level, Test 122. Basic Level, Test 223. Basic Level, Test 324. Basic Level, Test 4
25. 1st Level & Above - Test # (enter below):
26. Other Test of Choice (enter below):
27. Other Test of Choice (enter below):
Fun Classes

28. Costume Class29. Bribe Your Horse
RELEASE OF LIABILITY

In accepting my entry, I hereby release and discharge Heartland Equestrian Center LLC. And their respective officers, member, sponsors and owners from any and all claims for right of damage that may occur to my horses(s) or myself, I also assume and accept full responsibility for any damages done by myself or my horse(s) at this show. I hereby release any photo taken of me and my horse to be used on the Heartland Equestrian Center web site and Facebook page
Signature*

Clear
Please Total Registration & Class Entry Fees In Box Below. If you have any issues with making paymet please contact us at events@heartlandec.com

Total amount charged

USDDescription

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

REMEMBER TO SEE THE OFFICE THE MORNING OF THE SHOW OR THE NIGHT BEFORE:

1. Be sure office has a copy of current negative Coggins (WI State Law) either emailed in or bring in day of arrival.

2. Pick up packet on table by the show office

NO ARRIVAL BEFORE 4 P.M. THE FRIDAY BEFORE THE SHOW

SHOW STARTS AT 8 A.M.

JUDGE: Michael Peters “L” with Distinction
Should be Empty:

Fall Dressage Schooling Show

Each Test is $30.00 Fun Classes are Free