Official Entry Form
R.I.D.E.R.S. Seahorse Bronze/Gold Dressage Competition #2 Saturday, September 3rd and Sunday September 4th, 2022 Please Complete Before: Monday, August 29th 2022 @ 6:00 PM AST
Horse Registration
Only 1 Horse Per Entry Form.
Name of Horse
*
Breed
*
Gender
*
Mare
Gelding
Stallion
Details
Height
Age
Colour
EC Horse Recording # (Gold Only)
Please include a copy of EC Horse Recording # in Required Document section below.
Rider Information
Upload photocopies of Rider's EC Sports License and Prov. Membership # in Required Document Section below.
Name of Rider
*
First Name
Last Name
Mailing Address
Street Address
Street Address Line 2
City
Province
Postal Code
Phone #
Cell
Home
Work
Work
Postal / Zip Code
Email Address
*
example@example.com
Rider's EC Sport License #
*
Upload copy in Required Documents below
Rider's Provincial Membership #
*
Upload copy in Required Documents below
Horse Owner Information
Please indicate if you are Same as Rider. If Owner is different than Rider, please provide Horse Owner information below.
Owner is Same as Rider
*
Yes
No
Name of Horse Owner
First Name
Last Name
Mailing Address
Street Address
Street Address Line 2
City
Province
Postal Code
Phone #
Home
Cell
Work
Work
Postal / Zip Code
Email
example@example.com
Owner EC Sport License #
Be sure to attach a copy for our records
Owner Provincial Membership #
Be sure to attach a copy for our records
Person(s) Responsible for Horse (MANDATORY) Must be 18 years of age or older.
If Person Responsible is a Parent of a Junior, neither EC Membership nor Registered Participant License is required but PTSO (e.g NSEF) Membership is mandatory. Non-parent Person Responsible(s) must have EC Sport License and PTSO.
I am Parent of a Junior (Must have PTSO)
Yes
Not Applicable
I am a Non-Parent of a Junior (Must have PTSO and EC Sport)
Yes
Not Applicable
PTSO # (e.g NSEF)
EC Sports License #
Name of Person Responsible for Horse (Must be over 18 years of age)
*
First Name
Last Name
Name of Coach (Enter "Self-Coached" if that is the case)
*
I verify that I am 18 years of age or over and will be held responsible for Horse registered in this Official Entry Form.
*
Required Documents
Include a photocopy of all relevant current memberships. EC Horse Recording Certificate (Gold), Sport License, Provincial Membership, for both Rider, Owner/Lessee, and Person(s) Responsible for the horse, if not the same person (if applicable) (A802.5b), as well as proof of vaccination (Vet cert. or purchase invoice).
EC HORSE RECORDING CERTIFICATE (GOLD)
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RIDER - EC SPORT LICENSE
Upload File(s)
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RIDER - PROVINCIAL MEMBERSHIP
Upload File(s)
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OWNER/PR - EC SPORT LICENSE (if not the same person as Rider)
Upload File(s)
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OWNER/PR - PROV. MEMBERSHIP (if not the same person as Rider)
Upload File(s)
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PROOF OF VACCINATION
*
Upload File(s)
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of
TESTS OFFERED (Please select Test and Day) Saturday, September 3rd and Sunday, September 4th, 2022
EC Introductory to Fourth Level Riders may enter a Maximum of 4 tests/day, including Freestyle. EC Para-Equestrian and FEI Riders may enter a maximum of 3 tests/day, including Freestyle.
Please Specify EC Show Level
*
Bronze $35/TEST
Gold $40/TEST
Amateur Status
*
Yes
No
Division
*
JR
AA
OPEN
Signature of Parent/Guardian (If Rider is JR)
Clear
Level - Introduction (Saturday / Sunday)
A - Sat
B - Sat
C - Sat
A - Sun
B - Sun
C - Sun
Training Level (Saturday / Sunday)
1 - Sat
2 - Sat
3 - Sat
1 - Sun
2 - Sun
3 - Sun
First Level (Saturday / Sunday)
1 - Sat
2 - Sat
3 - Sat
1 - Sun
2 - Sun
3 - Sun
Second Level (Saturday / Sunday)
1 - Sat
2 - Sat
3 - Sat
1 - Sun
2 - Sun
3 - Sun
Third Level (Saturday / Sunday)
1 - Sat
2 - Sat
3 - Sat
1 - Sun
2 - Sun
3 - Sun
Forth Level (Saturday / Sunday)
1 - Sat
2 - Sat
3 - Sat
1 - Sun
2 - Sun
3 - Sun
Freestyle (Please indicate Test day)
Saturday
Sunday
Freestyle (Specify Level)
FEI Test of Choice (Please indicate Test day)
Saturday
Sunday
FEI Test of Choice (Specify)
Para - Equestrian (Please indicate Test day)
Saturday
Sunday
Para-Equestrian (Specify)
Subtotal of TEST Fees (Calculation will be based on selections above: $35/Bronze - $40/Gold)
Final Fee will be calculated below. Please double-check to make sure you selected all your TEST requests.
Please Indicate Additional Fees that apply to your application
*
Administration Fee $40.00
Dressage Canada Levy $10.00
Windsor Exhibition Grounds Fee $5/per horse
Medication Control Fee (Bronze) $4.00
Medication Control Fee (Gold) $7.00
Warm-up Reservations @$5.00 (Please indicate # of 1/2 slots and warm-up time(s) below)
Stabling @$30.00 per day (Please indicate # of days below)
R.I.D.E.R.S Non-Member $20.00 (Ask us about Memberships)
R.I.D.E.R.S Member (no fee)
Late Fee (if submitted after June 6th) @6:00 pm $25.00
Warm-up Reservation(s) @$5 per 1/2 hour slots
Please indicate Number of 1/2 hour slots
Preferred Warm-up Time(s) between 1:00 - 6:30 PM Friday, Aug 30th (we will do our best to accommodate)
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
30
Minutes
PM
AM/PM Option
Until
until
1
2
3
4
5
6
7
8
9
10
11
12
:
Hour
00
30
Minutes
PM
AM/PM Option
Stabling @$30 per day:
Please Indicate Number of Days
TOTAL AMOUNT DUE
Calculation will be based on your selections above plus TEST fees. Final Amount to be Remitted to Complete your Official Entry. See Payment Details below.
Payment Details
E-Transfer may be made to dlifset@eastlink.ca, security word RIDERS If using Canada Post, make cheques or money order payable to R.I.D.E.R.S Complete entry documents Online or Submit paper copy to Competition Secretary Deanne Hemphill #103 - 194 Basswood Run. Dartmouth, NS B2W 0M3 If you have any questions, Please email riderssecretary@gmail.com
HAVE YOU INCLUDED?
*
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