Event Entry Form - Comp #2 2024

Official Entry Form

R.I.D.E.R.S. Seahorse Bronze/Gold Dressage Competition #2 Saturday, August 31st and Sunday, September 1st, 2024 Please Complete Before: Monday, August 26th, 2024 @ 6:00 PM AST
Entries will not be accepted until all relevant fees have been paid. Please do not submit the entry form until you have made payment!
Horse Information

Only 1 Horse Per Entry Form.
Name of Horse*
Breed*
Gender*
Details

HeightAgeColour
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 NameLast Name
Mailing Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Phone #

Cell

Home

WorkWork

Postal / Zip Code
Email Address*
example@example.com
Rider's Provincial Membership #*
Upload copy in Required Documents below
Rider's EC Sport License #*
Upload copy in Required Documents below
Amateur Status*

YesNo
Division*

EC JRScotia JREC AAScotia AAEC OPENScotia OPEN
Date of Birth (If Junior)

MonthDayYear
Coach Information

As of July 1, 2023, for Bronze Competitions Canadian Coaches must hold a minimum Registered EC Coach Status to coach at an EC sanctioned competition. For Gold Competitions, Canadian Coaches must hold a minimum Licensed EC Coach Status to coach at an EC sanctioned competition. Coaches listed as “Pending” at the time of the competition are NOT deemed to have met the minimum coaching requirement. A temporary status form will be available for purchase for $30 for those who do not meet the requirements.
Are you self-coached? (EC Only)

YesNo
Name of Coach
Coach Phone Number
Coach EC Sport License #
Please select all that apply:

Registered EC CoachLicensed EC Coach
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*

YesNo
Name of Horse Owner

First NameLast Name
Mailing Address

Street Address

Street Address Line 2

CityProvince

Postal Code
Phone #

Home

Cell

WorkWork

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 EqNS) Membership is mandatory. Non-parent Person Responsible(s) must have EC Sport License and PTSO.
I am Parent of a Junior (Must have PTSO)

YesNot Applicable
I am a Non-Parent of a Junior (Must have PTSO and EC Sport)

YesNot Applicable
PTSO # (e.g NSEF)
EC Sports License #
Name of Person Responsible for Horse (Must be over 18 years of age)*

First NameLast Name
I verify that I am 18 years of age or over and will be held responsible for Horse registered in this Official Entry Form. *
Every entry form for an EC sanctioned competition must identify the Person(s) Responsible. (A802.6)

I hereby certify that every horse and rider is eligible as entered and agree for myself and my representatives to be bound by the Constitution and rules of Equestrian Canada at this competition. (A802.4) It is hereby recognized that all equestrian sports involve inherent risk and that no headgear or protective equipment can protect against all foreseeable injury. I hereby accept the risk and hold harmless EC, the competition, their officials, organizers, agents, employees and their representatives. The person(s) responsible agrees to the release of any information on the entry form to EC. (A802.4)
Signature of Person Responsible:*

Clear
I hereby declare that in making this entry 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.
EC# (Person Responsible)*
Date

MonthDayYear
Signature of Rider:*

Clear
I hereby declare that in making this entry 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.
EC# (Rider)*
Date

MonthDayYear
Signature of Owner:*

Clear
I hereby declare that in making this entry 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.
EC# (Owner)*
Date

MonthDayYear
If rider is under eighteen years, the Parent/Guardian must also sign below:
In the event that   First Name   Last Name   participates in an Equestrian Canada sanctioned competition, protective headgear is required for juniors, he/she will wear properly fitted and fastened approved headgear at all times while riding at the event location. It is understood that juniors not meeting this requirement will not be allowed to compete at these competitions. (A802.6 & A905).

I acknowledge as Parent/Guardian of   First Name   Last Name   that I have read and fully understand and agree to the terms and conditions stated herein on behalf of   First Name   Last Name   .

Signature of Parent/Guardian:   Signature   Date:   Date
Emergency Contact Information (Someone who will be available throughout the show weekend):
Name:   First Name   Last Name   Relationship:    Parent, Spouse, etc
Phone #1:      Area Code   Phone Number   Phone #2:   Area Code   Phone Number
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)

Upload File(s)

Cancelof
RIDER - EC SPORT LICENSE

Upload File(s)

Cancelof
RIDER - PROVINCIAL MEMBERSHIP

Upload File(s)

Cancelof
OWNER/PR - EC SPORT LICENSE (if not the same person as Rider)

Upload File(s)

Cancelof
OWNER/PR - PROV. MEMBERSHIP (if not the same person as Rider)

Upload File(s)

Cancelof
PROOF OF VACCINATION*

Upload File(s)

Cancelof
TESTS OFFERED (Please select Test and Day) Saturday, August 31st and Sunday, September 1st, 2024

Introductory, Training, and First Level Riders may enter a Maximum of 4 tests/day, including Freestyle. Second, Third, Fourth, and FEI Riders may enter a maximum of 3 tests/day, including Freestyle. Para Dressage riders may enter a maximum of 4 tests/day. (E6.4.5)
Please Specify Show Level*

EC Bronze $31/TESTEC Gold $48/TESTScotia Series $38/TEST
Level - Introductory (Sat/Sun) EC & Scotia

A - SatB - SatC - SatA - SunB - SunC - Sun
Training Level (Sat/Sun) EC & Scotia

1 - Sat2 - Sat3 - Sat1 - Sun2 - Sun3 - Sun
First Level (Sat/Sun) EC & Scotia

1 - Sat2 - Sat3 - Sat1 - Sun2 - Sun3 - Sun
Second Level (Sat/Sun) EC Only

1 - Sat2 - Sat3 - Sat1 - Sun2 - Sun3 - Sun
Third Level (Sat/Sun) EC Only

1 - Sat2 - Sat3 - Sat1 - Sun2 - Sun3 - Sun
Forth Level (Sat/Sun) EC Only

1 - Sat2 - Sat3 - Sat1 - Sun2 - Sun3 - Sun
Freestyle (Please indicate Test day) EC Only

SaturdaySunday
Freestyle (Specify Level) EC Only
FEI Test of Choice EC Only (Please indicate how many tests per day)

Saturday 1 TestSunday 1 TestSaturday 2 TestsSunday 2 TestsSaturday 3 TestsSunday 3 Tests
FEI Test of Choice (Specify Tests) EC Only
Para - Equestrian - EC & Scotia (Please indicate how many tests per day)

Saturday 1 TestSunday 2 TestSaturday 2 TestsSunday 2 TestsSaturday 3 TestsSunday 3 TestsSaturday 4 TestsSunday 4 Tests
Para-Equestrian (Specify Tests) EC & Scotia
Please Indicate Additional Fees that apply to your application*

Administration Fee $50.00Dressage Canada Levy (Bronze & Gold Only)$10.00Medication Control Fee (Bronze) $4.00Medication Control Fee (Gold) $8.00Scotia Series $3.00Warm-up Reservations @$5.00 (Please indicate # of 1/2 hour slots and warm-up time(s) below)Stabling @$45.00 per day (Please indicate # of days below)R.I.D.E.R.S Non-Member (Ask us about Memberships)R.I.D.E.R.S Member ($20.00 discount will automatically be applied)Late Fee (if submitted after June 3rd) @6:00 pm $30.00
Subtotal of TEST Fees: Calculation will be based on selections above. $31/Bronze - $48/Gold - $38/Scotia
Final Fee will be calculated below. Please double-check to make sure you selected all your TEST requests.
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, June 9th (we will do our best to accommodate)

:HourMinutesAM/PM Option
Until
until :HourMinutesAM/PM Option
Stabling @$45 per day: (Arriving Friday and leaving Sunday counts as 2 days)
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? *
Liability waivers must be signed upon arrival at the venue when picking up your registration package.
DO NOT SUBMIT FORM WITHOUT PAYMENT!
Should be Empty:

Official Entry Form

Horse Information

Rider Information

Coach Information

Horse Owner Information

Person(s) Responsible for Horse (MANDATORY) Must be 18 years of age or older.

Required Documents

TESTS OFFERED (Please select Test and Day) Saturday, August 31st and Sunday, September 1st, 2024

Payment Details

DO NOT SUBMIT FORM WITHOUT PAYMENT!