QSLB Dressage Show Online Entry Form

QSLB Dressage Show Online Entry Form
Please Select the Show Date you are registering for;*
Rider Name*

First NameLast Name
Horse Owner Name*

First NameLast Name
Rider Email*
example@example.com
Rider Date of Birth*

MonthDayYear
Date
Rider Phone Number
Please enter a valid phone number.
Rider Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Rider EC Membership Number*
Equestrian Canada
Owner EC Membership Number
Equestrian Canada (Leave blank if same rider/owner)
Rider OE Membership Number*
Ontario Equestrian
Owner OE Membership Number
Ontario Equestrian (Leave blank if same rider/owner)
Registered/Licensed Coaches Name*

First NameLast Name
Registered/Licensed Coaches EC Membership Number*
Horse's Name*
Horse's Height - For NDPC (Pony Cup) & Small Horse Classes
Horse's Sport License Number
For Silver/Gold/FEI ONLY
ATTENTION! BEFORE SELECTING YOUR CLASSES;

Please ensure you review the QSLB Prize List prior to entering to ensure the tests you are entering are available on the Show Date selected as not all tests are available at every show.
Do you require a bridle number?*

NO - I have my own bridle number/holderYES - I don't have one
Select JR/AA/OPEN*
Please select the appropriate division
Select BRONZE/SILVER/GOLD*
Please use a separate form for each designation if showing different ratings with the same horse
Select the classes you wish to enter*

INTRO ATRAINING 1INTRO BTRAINING 2INTRO CTRAINING 3INTRO Test of ChoiceTRAINING Test of ChoiceFIRST 1SECOND 1FIRST 2SECOND 2FIRST 3SECOND 3FIRST Test of ChoiceSECOND Test of ChoiceTHIRD 1FOURTH 1THIRD 2FOURTH 2THIRD 3FOURTH 3THIRD Test of ChoiceFOURTH Test of ChoiceNDPonyCup/Small Horse Test of ChoiceMasters Dressage Test of ChoiceEventing Test of Choice (Eventing Tests)FEI Test of ChoiceFreestyle Test of Choice
*If showing Test of Choice please indicate which test;
*If showing a second Test of Choice please indicate which test;
# of Classes entered *
Total Amount Due for classes entered*
Bronze $40/Silver $45/Gold $50/FEI Silver $55/FEI Gold $60/Masters $45 (per class)
Fees*
prevnext( X )
Dressage Canada Levy FeeMandatory Fee
$10.00CAD Quantity
Item subtotal:$0.00CAD



Equine Medication Fee GOLDChoose the appropriate Medication Fee for your entry
$8.00CAD Quantity
Item subtotal:$0.00CAD



Equine Medication Fee SILVERChoose the appropriate Medication Fee for your entry
$8.00CAD Quantity
Item subtotal:$0.00CAD



Equine Medication Fee BRONZEChoose the appropriate Medication Fee for your entry
$4.00CAD Quantity
Item subtotal:$0.00CAD



First Aid FeeMandatory
$10.00CAD Quantity
Item subtotal:$0.00CAD



ADMIN FEE - QSLB MEMBERQSLB Members Only pay this admin fee
$25.00CAD Quantity
Item subtotal:$0.00CAD



ADMIN FEE - NON QSLB MEMBERNon Members of QSLB pay this admin fee
$40.00CAD Quantity



LATE FEEFor entries submitted after the posted closing date
$10.00CAD Quantity
Item subtotal:$0.00CAD



Total

$0.00CAD
*PLEASE ENSURE YOU ADD ENTRY CLASS FEES & THE ADMIN/DRUG FEES/ETC TO OBTAIN THE TOTAL DUE*
TOTAL AMOUNT DUE*
Add total for all classes and fees
Select form of Payment*

PaypalE- Transfer to qslbinfo@gmail.com
Signature*

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Parent/Guardian Name (if exhibitor is under 18)

First NameLast Name
Parent/Guardian Signature (if exhibitor is under 18)

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QSLB Liability Waiver & Vaccinations Proof Upload

Can also be emailed to qslbinfo@gmail.com
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ATTENTION !! BEFORE YOU SUBMIT SEE BELOW;

All entries must be accompanied by payment in full, with a signed QSLB liability waiver (Found HERE) and proof of Vaccinations per EC showing regulations A519 (Receipt of Vaccines). Please email this information to the show secretary with your entry OR upload through the link above. This is required to confirm and accept your entry.

E transfers are sent to qslbinfo@gmail.com
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