Platinum P Ranch Horse Show Buckle Series Entry Form

Ranch Horse Show Buckle Series Entry Form

Spring Series - Show 1 - February 1, 2025
1 FORM PER HORSE/RIDER COMBINATION
Owner Name*

First NameLast Name
Business Name
If applicable
Horse Name*
Exhibitor Name*

First NameLast Name
Exhibitor Birth Date*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Exhibitor E-mail*
example@example.com
Exhibitor Phone Number*
Division*

OpenAmateurYouthNoviceGreen HorseWalk/Trot AdultWalk/Trot YouthLeadline
Classes - $20 per class or $100 per division*

Ranch RailRanch PleasureRanch ReiningRanch RidingRanch TrailRanch ConfirmationLeadline (FREE)
Other Fees (excludes leadline)*

Office Fee (Mandatory) - $10All Day Division Fee - $100Late Fee (Mandatory after January 25, 2025) - $15
Coggins: Negative Coggins are required. Please upload or bring it to the show

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Payment*

Check (mail in/bring check to show)Cash (mail in/bring cash to show)Venmo (@platinumpranch)Credit Card (fees apply) (pay.platinumpranch.com/entry-fee)
Payment Total*
UNDER TEXAS LAW, AN EQUINE SPONSOR OR PROFESSIONAL SHALL NOT BE LIABLE FOR AN INJURY TO OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES. (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE)

BY MY SIGNATURE BELOW, I HEREBY ACKNOWLEDGE THAT I UNDERSTAND THAT RISKS INVOLVED IN RIDING HORSES AND VOLUNTARILY ASSUME THOSE RISKS. I AGREE THAT I WILL NOT HOLD PLATINUM P RANCH LLC AND/OR THE SHOW FACILITY (DIAMONDS SPLIT RANCH), NOR ANY OF THEIR DIRECTORS, OFFICERS, EMPLOYEES, VOLUNTEERS, OR PARTICIPANTS, LIABLE FOR ANY INJURY.DIAMONDS SPLIT RANCH IS A WORKING RANCH WITH HORSES, DOGS, LIVESTOCK, MOTOR VEHICLES, CHILDREN PLAYING, ETC AND I TAKE FULL RESPONSIBILITY FOR MY ACTIONS.

I HAVE READ THIS RELEASE AND UNDERSTAND ITS TERMS.

DOGS MUST BE ON A LEASH AT ALL TIMES.
Signature*

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Date*

MonthDayYear
Date
PARENT / GUARDIAN WAIVER FOR MINORS

In the event that the participant is under the age of consent (18 years of age), then this entry form must be signed by a parent or guardian, as follows:

I HEREBY CERTIFY that I am the parent or guardian of minor , named above, and do hereby give my consent without reservation to the foregoing on behalf of this individual.
Parent/Guardian Name

First NameLast Name
Relationship
Parent/Guardian Signature

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Date

MonthDayYear
Date
Waiver and Photo Release File Upload

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Entry Fees can be paid through Venmo @platinumpranch or using the QR code below.

Entry fees can be paid online by QR Code or at https://pay.platinumpranch.com/entry-fee
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