Melissa's Good Timin Jackpot - Jackpot only - Saturday, November 30, 2024 Entry Form -

1

Rider's Name

First Name

Last Name

2

Emailrequired please

example@example.com

3

Address - OptionalThis is for office if you leave before payout so winnings can be mailed.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

4

Phone Numberoptional

Area Code

Phone Number

5

Entry fees & classes:

Remember, gates do not open till 10 am. Plan accordingly

Exh 11:00 am - 12:30 noon SHARP $4 EACH - One at a time, no riding around arena, keep forward motion

12:30- 1:00 - Final Arena Prep

Show starts 1:00 pm

There is no pee wee

Open 4D (open to all) - EF $30 +5 to go toward added money = $35 EF Total FOR ALL

Sidepots:

Youth 2D - 17 & younger - $25 for all - 1 sec split - - roll over only

Senior 2D - 40 + years - $25 for all - 1 sec split - roll over only

MUST HAVE 30 PREPAID PRE ENTERED ENTRIES - THIS MUST BE DONE BY By 11 am Friday, November 29, 2024.

Accident Waiver and Release Liability Forms are to be signed again for the 2024 year.

All information is on the Melissa's Good Timin Jackpot link at floridaequineathlete.com - This includes Rules, Policies, and Payouts are on these rules and policies.

THIS IS A JACKPOT ONLY!!! IT IS NOT PART OF THE BUCKLE SERIES!! There is NO WAE sidepot!

Entries that are paid at the show are CASH ONLY and please bring small bills. 10s, 5s, 1s are always a good thing!!

I will need help with barrel setting. Please help

ABSOLUTELY NO DRAMA IS ALLOWED AND NO ALCOHOLIC BEVERAGES.

NO HALTER TOPS, SPAGETTI STRINGS, LOW CUT SHIRTS, SHORTS, MIDRIFFS. MUST WEAR COWBOY BOOTS.

WISTY WATSON WILL BE DOING CONCESSION STAND

IF BY CHANCE, i DO NOT GET ENOUGH ENTRIES, MONIES WILL BE REFUNDED OR CAN CREDIT THEM TO THE NEXT SHOW.

6

Youth Rider's Birth Date:Must be 17 or under

7

How many Exhibitions

8

First Horse's Name

9

Classesclick on each class wanted

Open ($35 for all) - Open to all - $30 EF + $5 that goes toward added money = $35 total entry fee

Youth - 17 & under - $25 for all - roll over only

Seniors - 40+ years - $25 for all -- Roll over only

10

For the Open, please give me 3 numbers you would like and I will try to give your the earliest number possible.

Please enter a number

11

2nd Horse's Name

12

Classesclick on each class wanted

Open - $30 EF + $5 toward added = $35 total EF

Youth - 17 & under - $25 for all - ROLL OVER ONLY

Seniors - 40+ years - $25 for all - roll over only - Roll over Only

13

For the Open, please give me 3 numbers you would like and I will try to give your the earliest number possible.

Please enter a number

14

3rd Horse's Name

15

Classesclick on each class wanted

Open - $30 EF + $5 to go toward added = $35 Total EF

Youth - 17 & under - $25 for all - Roll over only

Seniors - 40+ years - $25 for all - roll over only - Roll over Only

16

For the Open, please give me 3 numbers you would like and I will try to give your the earliest number possible.

Please enter a number

18

In accepting this entry, the applicant hereby releases and discharges the Florida Equine Athlete, all officers, personnel, representatives, employees, agents, Melissa Greer Ph.D., host arenas, arena owners (Lise Blanton), and family members from liability, loss, claims, damages, and/or expenses for injuries or death to person, animal, property, family member(s), friends, or anyone affiliated with applicant, reputations, or financial conditions as a results of, or in any way, relating to applicant’s participation or nonparticipation in FEABRA or Melissa's Good Timin Jackpot sanctioned event whether caused by negligence, arena conditions, and/or by the conduct of the Florida Equine Athlete, Melissa Greer, PhD or arena hosts, owners, officers, etc.PLEASE BE SURE TO MARK THE BOX BELOW.

I have read, understood, and accepted the above waiver statement for entry and participataion of this show.

19

Signature For Youth entries, this form MUST be signed by parent or guardian; I will need a parent or guardian to verify this permission at the day of the show, and/or sign at show.

Clear

20

Date signed

21

Thank you for coming, See you on Saturday, November 30th and drive safe.

If you complete this online entry form and prepay entries, you will need to just text me at 863-398-6802 and let me know you are here. You can also PM me on FB (as long as my connection is working). When texting, please be sure to state your name as I do not have everyone logged into my phone contacts.