TPH Fuzzy Pony Winter Clinic Show entry form

Toms Performance Horses, LLC Fuzzy Pony Winter Clinic Show Series
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EXHIBITOR AGE if under 18
EXHIBITOR NAME
Phone
Email
example@example.com
HORSE NAME
ADDRESS street city state zip
COGGINS Lab Access No
State
Test Date

MonthDayYear
Date
HORSE OWNER only if different from exhibitor
OWNERS ADDRESS only if different from exhibitor
Select Pattern Class

1. Open Pattern * January – Showmanship, February – Ranch W/J, March – Open Equitation W/T or J
Select Green Class

8. Green Horse GAYP (horses in first 2 years of showing)15. Green Rider GAYP (riders in first 2 years of showing)
Select Western Classes

2. Youth Western W/J*3. Youth Western W/J/L*4. Youth Western GAYP5. Adult Western W/J*6. Adult Western W/J/L*7. Adult Western GAYP
Select Ranch Classes

9. Youth Ranch W/J*10. Youth Ranch W/J/L*11. Youth Ranch GAYP12. Adult Ranch W/J*13. Adult Ranch W/J/L*14. Adult Ranch GAYP
Select Hunter Classes

16. Youth Hunter W/J*17. Youth Hunter W/J/L*18. Youth Hunter GAYP19. Adult Hunter W/J*20. Adult Hunter W/J/L*21. Adult Hunter GAYP
$50.00 per horse/rider for the day (any additional horses for same rider are $25 each) $20 to Audit (Parents and spouses of exhibitors are free)

* Entry forms and all fees are due by Wednesday before show. **Entries fees are non-refundable unless management cancels the show. Entries mailed to Toms Performance Horses, LLC 2965 Hat Creek Road, Brookneal, VA 24528 If paying electronically: We take PayPal friends and family (danielletoms80@gmail.com) and Venmo (danielle-kernen) *We will only be accepting the first 20 entries for each clinic.

I, the exhibitor or guardian of the minor (under 18), enter the above horse at my own risk subject to all rules and regulations of the show, Hat Creek Equestrian, and Toms Performance Horses LLC. I agree if any injury or death occurs to the animal exhibited, myself or minor exhibitor, spectators, or damage to any personal property on the grounds, that I hereby waive and release any claim to liability whatsoever from Hat Creek Equestrian and Toms Performance Horses LLC, all committees, property owners, employees, members, and volunteers whether the injury, death, or damage be caused by gross negligence or simple negligence of Hat Creek Equestrian and Toms Performance Horses LLC.
Exhibitor Signature or guardian if under 18

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Date

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Date
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