Melissa's Good Timin Buckle Series #6 - December 22, 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:

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

12:35 - 1:05 pm Church

There is no pee wee

1:30 pm - 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

WAE 4D - $30 EF + $5 goes toward added money - All information on the World Athlete Entrepreneur link at floridaequineathlete.com. You do not have to be a WAE member to run, just if you want points to go to the finals. Roll over only

Prepaying entries must be paid by 11 am Friday, December 20, 2024.

If first time coming out to my race, an Accident Waiver and Release Liability Form has to be signed 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.

Buckles awarded to Open class division champions at the end of the series. For tie breakers, I look at volunteer hours and show count.

For the WAE Sidepot, you do not have to be a member to run this sidepot.

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

REMEMBER THERE ARE 6 SHOWS IN THE BUCKLE SERIES AND YOU MUST ATTEND, AT LEAST, 3 FOR YOUR POINTS TO COUNT. THIS PARTICULAR SHOW IS NOT THE LAST SHOW OF THE SERIES. SHOW #5 WAS CANCELLED DUE TO THE HURRICANE AND IT IS SCHEDULED FOR SATURDAY, JANUARY 4, 2025.

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

WAE 4D - do not have to be a member to run; but, if want points to go to the WAE finals, you must be a member - $25 EF + $5 toward added = $30 Total EF Roll over only. 2023 membership is due

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

WAE 4D - do not have to be a member to run; but, if want points to go to the WAE finals, you must be a member - $25 EF + $5 going toward added = $30 Total EF; 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

WAE 4D - do not have to be a member to run; but, if want points to go to the WAE finals, you must be a member - $25 + $5 toward added = $30 Total Entry. 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

17

How would you like to pay for your entries

dPaypal - drmgreer@gmail.com (be sure it states family/friends)

Venmo - @Melissa-GreerPhD-1 (be sure its family/friends, personal)

Cash App - $FLEquineAthlete

Zelle - drmgreer@gmail.com

Cash at show

Credit Card - there is a fee

18

I am a MGTJ buckle series member

I am not a MGTJ buckle series member

If running the WAE sidepot, I am a WAE member

if running the WAE sidepot, I am not a WAE member

19

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.

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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

21

Date signed

22

Thank you for coming, See you on Sunday, December 22nd 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.