Saskatoon Classic Bronze Entry Form Bridle # September 4-6, 2015 Paid:_____________ A Bronze Level Equine Canada Show – SHF Heritage Series & Prairie Cup Circuit Show Ebon Stables – Saskatoon SK Chq #:___________ Mail Entries to: Ebon Stables Fax Entries to: 306-477-0199 c/o Victoria Kendall Email inquiries: info@ebonstables.com Box 27, RR#5 Entry inquiries: 306-241-2579 Saskatoon, SK S7K 3J8 Entry Deadline is Aug 28, 2015 – please use separate form per horse Horse Information Show Fees Horse Name: Age: Total Entry Fees: Breed: TIP#: Pony: L__ M__ S__ Stable with: Stall Fee: _______x$80.00/stall Shavings Pre-Order: _______ bags x $8.00/bag Trainer: Hunter Warm Up Rounds - $15.00 Owner of Horse: Owner EC # EC membership Level: Owner address: $30.00 Paramedic Fee $10.00 Drug Levy Fee Early Bird entered in draw for stabling (received by Aug 21) $25.00 Late Fee (if received after Aug 28) Rider Information Name: $3.50 Power Hook Up - $25.00 EC: SHF# Subtotal SHJA# GST 5% Date of Birth if Junior: Saturday Supper Tickets:_______x$15.00/ticket Street Address: Payable to Ebon Stables Total Show Fees *Separate Chq* Stall Cleaning and Bridle # Refund City, Province: Postal Code: Phone: Cell/Alternate Phone #: Email: Emergency Contact Name & Phone #: Make Prize money payable to: ____Owner ____Rider Entry Fees Div Office Fee Class Numbers Entry Fee This Document will affect your legal rights and liabilities. Please read carefully: I __________________________________ acknowledge that the sport of horses is a risk sport and that I am participating at my own risk and in full knowledge of the hazards which are inherent in this sport. I further acknowledge that inherent risks in riding and working around horses, which include bodily injury to both horse and rider which can result from normal use, competition, or schooling. It is hereby also understood that no helmet or protective equipment can protect against all foreseeable injury. I hereby certify that every horse and rider is eligible as entered and agreed for myself and my representatives to be bound by the Constitution and Rules of Equine Canada and the Saskatoon Classic Show’s Prize List. In consideration of being allowed to participate in this event, I hereby assume all risk and I hereby release and absolve Equine Canada, SHF, SHJA, Ebon Stables, Holliston & Associates, and their directors, officers, employees, volunteers, and their representatives for all responsibility, liability or claims of any nature and kind which I may have arising from my participation in this activity, including but not limited to bodily injury or death to myself or my horse(s) and damage to property arising from any cause whatsoever, including the negligence of one or more of the individuals and organizations referred to herein. All persons mounted on a horse on the competition grounds are required to wear properly fitted ASTM or BSI approved helmet with safety harness correctly fastened (se EC Article G102) In the event that ___________________ participates in an Equine Canada sanctioned competition where protective headgear is required for juniors, he/she will wear properly fitted and fastened approved headgear at all times while riding or driving at the event location. It is understood that juniors not meeting this requirement will not be allowed to compete at these competitions. (A802.6) I hereby declare that in signing this document that I have read and fully understand and agree to the terms and conditions stated herein and that it is binding upon my executors, heirs and assigns. Signature of Rider or Legal Guardian if rider is a Junior Signature of Owner Total Entry Fees $40.00 Date