KING OAK FARM SCHOOLING DRESSAGE SHOW – Entry Form WNEPHA Recognized SUNDAY, October 19, 2014 CLOSING DATE: Sunday, October 12, 2014 Entry Fee $30 per class Class 1: WDAA Intro Level - Test 1 or 2 Class 8: USDF Intro Test B – W/T Class 2: WDAA Intro Level - Test 3 or 4 Class 9: USDF Intro Test C – W/T/C Class 3: WDAA Basic Level - Test 1 or 2 Class 10: USEF Training Level - Test 1 or 2 Class 4: WDAA Basic Level - Test 3 or 4 Class 11: USEF Training Level - Test 3 Class 5: WDAA Level 1 and above – Class 12: USEF First Level and above – Test of Choice A (1, 2, 3 or 4) Class 6: WDAA Level 1 and above – Test of Choice A (1, 2 or 3) Class 13: USEF First Level and above – Test of Choice B (1, 2, 3 or 4) Class 7: USDF Intro Test A – W/T Checks payable to: King Oak Schooling Show King Oak Farm, PO Box 12 Southampton MA 01073 Test of Choice B (1, 2,or 3) Class 14: Professionals Test of Choice Fran Cross (413) 527-4454 or Fax (413) 529-0484 Judy Zedonis (413) 330-6752 or JAZKOF@Hotmail.com Rider’s Name: WNEPHA Member Circle one Yes or No Circle one: Junior (under 18) or Adult (18+) Address: Phone: Email: Horse’s Name: Horse Owner: WNEPHA Member Circle Yes or No Classes Entered: Total Fees Enclosed: Under Massachusetts law, an equine professional is not liable for injury to, or the death of, a participant in equine activities resulting from the inherent risk of equine activities pursuant to Section 2D of Chapter 128 of the General Laws. I AGREE that I choose to participate voluntarily in the Competition with my horse as a rider, or as parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sports and the Competition involve inherent dangerous risks of accident, loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death (“Harm”). I AGREE to release the Competition from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm caused by me or my horse to others, even if the Harm resulted, directly or indirectly, from the negligence of the Competition. I AGREE to expressly assume all risks of Harm to me, or my horse, including Harm resulting from the negligence of the Competition. I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the Competition and to hold them harmless with respect to claims for Harm to me, or my horse, and for claims made by others for any Harm caused by me or my horse at the Competition. If I am a parent or guardian of a junior exhibitor, I consent to the child’s participation and AGREE to all of the above provisions and AGREE to assume all of the obligations of this Release on the child’s behalf. I AGREE that the “Competition” as used above includes all of their officials, officers, directors, employees, agents, personnel, volunteers and affiliated organizations. I represent that I have the requisite training, coaching and abilities to safely compete in this competition. BY SIGNING BELOW, I AGREE to be bound by the rules and all terms and provisions of this entry blank. Rider’s Signature: ___________________________________________________ (Parent or Guardian if Rider is under 18 years old) ____________________