AZRAEL ACRES ** 2014 Horse Trials & Dressage Show Series ** w/ Year End Awards Banquet !! 144 Williams St., Uxbridge, MA 01569 ~ www.azraelacres.com June 1 ~ July 20 ~ September 21 ~ October 12 Judges: TBD Closing Date: Entries must be postmarked the Monday before Event Horse Trials Info: DIVISIONS Offered: Pre-Elementary Elementary Beginner Novice Novice Entry Fee: $90.00 2011 USDF Intro Test C 2014 USEF Beginner Novice Test A 2014 USEF Beginner Novice Test B 2014 USEF Novice Test A Jumps Not to exceed 18” Jumps not to exceed 2’3” Jumps not to exceed 2’7” Jumps not to exceed 2’11” * Want to run the Cross Country course again or try a different height? Additional schooling XC rounds available, $25.00 each, see entry form. Dressage Test Only Info: Entry Fee: $25.00 per Test Dressage Tests Only Classes Offered: 2011 USDF Intro Test A, B & C 2011 USEF Training Level Test 1 - 3 USEA or USEF TOC AWARDS: Trophy and 8 Ribbons awarded for each division/class Year End Awards Banquet for the Series! RULES: • Modified AHSA, USDF and USEA rules will be used as general guidelines. • Azrael Acres reserves the right to combine any classes/divisions with less than 3 entries, to vary or change officials or judges, or decline any entry. • All entries must be accompanied by payment and a copy of current coggins. • Jumping portion of 2-Phase will be ridden across fields over Cross Country Obstacles. • Approved headgear required at all time when riding. Safety vests required when jumping. Appropriate show attire required for Dressage Tests. Half Chaps and Paddock boots will be allowed for all riders. • Refunds will only be given to riders who cancel before closing date and slot can be filled from a wait list. NO refunds or credits after closing date will be given. Closing date is 8 days before event; entries must be postmarked by then. For more information, contact: Faith at azraelacres@gmail.com or Danielle at daniellecyr2007@gmail.com www.azraelacres.com AZRAEL ACRES Horse Trials & Dressage Show Entry Form SHOW DATE : ______ / ______ / 2014 NAME________________________________________ PHONE # _________________________________ ADDRESS____________________________________ CITY______________________ST________ZIP_______ EMAIL_____________________________________________________________________________________ Name of Horse____________________________________ Breed________________Age________________ EMERGENCY CONTACT PERSON & PHONE # FOR DAY OF EVENT NAME________________________________________________PHONE______________________________ Horse Trials Division $90.00 per Division _____Pre-Elementary (Intro C & 18”) _____Elementary (2014 Beg. Nov. A & up to 2’3”) _____Beginner Novice (2014 Beg. Nov. B & up to 2’7”) _____Novice (2014 Nov. Test A & up to 2’11”) *Additional Schooling SJ/XC Rounds Available for $25.00 (can be added day of Show also) Height Requested for Extra Jumping Round ________ Dressage Test Only $30.00 per Test _____2011 USDF Intro Test A _____2011 USDF Intro Test B _____2011 USDF Intro Test C _____2011 USEF Training Level Test 1 _____2011 USEF Training Level Test 2 _____2011 USEF Training Level Test 3 _____USEA/USEF TOC ___________________________ _____USEA/USEF TOC ___________________________ TOTAL ENTRY AMOUNT Horse Triais Entry $90 # of Dressage Tests x $30.00 ea. Additional SJ/XC Rounds @ $25 ea Insurance/ Office / Admin Fee $ $ $ $ 8.00 TOTAL AMOUNT ENCLOSED CHECK PAYABLE TO: Azrael Acres SEND TO: Azrael Acres, 144 Williams St., Uxbridge, MA 01569 TIMES: will be posted on the website Thursday or Friday before event. Before Mailing, Be Sure all of the following is included in your envelope: Completed Entry Form w/ Signed Release, Negative Coggins within 1 year, & Check payable to Azrael Acres AZRAEL ACRES Horse Trials & Dressage Show Series General Activity Release I hereby attend this competition at my own risk, subject to the rules of Azrael Acres. I hereby agree to be responsible for any injury or damages that may occur to, or be caused by any animals, vehicles, or trappings, or the loss of any animal, vehicle, or trappings belonging to or exhibited by me. I further agree to be absolutely responsible for the physical condition of any animal under my control or ownership and will also release, indemnify and save harmless the said competition, its show managers, volunteers, and Azrael Acres from any damage, expense and/or liability arising out of or resulting from any act or omission of the exhibitor or Azrael Acres or their agents, servants or employees. I certify that all my horse(s) are free from contagious disease. Warning: Under Massachusetts Law, an Equine professional is not liable for any injuries to, or death of, a participant in equine activities, pursuant to chapter 128, section 2D of the general laws. ________________________________________________________________________________________________________ Exhibitor Signature (Parent or Guardian if under 18) Date