MARK DIVISIONS ENTERED FOR EACH DAY

Hot Daze Horse Show &

Mo Hot Daze Horse Show August 21 & 22, 2010

Entries received after 6 pm Thursday will pay $10 late fee. Mail or fax to 936-372-9499 before 6:00 p.m. Thursday.

NO FAXED ENTRIES AFTER THURSDAY—Bring entry to show on Friday Entries received by 5:00 pm Wednesday receive $10 credit on account

ENTRY FORM Checks payable to: Britannia Farm 26901 West Brooks Rd. Waller, TX 77484

NAME OF HORSE OWNER RIDER

COGGINS Acc. #: _________________ Date: _________ Lab:______________ Horse GHHJA #: ___________________

___________________________________ Name

___________________________________ Address

___________________________________ City, State, Zip

OWNER GHHJA #: _________________

____________________________ ______ Name Age

___________________________________ Address

___________________________________ City, State, Zip

RIDER GHHJA #: ___________________

A B C D E F G H I J K L M N O P Q R S

Walk Trot

Pre Beg

Beg Grn Grass

Nov Sm Pony

Med Pony

Lg Pony

Limit Hntr

Pre Grn Hntr

Jr/Ad Hntr

Low Hntr

Non Pro Hntr

Opn Hntr

Sch Hntr

Sch Jmpr

Jr/Ad Jmpr

Open Jmpr

Ity Bity Jmpr

SAT

SUN

THIS ENTRY IS AN AGREEMENT THAT THE PERSON ENTERED, ALONG WITH THE OWNER, LESSEES, TRANER, MANAGER, COACH AND HORSE: (1) THAT EVERY HORSE AND RIDER IS ELIGIBLE AS ENTERED; (2) THAT THE OWNER AND ANY OF HIS/HER REPRESENTATIVES WILL AGREE TO THE FINAL DECISIONS MADE BY THE MANAGEMENT AND HOLD THE COMPETITION OF THE GHHJA, PAULINE COOK; DBA BRITANNIA FARM, GREAT SOUTHWEST EQUESTRIAN CENTER L.P., LUCIA HANSEN, MAURENE MOFFETT, THEIR OFFICIALS, THE MANAGE-MENT EMPLOYEES AND AGENTS HARMLESS FOR ANY INJURY OR LOSS SUFFERED DURING OR IN CONJUNC-TION WITH THE COMPETITION, WHETHER OR NOT SUCH INJURY OR LOSS RESULTED, DIRECTLY OR INDI-RECTLY, FROM THE NEGLIGENT ACTS OR OMISSIONS OF SAID OFFICIALS, EMPLOYEES, AGENTS, THE MANAGE-MENT, GHHJA, PAULINE COOK; DBA BRITANNIA FARM, GREAT SOUTHWEST EQUESTRIAN CENTER L.P. LUCIA HANSEN, MAURENE MOFFETT, .

WARNING, UNDER TEXAS LAW (CHAPTER 87, CIVIL PRACTICE AND REMEDIES CODE), AN EQUINE PROFESSIONAL IS NOT LIABLE FOR AN INJURY TO OR THE HEATHOF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISKS OF EQUINE ACTIVITIES.

PERMISSION FOR A MINOR TO SHOW:

MUST be signed if rider is under 18 years of age. Numbers will not be issued until this form is signed!

I hereby consent to the entry of my child _____________________________________ in this show and certify that I have read the foregoing representations and statement, and that I hereby agree and accept responsibility there under for the participation of said minor. _____________________________________________________________ Signature of Parent/Guardian/Trainer

NUMBER (office use only)

ENTRY FEES

______STALLS @ $70.00

______STALLS @ $50.00

______DAY STALL @ $40/day

NON—SHOWING FEE @ $30/day

____GROUND FEE @ $20/day

______SHAVINGS

OFFICE FEE @ $10 per entry

GHHJA N/M FEE @ $10

CLASS FEES

LATE FEE

TOTAL

INDIVIDUAL CLASSES EQUITATION CLASSES

SAT

SUN

PLEASE STABLE WITH:

Notice: Stalls will not be held unless check accompanies entry.

Trainer’s Name ____________________________________________________ Trainer’s Signature __________________________________________________ Trainer’s GHHJA Number ____________________________________________ Where a minor exhibitor has no trainer, parent or guardian must sign and assume responsibility.

Exhibitor Signature _________________________________________________ (Must be signed by exhibitor, owner or his agent.)

Emergency Contact / Cell Phone No.___________________________

*** NO FAXED ENTRIES AFTER THURSDAY ***