CLASSES

Great Southwest Equestrian Center Open Horse Show September 17, 2011

Entries received before Wednesday 09/14/2011 will receive a $10 credit. Entries received after Friday, 09/16/2011 will pay

$10.00 late fee. PAYMENT IS NOT REQUIRED UNTIL BACK NUMBER IS PICKED UP FROM SHOW SECRETARY

ENTRY FORM

Checks payable to: GSEC 2501 South Mason Rd., Ste. 100 Katy, TX 77450 Fax # 281-578-6651

NAME OF HORSE OWNER RIDER

COGGINS Acc. #: _________________ Date: _________ Lab:______________ Horses GSEC number_____________

___________________________________ Name

___________________________________ Address

___________________________________ City, State, Zip

Email______________________________

____________________________ ______ Name Age

___________________________________ Address

___________________________________ City, State, Zip Phone number ______________________

THIS ENTRY IS AN AGREEMENT THAT THE PERSON ENTERED, ALONG WITH THE OWNER, LESSEES, TRAiNER, 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 GREAT SOUTHWEST SHOWS OPEN SERIES, GREAT SOUTHWEST EQUESTRIAN CENTER L.P., THEIR OFFICIALS, THE MANAGEMENT EMPLOYEES AND AGENTS HARMLESS FOR ANY INJURY OR LOSS SUFFERED DURING OR IN CONJUNCTION WITH THE COMPETITION, WHETHER OR NOT SUCH INJURY OR LOSS RESULTED, DIRECTLY OR INDIRECTLY, FROM THE NEGLIGENT ACTS OR OMISSIONS OF SAID OFFICIALS, EMPLOYEES, AGENTS, THE MANAGEMENT, GSEC, GREAT SOUTHWEST EQUESTRIAN CENTER L.P..

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 thereunder for the participation of said minor. _____________________________________________________________ Signature of Parent/Guardian/Trainer

NUMBER (office use only)

ENTRY FEES

Zero In Reining $50.00

______STALLS @ $30.00 Includes one bag of shavings

______GROUNDS FEE $30.00

______CLASSES @ $10.00

ALL DAY FEE @ $50.00

NON—SHOWING FEE @ $20.00 MUST ALSO PAY GROUNDS/STALL FEE

OFFICE FEE @ $10 per entry

ANNUAL (ONE TIME) GSEC ASSOCIATIONFEE @ $20

___ADDITIONAL SHAVINGS $11.00

RV HOOKUP @ $30.00/

NIGHT

LATE FEE @ $10.00

EARLY DISCOUNT $10.00

TOTAL

PLEASE STABLE WITH:

Trainer’s Name ____________________________________________________ Trainer’s Signature __________________________________________________ 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

.___________________________