Shadowbrook at Gettysburg, LLC
303 Rentzel Road
Gettysburg, PA 17325
(717 ) 337-1926		 Shadowbrook at Gettysburg, LLC Show Series (S.A.G., LLC) Each Class
$12.00
     
DATE :02-15-2012 * JR. RIDERS AGE: as of December 1, of PRIOR YEAR   
OFFICE CLASSES HORSE/PONY COGGINS # & DATE RIDER NAME AGE* FEE
MAKE CHECKS PAYABLE TO : S.A.G.,LLC TOTAL DUE
Returned checks will be charged a $25 . 0 0 fee    
 
  I AGREE in consideration of participation in the Competition at Shadowbrook at Gettysburg, LLC (S.A.G., LLC) to the Following:

I AGREE that I choose to participate voluntarily in the Competition with my horse (pony), as a rider, driver, handler, lessee, owner, agent, coach, trainer, or as a parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sport 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 S.A.G., LLC. and the Competition from all claims for money damages or otherwise from any Harm to me or my horse (pony), and from any Harm caused by me or my horse(pony) to others, even if the Harm resulted, directly or indirectly, from the negligence of S.A.G.,LLC and of the Competition. I AGREE to expressly assume all risks of Harm to me or my horse(pony),including Harm resulting from
the negligence of S.A.G., LLC, or the Competition. I AGREE to indemnify (that is, to pay any losses, damages or cost incurred by ) S.A.G., LLC, or the Competition and to hold them harmless with respects to claims of Harm to me or my horse(pony), and for claims made by others for any Harm caused by me or my horse(pony) at the Competition. I have read the USEF Rules about protective equipment, including Article 318 and 317 and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that S.A.G., LLC REQUIRES that I do so when mounted, while Warning that no protective equipment can guard against all injuries. 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 “S.A.G., LLC” and “the Competition” as used above includes all their officials, officers, directors, employees, agents, personnel, volunteers and affiliated organizations. BY SIGNING BELOW, I AGREE to be bound by all applicable S.A.G., LLC, and Competition Rules and all the terms and provisions of this entry blank.
   
OWNER/AGENT NAME: RIDER NAME: PARENT/GUARDIAN:
   
* * * * * * * * * * * PARENT / GUARDIAN / TRAINER MUST SIGN IF RIDE R IS UNDER 18 * * * * * * * * * * *
Please check one *MUST provide proof of membership (membership card or letter from your leader) at EACH show
√   Rider Status RIDER INFORMATION OWNER INFORMATION TRAINER INFORMATION
Junior
Adult/Amateur
Adult/Professional
Pony Club
4H
NAME
 NAME
NAME
ADDRESS
ADDRESS
ADDRESS
CITY,ST,ZIP
CITY,ST,ZIP
CITY,ST,ZIP
PHONE
PHONE
PHONE
CELL
CELL
CELL
EMAIL
EMAIL
EMAIL
FARM NAME
FARM NAME
FARM NAME
 

PRE-ENTRY is encouraged. Entries can be submitted on line or faxed the week prior to the show, until 1PM on the Saturday before the Show.
If FAXING, PLEASE CALL (717) 337-1926 prior to sending the entry.  Entry form can be copied and EMAIL entry form to info@shadowbrookhorseshows.com.
COGGINS must be presented to the office BEFORE rider numbers will be given out.