Shamrock Show "Event Mixer"
Mar. 22, 2008 at BRIAR FOX FARM
Schooling Horse Trials & Dressage Classes with optional XC Schooling on Mar. 23
Official Entry Form...Entries Close Mar. 17


Horse:   Age:   Sex:   Ht.   Color:   

Breed:   Rider Email:     


Rider:   Age Div:   Phone:   Cell:    

Rider Address:     City:     State:   Zip:    

ENTRIES

 

FEE SUMMARY

Dressage Show-Sat. AM

Dressage Classes Total at $10 each or any 3 for $25 $10 $

Class Name

Fee $10

Schooling Horse Trials $65 per Division $65 $
    $ Combined Test (Drsg. Test & Stadium-No XC) $40 $
    $ XC Schooling (Sun.) Select option & enter your fee   $
  $      
    $ Day Stall (5 minutes to 8 hours) $15 $
 

Total Class Fees

$ Overnight Stall (per night) $25 $

Horse Trials

Use of School Horse (Tack included if needed) $30 $

List Division(s) - One horse may enter two divisions

VISA, Mastercard Accepted~Process Fee $5 $5 $
Div    Office Fee per Horse & Rider Combo $10 $
Div   

TOTAL FEES: CLASSES, STABLING, OFFICE, etc. 

  $

XC Schooling Sat.

       

Select an option & enter fee below

       
Sat

 

$        

Make Check to : Briar Fox Farm, 9718 SW Hwy 54, Augusta, KS. 67010

Refund Policy

Credit Card Information

Refunds after closing only with Vet. Cert. less $15 Fee. Dressage clinic riders will receive a refund only if their clinic time is filled less $15.
I AGREE TO AND UNDERSTAND THE REFUND POLICY.
       
Credit Card No.      Exp Date:
Repeat Cr Card No. for accuracy
 Visa       Mastercard      Card Holder's Name:

RELEASE OF LIABILITY. (A)WARNING: Under Kansas law, there is no liability for an injury to or the death of a participant in domestic animal activities resulting from the inherent risks of domestic animal acitivities, pursuant to section 1 through 4. You are assuming the risk of participating in this domestic animal activity (b)Inherent risks of domestic animal activities include, but shall not be limited to:(1)The propensity of a domestic animal to behave in ways, I.e. running, bucking, biting, kicking, shying, stumbling, rearing, falling or stepping on, that may result in an injury, harm or death to persons on or around them;(2)The unpredictability of a domestic animal's reaction to such things as sounds, sudden movement and unfamiliar objects, persons or other animals:(3)certain hazards such as surface and subsurface conditions;(4)collusions with other domestic animals or objects, and(5)the potential of a participant to act in a negligent manner that may contribute to injury to the participant or others, such as falling to maintain control over the domestic animal or not actiing within such participant's ability. I desire to compete or as the case may be, have my child compete. I therefore, in consideration of the opportunity to ride horses at Briar Fox Farm, Inc. and for other good and valuble consideration do, hereby:RELEASE: Briar Fox Farm, Inc., their employees or agents & all other persons, corporations, associations or partneships from any and all claims whatsoever which I may hereafter incur on account of or in any way growing out of bodily & personal injury and/or damage to property or animal. I shall INDEMNIFY & save Briar Fox Farm harmless against any and all further claims & damages, costs or expenses which might be incurred by any of the people identified aboue as the result of any accident or injury to me, members of my family or guests, or my horses which may result from the negligence of any of the abouve. I execute this Release with my signature.
                                                         ______________________________________________Date:_______
                                                         RIDER SIGNATURE (PARENT OR GUARDIAN, IF UNDER 21

RIDER:  I,    execute this Release of Liability by checking the box:   

PARENT: I, execute this Release of Liability by checking the box:  (Must insert parent name and check the box if Rider under age 18)

Below please add any additional comments or requests concerning your arrival, stabling, scheduling, etc.

  Caution !  This button will clear all fields and you must start again.