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Octoberfest "JUST JUMP IT"
Show
Saturday, October 16, 2010 at BRIAR FOX FARM
Schooling Hunter Jumper Show, some Dressage & Fun Classes
Official Entry Form...Pre-entry encouraged.
Entries accepted Sat. morning) |
Horse:
Age:
Sex:
Ht.
Color:
Breed: |
Rider:
Age:
Phone: |
Email:
Rider Address: |
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ENTRIES |
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FEE SUMMARY |
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Classes Entered |
Class Fees-Flat Fee of $25 per Div.
or any 3 |
$25 |
$_________ |
| Cl# |
Class Name |
Fee |
Class 16 or Class 17 @ $5 each |
$5 |
$_________ |
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Class 18-Any 3 Dressage Classes (or
$10 each) |
$25 |
$_________ |
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Day Stall (5 minutes to 8 hours) |
$15 |
$_________ |
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Overnight Stall (per night) |
$25 |
$_________ |
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Use of School Horse (Tack included if
needed) |
$30 |
$_________ |
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VISA, Mastercard Accepted-Process Fee
$5 |
$5 |
$_________ |
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Office Fee per Rider |
$5 |
$_________ |
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Total Class Fees |
$ |
TOTAL FEES: CLASSES, STABLING,
OFFICE, etc. |
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$_______ |
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Make Check to : Briar Fox Farm, 9718 SW Hwy
54, Augusta, KS. 67010 |
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Refund Policy- 316-775-5512 |
Credit Card Entry: FAX 316-775-2072 |
| 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. |
Credit Card
No.:_______-_______-_______-_______Exp Date______ |
| Signature:________________________________ |
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 activities, 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 acting 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 valuable consideration do, hereby:RELEASE: Briar Fox Farm, Inc.,
their employees or agents & all other persons, corporations,
associations or partnerships 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 above 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 above. I execute this Release with my
signature.
______________________________________________Date:_______
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RIDER SIGNATURE (PARENT OR GUARDIAN, IF UNDER 21
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