/2011GSECPlatinumClassicDressageShowPrizeList by Great Southwest Equestrian Center

GSEC

PLATINUM CLASSIC SHOWS I & II OCTOBER 8-9, 2011

OFFICIAL USDF QUALIFYING COMPETITIONS FOR: the 2011 Great American Insurance Group USDF Regional Dressage Championship and the 2011 Southwest Dressage Championship

OFFICIAL QUALIFYING COMPETITIONS FOR: 2012 FEI North American Junior & Young Rider Championships 2012 Collecting Gaits Farm/ USEF National Pony Rider, Junior, Young Rider & Brentina Cup Championships Dover/USDF Adult Amateur Medal Program USEF Level 3 Dressage Shows – Two One Day Shows Free Competitor dinner Saturday night! Entertainment! 2501 S. Mason Road, Katy, TX 77450 www.gswec.com

New Award ‐ Calaveras County Diamond & Platinum Adult Amateur Championship Award!

Opening Date: August 12, 2011 Closing Date: September 12, 2011 (postmarked or on‐line)

Championship Warm‐Up & Last Chance to Qualify for 2011 Great American/USDF & Southwest Dressage Championships!

Great Southwest Equestrian Center Platinum Classic Shows I & II October 8‐9, 2011 Official USDF Qualifying Competitions for the 2011 Great American Insurance Group USDF Regional Dressage Championship and the 2011 Southwest Dressage Championship Official Qualifying Competitions for 2012 FEI North American Junior and Young Rider Championships 2012 Collecting Gaits Farm/USEF National Pony Rider, Junior, Young Rider & Brentina Cup Championships Dover/USDF Adult Amateur Medal Program USEF Level 3 Dressage Shows – Two One Day Shows

Free Competitor dinner Saturday night! Entertainment! New Award ‐ Calaveras County Diamond & Platinum Adult Amateur Championship Award!

Location: Great Southwest Equestrian Center, 2501 South Mason Road, Katy, TX Directions: I‐10 between Houston and Katy. Exit #745 Mason Road‐head south, approximately 3 miles on the left hand side. Phone: (281) 578‐7669 Show Manager and Entry Secretary Day of Show Secretary Marilyn Kulifay Mary Mobley (Kyle, TX) P.O. Box 3452 Houston, TX 77253 Licensee: Great Southwest Equestrian Center, LLP (713) 861‐0761 Email: marily2004@yahoo.com Check www.gswec.com for updates, stabling chart, ride times Braider: Bree 512‐826‐7551 or kelibandy@yahoo.com Recognized by: United States Equestrian Federation and United States Dressage Federation Competition numbers 328480 & 328481, SWDC 21102A & B Judges: Joan Humphrey “S” (Fort Meyers, FL), Marlene Schneider “S” (Long Lake, MN), others TBA Technical Delegate: Cleon Wingard “R” (Lebanon, OH)

Warning: Under Texas Law (Chapter 87, Civil Practices and Remedies Code), a livestock show sponsor is not liable for an injury to or the death of a participant in a livestock show resulting from the inherent risks of livestock show activities.

Rule Enforcement: All rules are in effect and will be enforced from the time a competitor arrives on the show grounds. Tentative Schedule: All standard dressage classes will be offered. See following class list. Indicate Division on Region 9 entry form, i.e. Open, AA or JR/YR. Class Number Class Division 5 6 6x 7 8 51 52 53Q 53P 11 12 13Q 13P 15Q 21 22 23Q* 25Q 31 32 33Q 35Q 41 42 43Q 45Q 60Q 62Q (Sun only) 63Q (Sat only) 64Q (Sun only) 67Q (Sun only) 68Q (Sat only) 69Q (Sun only) 70Q 71Q 72Q 73Q 74Q 75Q 78Q (Sun only) 79Q (Sat only)

Intro A Intro B Intro C Dressage Eq 13 & under Dressage Eq 14‐18 Training 1 Training 2 Training 3‐Great Am/USDF/SWDC Qual Training 3‐Pony‐SWDC Qual First 1 First 2 First 3‐Great Am/USDF/SWDC Qual First 3‐Pony‐SWDC Qual First Freestyle‐Gr Am/USDF/SWDC Qual Second 1 Second 2 Second 3‐Gr Am/USDF/SWDC Qual/AA Dover Medal Second Freestyle‐Gr Am/USDF/SWDC Qual Third 1 Third 2 Third 3‐Gr Am/USDF/SWDC Qual Third Freestyle‐Gr Am/USDF/SWDC Qual Fourth 1 Fourth 2 Fourth 3‐Gr Am/USDF/SWDC Qual Fourth Freestyle‐Gr Am/USDF/SWDC Qual USEF Brentina Cup‐USEF FEI Young Rider Individual‐NAJYRC/USEF FEI Young Rider Team‐NAJYRC/USEF FEI Young Rider Freestyle‐NAJYRC/USEF FEI Junior Rider Individual‐NAJYRC/USEF FEI Junior Rider Team‐NAJYRC/USEF FEI Junior Rider Freestyle‐NAJYRC/USEF Prix St. Georges‐Gr Am//USDF/SWDC Qual Intermediate I‐Gr Am/USDF/SWDC Qual Intermediate I Frstyle‐Gr Am/USDF/SWDC Qual Intermediate II‐Gr Am/USDF/SWDC Qual Grand Prix‐Great Am/USDF/SWDC Qual Grand Prix Freestyle‐Gr Am/USDF/SWDC Qual FEI Pony Rider Individual‐USEF FEI Pony Rider Team‐USEF

O O O JR/YR JR/YR O, AA, JR/YR O, AA, JR/YR O, AA, JR /YR O O, AA, JR/YR O, AA, JR/YR O, AA, JR/YR O O O, AA, JR/YR O, AA, JR/YR O, AA, JR/YR O O, AA, JR/YR O, AA, JR/YR O, AA, JR/YR O O, AA, JR/YR O, AA, JR/YR O, AA, JR/YR O O YR YR YR JR JR JR O, AA, JR/YR O, AA, JR/YR O O, AA, JR/YR O, AA, JR/YR O JR JR

* This class is designated as the USDF/Dover Medal class for Adult Amateurs 80 90

Materiale TOC (specify test) Pas de Deux (state level and riders)

O O

91 92 101 102

Para‐Equestrian TOC Para‐Equestrian Freestyle TOC Training Level Test 1 Opportunity Class Training Level Test 2 Opportunity Class

O O O O

Note: If competitor intends to enter the Great American/USDF Qualifier classes as a qualifier include the qualifying fee of $10.00. If competitor intends to enter the Southwest Dressage Championships Qualifier class as a qualifier, include the qualifying fee of $8.00. FEE SCHEDULE (all fees are per entry per show unless noted otherwise): Class/Qualifying Fees Intro thru Fourth, Opportunity & Equitation $35.00 FEI, Freestyle, Materiale & ParaEquestrian Classes $45.00 NAJYRC & Brentina Cup $60.00 Pas de Deux (per couple) $60.00 Great American/USDF Qualifying Fee (addl) $10.00 SWDC Qualifying Fee (addl) $ 8.00 USDF/USEF Fees USEF Drug/Medication Fee (D/M $7, USEF $8) $15.00 USEF No Proof of Membership Fee $30.00 USDF Non‐member/No Proof of Membership Fee $25.00 USDF No Proof of Membership Affidavit Fee $ 5.00 Stabling & Grounds Fees One Day Stall Fee (2 bgs shavings) $65.00 Two Day Stall Fee (Fri 1 PM – Sun 6 PM)(2 bgs shavings) $99.00 Two Day Tack Stall Fee (Fri 1 PM – Sun 6 PM) $75.00 Early (Fri) Arrival/Late Departure (per night) $35.00 Grounds Fee (per day) $35.00 Additional Shavings/Bag $11.00 Office Fees Office Fee (per entry per show) $30.00 Office Fee (per entry per show – on‐line entry) $25.00 Late Entry Fee (if space & schedule avail. & discr. of mgmt) $35.00 Change After Closing Date (per chg) $15.00 Amount Owed Billing Fee $35.00 Incomplete Entry Fee (per entry) $20.00 Returned Check Fee $35.00 Miscellaneous Fees RV Hook‐Up (per night‐must specify RV make & license no.) $40.00 Extra ticket to dinner for non‐competitor $10.00 Pony Measurement Fee (measurement before ride) $30.00 Non Compete fee per show $30.00 (Horses not competing in classes must have an entry form for each show, with signatures, current Coggins, and pay a non‐compete fee, office fee and either grounds or stall fee.)

Note: There is no additional (non‐member) fee if you are not a member of a GMO (i.e. DDC, HDS, etc.). RULES AND GENERAL INFORMATION 1. All Great Southwest Equestrian Center shows, are covered by the rules and specifications of the current US Equestrian Federation Rule Book and will be conducted and judged in accordance therewith. 2. Life, senior active and junior active members shall be eligible to participate in all classes at Regular Competitions, Eventing Competitions at the Preliminary Level or above and Combined Driving

Competitions at the Advanced Level, Dressage, Reining and Vaulting Competitions and Endurance Rides. A nonmember may participate as a handler, rider, driver, owner, lessee, agent, coach or trainer at Regular Competitions, Eventing Competitions, Dressage Competitions, Reining Competitions and Combined Driving Competitions upon payment of a $30 nonmember registration fee. Participants in the following classes are exempted from the Requirements of this rule: 1) leadline; 2) exhibitions; 3) games and races; 4) classes for 4‐H members; 5) walk trot and academy classes (academy classes are classes limited to horses used regularly in a lesson program); 6) USDF introductory level tests, pas de deux and quadrille classes; 7) NRHA Endorsed Reining Competitions. 8) Opportunity classes, 9) citizens of other nations who have proof, in English, of current membership in good standing of their own National Federation, 10) USEA beginner novice division; and 11) assistant handlers in Dressage Sport Horse Breeding classes. 3. Amateurs, Juniors & Young Riders: Amateurs are defined by the rules and specifications of the current USEF Rule Book. All riders entering the Amateur classes must possess or have applied for an USEF Amateur Card prior to riding in the class. All riders in Amateur Divisions must present a USEF Amateur Card when picking up their number or they will not be allowed to show in the Amateur Division. Cards may be applied for at the show office. Jr/YR rider classes are offered to anyone 21 and under (may compete until the end of the calendar year in which they turn 21). Young Riders are eligible for FEI Young Rider classes from 16‐21 yrs. of age. 4. CONDITIONS OF ENTRY: Every horse entered for competition will be under the control of the Horse Show Management, but the Horse Show Management will, in no case, be responsible for any loss or damage that may occur, and it shall be a condition of entry that each exhibitor shall hold the Horse Show Management, Facility and its Directors harmless for any loss or accident to his horse, horses or equipment which may occur from sickness, fire or otherwise. 5. ENTRY PROCEDURES: PLEASE READ CAREFULLY!! A. Fees for GSWEC Shows: Mail‐In Entries: Fill out a separate entry form for each show. For each horse entered, send your completed entry form, including USDF & USEF membership cards (print from www.eqverification.com) Coggins and a check for each show day entered, made payable to GSWEC. Mail to Marilyn Kulifay, Entry Secretary, P.O. Box 3452, Houston, TX 77253. No postdated checks accepted. Mail‐in entries may also be done on‐line (see below), printed and sent in with cards, Coggins & check to Marilyn. On‐Line Entries (credit card payments): Go to www.EquestrianEntries.com , register, and select classes, fees, stabling & pay. For on‐line entries, mail or email Coggins & signature pages to Marilyn: marily2004@yahoo.com Horse not officially entered until payment & completed entry received. B. At the Show: No bridle numbers will be issued without full payment and completed entries, including signatures and emergency contact information. C. Entry Acceptance: Entries will be accepted on a first come‐first serve basis based on postmark date and On‐Line Entry date until classes are filled. Entries received after classes are filled will be notified and, if desired, put on a waiting list (in the order of postmark). Those entries postmarked after closing will be accepted at the discretion of the show secretary and show committee, based on a space available basis and charged a $35 late fee per show. Those on the waiting list who entered show prior to closing date and did not get into the show will have all fees refunded. NO PHONE entries, FAX entries or entries attached to emails will be accepted. All entries must be made on official entry blanks and filled out completely as to classes, exhibitors , owners, trainers, coaches, horse names, addresses, phone numbers, association numbers, USEF & USDF cards and signatures and include a copy of current Coggins. Parents or guardians must sign the official entry blank of a minor before a number will be released. Make sure that Emergency Contact information is complete. Management reserves the right to refuse any entry. Entries close & MUST BE POSTMARKED OR ENTERED ON‐LINE BY September 12, 2011. D. A copy of horses’ Coggins pulled within 12 months of the show date must accompany each entry. Horse’s name on Coggins must match name on entry form and cards. E. Each competitor is responsible for supplying management with the correct association numbers (USDF, USEF) for horse, owner, rider, and trainer, before the day(s) of the competition. The scores of competitors who fail to supply correct numbers may not be counted toward national awards.

F. Any and all handlers, assistant handlers, drivers, riders, trainers, owners, agents, lessees, parent or guardian of a junior exhibitor, and coaches of horses (or riders) are required to sign an entry blank and with the exception of a parent or guardian of a junior exhibitor, must be USEF members or pay a non‐ member fee. G. Show management reserves the right to limit entries, add, combine or divide classes, modify the schedule, add, substitute or change officials, modify or cancel awards and prizes and/or make whatever changes are required by circumstances to the competition specifications listed herein. Show management reserves the right to cancel classes insufficiently filled and to refuse or require withdrawal of an entry for cause deemed sufficient by show management. H. Management reserves the right to cancel any classes due to hazardous weather, Acts of God, accident, or emergency. Every effort will be made to reschedule with priority given to any qualifying classes being offered. No refunds for cancellations due to hazardous weather, Acts of God, accidents or emergencies. Refunds will be made in accordance with scratch policy (See #6.) 6. SCRATCHES & SUBSTITUTIONS: Exhibitors have the responsibility of informing the Show Entry Secretary (October 7, 2011 and before) or Show Day Secretary (Oct. 8 & 9) of their intention to scratch in writing. Please keep your receipt of notification of scratching for proof. No refunds given at the show. A. Scratches of the whole show made in writing to Show Entry Secretary before the closing date may be made for any reason and all fees will be refunded. B. Scratches of the whole show made in writing to Show Entry Secretary after the closing date but before 5:00 PM on Wednesday, Oct. 5, 2011 will be refunded one‐half stall fees or grounds fees, and all shavings, drug & medication/USEF fee and any qualifying fee (GA/USDF or SWDC ) paid. C. Any scratches of the whole show after the closing date are liable for all unpaid fees, including but not limited to entry and office fees, and will be billed accordingly. D. Any scratches of the whole show that are “no shows” without notification to Show Entry Secretary in writing prior to 5:00 PM on Wednesday, Oct. 5, 2011, will receive drug & medication/USEF fee and GA/USDF or SWDC qualifying fees paid. E. Scratches of a class will receive no refund, unless it was a qualifying ride, then GA/USDF or SWDC qualifying fees only will be refunded. Scratches of a class must be made in writing, and if at the show, with the show secretary. F. All “no shows” that have not contacted the show office prior to first ride will be considered a scratch for the rest of the shows (both I & II) and time slots may be filled. G. After closing date, one horse may be substituted for another at no additional office fee if horse status (USDF/USEF memberships) and classes entered are the same and a note is provided from a veterinarian that the entered horse has been injured. New separate entry form per show must be filled out with substituted horse’s information, cards, Coggins and signatures. Riders may be substituted for one another if the rider’s status is the same regarding memberships and they are able to ride in the class that was entered by the original rider (i.e. open, amateur or junior) with a doctor’s note that the entered rider became ill. 7. LATE ENTRIES: All entries must be POSTMARKED on or before the closing date or will be considered a late entry. Each late entry will be charged a late fee of $35.00 per show. Late entries will be accepted and given a ride time only as schedule permits. 8. UNPAID CHARGES: Any exhibitor leaving the show with an unpaid balance of entry fees or other fees due, will be billed for these charges and a $35.00 billing fee will be added to the total due. Until these charges are settled, all future entries of horse, rider and owner will be returned AND USEF Rule 913 will be invoked. 9. RETURNED CHECKS: A $35.00 fee will be assessed for each returned check. All fees must be made good prior to packet pick‐up. 10. RIDE TIMES: Preliminary ride times will be e‐mailed about 5 days before the show and ride times will be posted on www.gswec.com by 5:00 PM Tuesday before the show. Ride times will also be posted at the show grounds by noon on Friday, Oct. 7. Any updates for Show II will be posted by 6:00 PM on Saturday. Adequate time intervals cannot be guaranteed when riders enter more than one horse in any class. It is

the responsibility of the rider to inform the management of any time conflicts as soon as possible and at least 72 hours (three days) before the scheduled rides. Any changes after closing date initiated by rider or owner will incur a $15 per change fee. 11. BRIDLE NUMBERS: Bridle numbers for the show entered must be worn at all times when a horse is out of its stall even on non‐show days. Each horse/rider combination is considered a separate entry and must fill out a separate entry form and will be issued a different number. 12. FREESTYLES: A photocopy of a test (score 60% at highest test of level) verifying eligibility must accompany entry. Music for all freestyles on CD or MP3 must be given to show announcer at least four hours before class. Competitors are responsible for picking up their music before the end of the show. 13. FACILITIES & ARENAS: All tests and warm‐up will be ridden in either indoor or outdoor arenas with sand/clay footing. Show may also use OttoSport footing arenas for warm‐up and tests; warm‐up arena footing opportunities will match competition arenas (i.e. if competitor competes on OttoSport, there will be opportunity to warm‐up on OttoSport). Competition arenas are 20m x 60m. No one on foot is allowed in designated warm‐ups. Lunging permitted in designated outdoor areas only. All horses in the warm‐up arenas must wear their competition numbers. All arenas must be vacated while equipment is being used. Arenas close at 9:00 PM. Schedule for schooling will be posted at the show grounds. Introductory, Training Level (non‐qualifying) & ParaEquestrian classes (except for Grade IV freestyle) may be ridden in small arena 20m X 40m. Dressage show will be in covered East Arena (Ring 3) & outdoor arenas; competitors and spectators are also invited to watch reining in Main Arena. 14. RIBBONS AND AWARDS: In classes where three or more riders complete the class, the winner will receive an award. If less than three, ribbons only will be given. Ribbons are awarded to sixth place. Qualifying classes will not be pinned separately. 15. MANAGEMENT: Horse Show Management reserves the right to itself to interpret all questions and conditions in regard to or arising out of any incident in the show without claims for damages or recourse of any kind. All questions not covered in these rules and regulations shall be decided by the Horse Show Management; their decision will be final. The Horse Show Management reserves itself the right to refuse, accept conditionally, or to cancel any entries, disqualify riders or exhibitors, prohibit exhibition of entries and cancel award prizes, without claim to damages; to change, cancel or combine any classes, to reschedule classes after due notice to exhibitors, or to change rings or rotate judges. 16. BEDDING: Only shavings provided by facility for bedding. No outside shavings permitted. 17. STABLING A. Permanent stalls are of wood construction, 10' X 10’ with wooden doors. Horse stalls are $99.00 Friday 1 PM through Sunday 6:00 PM, two bags of shavings included. Tack stalls are $75.00 Friday 1:00 PM to Sunday 6:00 PM. Additional days will be charged $35 per day (horse and tack stalls). One day stalls are $65.00 for day until 6:00 PM, two bags of shavings included. B. Electrical requirements must not exceed any more than 2.5 Amps per stall. Stall charts will be posted and check‐in will start at 1:00 PM on Friday, Oct. 7th. Early arrivals and late departures are only available by arrangement with Show Entry Secretary at $35/night/horse. Stalls must be vacated by 6 PM Sunday, except by prior arrangement with show management. Anyone using (without having paid) an unassigned stall or tack stall, even temporarily, will be charge a one‐day stall fee at a minimum. Anyone who has moved stalls after arrival at the show grounds must clean the stall from which they moved to the satisfaction of show committee/management, or will be charged a one‐day stall fee at the minimum. Anyone who places manure in an “empty” or unused stall will be charged a one‐day minimum stall fee. C. No smoking in the barns and near the indoor warm‐up arenas. Designated smoking areas will be provided. 18. SCHOOLING HORSES: Horses not entered in the show must be registered with the Horse show office and will be given a number to be worn at all times outside of the stall. Appropriate stall or ground fees and a $30 non‐compete and office fee per show must be paid. Any person(s) riding a schooling horse must have signed an official entry blank and/or release form PRIOR TO UNLOADING HORSE. Schooling of non‐compete horses are allowed in the warm‐up area during competition hours if there is ample room in

the arena. Non‐compete horses may be requested to move to a different area or arena, as determined by Show Management or the Technical Delegate. Entry to include the correct number of stabling days. 19. VETERINARIAN/FARRIER: Veterinarian will be on call each show day. Farrier will be on call each day. Phone numbers and information will be posted at the show grounds and in the show secretary’s office prior to the start of the show. 20. PONY MEASUREMENT: Please notify Show Entry Secretary with entry if pony needs to be measured at the competition. If there are ponies to measure, those competitors will be notified as to time & location. 21. DOGS: Dogs are not permitted to be loose on competition grounds and must be on a leash or otherwise contained. Individuals must not lead dogs on a leash while mounted. Dog owners are solely responsible for any damages, claims, losses or actions resulting from their dogs’ behaviors. Dog owners failing to comply with this rule may be subject to penalty under Chapters 6 and 7of the USEF General Rules, as well as issuance of warning cards. 22. CONCESSIONS: Concessions are available at the show grounds. 23. PARKING: Parking is allowed in designated areas only. Violators improperly parked, including NO PARKING ZONES AND FIRE LANES, will be issued citations and/or towed from premises at the vehicle owner’s expense. Please do not park in front of a trailer, blocking access to the hitch, unless it is your trailer. 24. MOTORIZED VEHICLES: Minors who do not have a valid driver's license which allows them to operate a motorized vehicle in the state in which they reside will not be permitted to operate a motorized vehicle of any kind, including, but not limited to, golf carts, motorcycles, scooters, or farm utility vehicles, on the competition grounds of licensed competitions. Minors who have a valid temporary license may operate the above described motorized vehicles as long as they are accompanied by an adult with a valid driver's license. The parent(s), legal guardian(s), or individual who signs the entry blank as a parent or guardian of a minor operating a motorized vehicle in violation of this rule are solely responsible for any damages, claims, losses or actions resulting from that operation. Violations of this rule will be cause for sanctions against the parent(s), guardian(s) and/or trainer(s) who are responsible for the child committing the offense. Penalties may include exclusion of the child, parent(s), guardian(s), and/or trainer(s) from the competition grounds for the remainder of the competition and charges being filed against any of the above individuals in accordance with Chapter 6. Wheelchairs and other mobility assistance devices for individuals with disabilities are exempt from this rule. 25. SHARPS CONTAINERS: Management will provide Sharps containers in the barns for competitors’ use. Competition management may fine any individuals including trainers, owners, exhibitors, or their agents up to $100 for improper disposal of needles or other sharp disposable instruments. If local law has different requirements, local law will prevail. 26. PROTECTIVE HEADGEAR: Anyone mounted on a horse must wear protective headgear except those riders age 18 and over while on horses that are competing only in FEI levels and tests at the Prix St. Georges level and above (including FEI Young Rider Tests, the USEF Developing Prix St. Georges Test and the USEF Brentina Cup Test). 27. LODGING: Make reservations early! Deadline Sept. 23, 2011. Hilton Garden Inn, 12245 Katy Fwy, Katy, TX 77079 (on south side feeder road I‐10 @ Dairy Ashford, exit 753B) Phone: 281/531‐0220 (11 miles from GSWEC) Special room rate. Mention “Great Southwest Dressage Show” when making reservations. LaQuinta Inn & Suites, 15225 Katy Freeway, Katy, TX 77094 Special rate. www.lq.com promo code HORSES Phone: (281) 646‐9200 (Hwy 6 & I‐10) (10 miles from GSWEC) TownePlace Suites Marriott, 15155 Katy Freeway, Katy, TX 77094 (Hwy 6 & I‐10) Special rate. Mention “GSWEC Dressage Show” Phone: (281) 646‐0058 (10 miles from GSWEC) 28. COMPETITOR DINNER: Saturday night approximately 1 hour after end of show. Platinum Show competitors free, just let us know you are attending with entry. Volunteers free, too! Guests $10.00 to be paid by 4:00 PM Monday, October 3, 2011.

29. OPPORTUNITY CLASSES: These classes do not require USEF & USDF memberships for the horse, rider or owner. USEF drug fees do not apply. If horse, rider or owner has memberships, please indicate so on entry. Riders may not cross enter into other classes. 30. Special Award Sponsored by Olva Pharo: Calaveras County Diamond & Platinum Adult Amateur Award – Bronze medal to be awarded to the highest averaged scores over the GSEC Diamond Classics I & II and GSEC Platinum Classics I & II in two sections. Two sections: 1. Training through Third must compete at least 3 rides on same horse over two days (two classes one day and one class the other). Highest score will count and be averaged with October show highest score (of three rides—see above) to determine winner. 2. Fourth through Grand Prix must compete at least two rides on same horse over two days. Highest score will count and be averaged with October show highest score (of two rides—see above) to determine winner. Horse & rider must be the same and enter both GSEC Diamond Classics I & II and GSEC Platinum Classics I & II. Tests that will count are Training‐Fourth, Tests 1, 2 & 3 and PSG, I‐1, I‐2 and GP. Equitation, opportunity classes, freestyles, and other classes not specifically listed are not eligible.

United States Equestrian Federation (USEF) Entry Agreement By entering a Federation‐licensed Competition and signing this entry blank as the Owner, Lessee, Trainer, Manager, Agent, Coach, Driver, Rider, Handler, Vaulter or Longeur and on behalf of myself and my principals, representatives, employees and agents, I agree that I am subject to the Bylaws and Rules of The United States Equestrian Federation, Inc. (the “Federation”) and the local rules of the competition. I agree to be bound by the Bylaws and Rules of the Federation and the competition. I will accept as final the decision of the Hearing Committee on any question arising under the Rules, and agree to release and hold harmless the competition, the Federation, their officials, directors and employees for any action taken under the Rules. I represent that I am eligible to enter and/or participate under the rules, and every horse I am entering is eligible as entered. I also agree that as a condition of and in consideration of acceptance of entry, the Federation and/or the competition may use or assign photographs, videos, audios, cable‐casts, or other likenesses of me and my horse taken during the course of the competition for the promotion, coverage or benefit of the competition, sport, or the Federation. Those likenesses shall not be used to advertise a product and they may not be used in such a way as to jeopardize amateur status. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropriation. The construction and application of Federation rules are governed by the State of New York, and any action instituted against the Federation must be filed in New York State. See GR908.4. USDF DOVER MEDAL ADULT AMATEUR MEDAL The USDF/Dover Saddlery Adult Amateur Medal Program is designed to specifically recognize and encourage adult amateurs riding at Second Level. Awards 1. USDF/Dover Saddlery Medal Recipient: The eligible rider with the highest score of 60 percent or better in the designated Second Level Test Three class or applicable test of choice USDF/Dover Saddlery Adult Amateur Medal class at a participating competition will receive a handcrafted USDF/Dover Saddlery pewter medal and neck ribbon. Winners will receive a $20 Dover Saddlery gift certificate for the first three USDF/Dover Saddlery Medals they win during the competition season. 2. USDF/Dover Saddlery National Merit Award: A USDF/Dover Saddlery National Merit Award will be awarded to riders winning three USDF/Dover Saddlery Medals in the same competition year. 3. Year‐End Awards: The USDF/Dover Saddlery Medal National Champion and Reserve Champion are determined from the average of the top three winning ride scores during the competition year. The champion receives a $1000 Dover Saddlery gift certificate and the reserve champion receives a $500 Dover Saddlery gift certificate. Rider Eligibility To be eligible, a rider must meet the following criteria: 1. Rider must be a current USDF participating or group member at the time of the competition. 2. Rider must be an adult amateur in accordance with Article GR1306 of the USEF rules and be designated with USEF as an adult amateur as of the competition date. For additional information and an updated list of competitions offering the USDF/Dover Saddlery Adult Amateur Medal Program, go to http://www.usdf.org/awards/performance/adultmedalprogram.asp

Southwest Dressage Championship 2011 Qualifying Percentages Southwest Dressage Championship Qualifying Classes will be governed by the rules published in the current SWDC/Region 9 Omnibus and/or on web site www.swdressage.org. Each rider must declare the division in which they are competing prior to each attempt at a qualifying ride at SWDC qualifying shows or for a score submitted under the rules (Amateur, Open, or Junior/Young Rider) and must provide proof of eligibility in the case of Amateur and Junior/Young Riders. Adult Amateur and Junior/Young Riders may also qualify for the Open division. Separate scores must be earned for each division. At the Championships, they must enter each division separately and ride in each division separately. There is no requirement of citizenship or horse/rider/owner registrations for SWDC, but each horse/rider pair must comply with USEF and competition rules. SWDC Classes Adult Amateur Junior/Young Rider Open Training Level 61% 61% 64% First Level 60% 60% 63% Second Level 59% 59% 62% Third Level 58% 58% 60% Fourth Level 57% 57% 58% Prix St Georges 57% 57% 58% Intermediare I 57% 57% 58% Intermediare II 57% 57% 58% Grand Prix 57% 57% 58% Musical Freestyle 1st Level 62% nd Musical Freestyle 2 Level 62% Musical Freestyle 3rdLevel 62% Musical Freestyle 4thLevel 62% Musical Freestyle FEI 60% Pony Championship – Training Level 56% Pony Championship – First Level 56% Competitors may check scores by checking the www.swdressage.org web site or by sending an email to Sarah Martin, SWDC Qualifying Secretary, at qualifying@swdressage.org. Qualifying scores must be reported within two weeks. To permit recording, scores will not be available until at least three weeks after the competition. For more information: Sarah Martin at 936 597-5439

GSEC Platinum Classic I & II 328480 & 328481 USEF Competition Name:_____________________________________________USEF#_____________________ Competition Division(s) and Rating(s):____________________________________________________________ _____________________________________________________________________________________________ Dressage Level 3 ____________________________________________________________________________________________

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usef.org or call one of

our Customer Care agents at 859.258.2472. 2-25-11 V1

USDF Membership Benefits: USDF is dedicated to education, the recognition of achievement, and promotion of dressage. For details on member benefits, including educational programs, awards, and other opportunities, refer to the USDF Competitor & Member Guide or the USDF Web site at www.usdf.org. U

This competition is recognized by USDF for 2011

Membership Requirements for USEF-licensed/USDF-recognized Competitions: Owners and riders, including foreign riders and owners who are not residents of the US, wishing to participate in a USEF-licensed/USDF-recognized competition as a rider or owner/lessee, must have either a USDF Group Membership, Participating Membership (PM), or have a USDF Non-Member (NM) identification number and pay the USDF NM fee. (Note: USDF business members can own horses but cannot compete as riders with their USDF BM.) Individuals cannot compete at a USEFlicensed/USDF-recognized competition with a USDF Education Membership.

Horses competing at USEF-licensed/USDF-recognized competitions must have either a USDF Horse Identification (HID) number or a USDF Lifetime Horse Registration (LHR). Proper credentials or verification certificates must be presented to the competition secretary. Riders and owners wishing to participate in a USEF-licensed/USDF-recognized competition, and not able to present the competition secretary with verification of a USDF membership or NM identification, and USDF LHR or USDF HID, must complete a USDF Competition Affidavit Form and pay the $5 affidavit filing fee. A copy of a completed affidavit form from another competition may also be used for verification purposes for up to 60 days. (Exception: Affidavits cannot be used at Great American Insurance Group/USDF Regional Dressage Championships.) Exceptions: • Horses competing only in Individual Breed Classes (IBCs) at DSHB competitions, sires and dams of horses in DSHB group classes, where those sires or dams are not actually competing in the same competition, horses competing only in breed restricted dressage or DSHB classes at Regular Competitions (e.g. all Arabian, all Friesian, or all Morgan classes), or in USDF Introductory Level tests, Pas de Deux, Quadrille, FEI ParaEquestrian classes, are exempt from this requirement. Also exempt are horses ridden in leadline, exhibitions, games and races, classes for 4-H members, walk-trot, academy and opportunity classes. For foreign-owned horses competing in a CDI, USDF accepts copies of the horse identification pages from an FEI passport in lieu of a USDF HID or LHR number. • Riders and owners/lessees competing only in classes which are exempt from the USDF HID requirements are also exempt from the USDF NM identification number and NM fee requirements. Also exempt are handlers of horses competing in DSHB In-Hand or Group classes. Memberships Defined Participating Membership (PM): A membership issued to an individual directly by USDF. The membership year is December 1 through November 30. PMs are available for 1-year ($75), 5-years ($300), or life ($1,500). A USDF Youth Participating Membership (YPM) is available for individuals who have not reached their 21st birthday by December 1 of the current membership year ($60). A PM allows the member to compete at USEF-licensed/USDF-recognized competitions and to participate as a rider and/or owner/lessee for all Adequan®/USDF Year-End Awards, Great American Insurance Group/USDF Breeders’ Championship Series Finals and the Great American Insurance Group/USDF Regional Dressage Championship program. Group Membership (GM): A membership issued to an individual by USDF when the member name and dues are submitted to USDF through an affiliate Group Member Organization (GMO). The GM year begins December 1 and ends November 30. A GM allows the member to compete at USEF-licensed/USDF-recognized competitions and participate in the USDF Rider Awards program. Business Membership (BM): A membership that runs December 1 through November 30 and is issued to a business or organization directly by USDF. The USDF BM ($200) offers a wider variety of advertising benefits. BMs satisfy requirements of horse ownership only. Education Membership (e-Membership): A membership issued to an individual directly by USDF. This online education only membership expires 12 months after the date joined. This membership type does NOT allow an individual to compete at a USEF-licensed/USDF-recognized competition. Non-Member (NM) Identification Number: For each USDF NM owner/lessee and USDF NM rider there will be a USDF NM fee of $25 and a USDF NM form per competition that must be collected by the show secretary and submitted to USDF along with the USDF Report of Fees document and the $5 affidavit fee if the person cannot provide a copy of their USDF NM card. Owners/lessees or riders exempt from the NM number requirements are also exempt from paying the USDF NM fee. If there are multiple owners of a horse and all are NMs, only one of the owners must pay the NM fee. If the horse has at least one owner who is a current USDF member there is no NM fee assessed. Competition management will be invoiced for all applicable USDF NM fees not received with the USDF post competition paperwork, along with a report listing all USDF NMs. Competition management is then required to submit the NM fees within 30 days to the USDF. An individual with a USDF NM identification number is not eligible for any USDF membership benefits. Once a USDF NM number has been assigned, a USDF NM card can be obtained from the USDF Web site. Horse Identification (HID) Number: A one-time tracking number for horses ($25). Scores earned by a horse with an HID number will be recorded, but will NOT be counted towards Adequan®/USDF Year-End Awards. A horse with an HID number is not eligible to compete in Great American Insurance Group/USDF Regional qualifying or championship classes or Great American Insurance Group/USDF Breeders’ Championship Series Finals. An HID number can be upgraded to a Lifetime Horse Registration (LHR) for a fee of $70. If a horse has a USDF LHR it does not need an HID number. An HID number is a one-time fee that does not need to be renewed. Lifetime Horse Registration (LHR): A horse with an LHR ($95) is eligible for Adequan®/USDF Year-End Awards, and eligible to compete at Great American Insurance Group/USDF Breeders’ Championship Series Finals and Great American Insurance Group/USDF Regional qualifying and championship classes, assuming requirements for the owner and rider are met. If a horse has an LHR it does not need an HID number. An LHR does not need to be renewed. How to Join USDF Applications for USDF Participating Membership (PM), Business Membership (BM), Horse Identification (HID) number, and Lifetime Horse Registration (LHR) may be found in the following locations: • On the USDF Web site: www.usdf.org. You can submit the application online or download the form and fax or mail it to the USDF office. • In the show office at USEF-licensed/USDF-recognized competitions classified by USEF as Dressage Competitions, and Regular Competitions which are open to all breeds. • By calling or writing the USDF office at (859) 971-2277, 4051 Iron Works Parkway, Lexington, KY 40511 The effective date of membership is the date the form and correct fees are received in the USDF office or, if applying at a competition, the date received by the competition secretary, provided the application is signed and dated by the competition secretary, member, and/or horse owner on that same day.

09/10

2011 Great American Insurance Group/USDF Regional Dressage Championships A single Regional Dressage Championship program organized by the United States Dressage Federation (USDF), and recognized by the United States Equestrian Federation, Inc. (USEF), will be held in each of the nine USDF regions. In addition, Alaska and Hawaii may each hold state championships if an official request from a Group Member Organization (GMO) is received by April 1 of the prior year. The Regional Championship Program Rules can be found on the USDF Web site at: http://www.usdf.org/Programs/RegionalChampionships/index.asp. Please refer to the USDF Competitor and Member Guide for the comprehensive list of rules and requirements for this program. Membership/Registration Requirements for Qualifying & Championships:Rider: • Must be a USDF Participating* Member (PM) at the time qualifying scores are earned and at the time of the championships. • Must be a USEF member (Junior Active, Senior Active, or Life) at the time the qualifying scores are earned and at the time of the championships. Horse: • Must be USDF Lifetime Registered (LTR) at the time qualifying scores are earned and at the time of the championships. • Must be USEF (Annual or Lifetime) recorded at the time qualifying scores are earned and at the time of the championships. • USDF horse registration and USEF horse/recording must be in the name(s) of the current owner(s) or lessee(s) of record. • A horse is not required to have registry papers. Owner: • Must be a USDF member (PM* or Business Member (BM)) at the time the qualifying scores are earned and at the time of the championships. • Must be a USEF member (Junior Active, Senior Active, or Life) at the time qualifying scores are earned and at the time of the championships. *PMs are USDF members who join USDF directly. USDF Group Members (GM) are ineligible. Minimum Qualifying Scores One set of nationally-standardized qualifying scores has been established for all USEF/USDF Regional Championships, for levels through Grand Prix, in three divisions: open, adult amateur, and junior/young rider. FEI Junior and FEI Young Rider classes have only one respective division. Freestyles have only open divisions. Training Level (Test 3) First Level (Test 3) Second Level (Test 3) Third Level (Test 3) Fourth Level (Test 3) FEI Junior (Team Test) FEI Young Rider (Team Test) Prix St. Georges Intermediate I Intermediate II Grand Prix

OPEN 68% 66% 64% 62% 62% — — 60% 60% 60% 60%

AA 63% 62% 61% 60% 60% — — 60% 60% 60% 60%

JR/YR 63% 62% 61% 60% 60% 60% 60% 60% 60% 60% 60%

Freestyle First Level Second Level Third Level Fourth Level Intermediate I Grand Prix

OPEN 65% 65% 65% 63% 63% 63%

AA — — — — — —

Jr/YR — — — — — —

Sports Programs/Competitions Revised 9/10

Bridle #

Great Southwest Equestrian Center

NOTES

www.gswec.com

Competition Name: GSEC Platinum Classic I Competition Date(s): October 8, 2011 Closing Date: September 12 , 2011 (postmarked date) Name of Horse

Previous Name (if any)

Breed

Sex

Sire

Color Dam

Height

USDF #

Year

Dam Sire

OWNER: _________________________________________________ USEF # ____________________

USEF #

Coggins (Blood drawn on date)

Country of Birth

Class #

Div

For Sale?

Breeder

Qual Y/N

Class Description

Fee

USDF # _____________________

Address: _________________________________________________ City: __________________________ State: ______ Zip: __________ Tel: ________________________ Cell: ________________________ Email: ___________________________________________________ RIDER: __________________________________________________ USEF # ____________________

Class & Qualifying Total:

USDF # _____________________

Fees

Other Required Fees

Address: _________________________________________________

Office Fee Mandatory for each horse/rider entry

City: __________________________ State: ______ Zip: __________

USEF Fee Mandatory for each horse competing $7 Drug / $8 USEF Fee = $15

Tel: ________________________ Cell: ________________________ Email: ___________________________________________________ Open____ AA____ JrYR____

$30 $15

Birthdate_______________

Stall Fee ____ Stall @ $99 (2 bags bedding incl) Tack Stalls ____ Stall(s) @ $75 per stall Bedding _____Bags @ $11 per Bag USEF Non-Member $30 per rider/owner/trainer

TRAINER:________________________________________________

USDF Non-Member Fee $25 per rider/owner

USEF # ____________________

USDF Affidavit Fee $5 if reqâ&#x20AC;&#x2122;d

USDF # _____________________

Address: _________________________________________________

Non-Compete Horse $30 (must pay Office Fee)

City: __________________________ State: ______ Zip: __________

Grounds/Haul in Fee $35 (if no stall)

Tel: ________________________ Cell: ________________________ Email: ___________________________________________________ COACH:_________________________________________________ USEF # ____________________

Late Fee $35 / Change Fee $15 Incomplete Entry Fee $20 Dinner for Competitor?

Yes No

(circle one)

Free

Other _______________________________

TOTAL FEES:

USDF # _____________________

REMEMBER to attach copies of cards & coggins. Reverse side must be SIGNED!

Tel: ________________________ Cell: ________________________

Stabling Information & Special Requests: Please list only one group name (either individual or barn) for entire group. Group/Farm/Self Horse Stall (Horse Name) Barn/Stall Preference Group Name:

Wed

Thu

Fri

Sat

Tack Stall(s) Contact:

Tel:

Sun

Mon

WARNING UNDER TEXAS LAW AN EQUINE ACTIVITY SPONSOR OR EQUINE PROFESSIONAL IS NOT LIABLE FOR INJURY TO, OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISK OF EQUINE ACTIVITIES. I hereby agree to release, indemnify, and hold harmless, USDF, its instructors. Officers, directors, agents, and volunteers from and against any and all loss, liability or damage arising from or because of, or in connection with participation in this competition or related activities. I also hereby agree to release, indemnify, and hold harmless, the competition licensees, show management, show staff, show committee and members, officers, directors, agents, and volunteers from and against any and all loss, liability or damage arising from or because of, or in connection with participation in this competition or related activities. MEMBERSHIP STATEMENT

Life, senior active and junior active members shall be eligible to participate in all classes at Regular Competitions, Eventing Competitions at the Preliminary Level or above and Combined Driving Competitions at the Advanced Level, Dressage, Reining and Vaulting Competitions and Endurance Rides. A nonmember may participate as a handler, rider, driver, owner, lessee, agent, coach or trainer at Regular Competitions, Eventing Competitions, Dressage Competitions, Reining Competitions and Combined Driving Competitions upon payment of a $30 nonmember registration fee. Participants in the following classes are exempted from the Requirements of this rule: 1) leadline; 2) exhibitions; 3) games and races; 4) classes for 4-H members; 5) walk trot and academy classes (academy classes are classes limited to horses used regularly in a lesson program); 6) USDF introductory level tests, pas de deux and quadrille classes; 7) NRHA Endorsed Reining Competitions. 8) Opportunity classes, 9) citizens of other nations who have proof, in English, of current membership in good standing of their own National Federation, 10) USEA beginner novice division; and 11) assistant handlers in Dressage Sport Horse Breeding classes.

Federation Entry Agreement

By entering a Federation-licensed Competition and signing this entry blank as the Owner, Lessee, Trainer, Manager, Agent, Coach, Driver, Rider, Handler, Vaulter or Longeur and on behalf of myself and my principals, representatives, employees and agents, I agree that I am subject to the Bylaws and Rules of The United States Equestrian Federation, Inc. (the “Federation”) and the local rules of San Antonio Spring & Fall (Competition). I agree to be bound by the Bylaws and Rules of the Federation and of the competition. I will accept as final the decision of the Hearing Committee on any question arising under the Rules, and agree to release and hold harmless the competition, the Federation, their officials, directors and employees for any action taken under the Rules. I represent that I am eligible to enter and/or participate under the Rules, and every horse I am entering is eligible as entered. I also agree that as a condition of and in consideration of acceptance of entry, the Federation and/or the Competition may use or assign photographs, videos, audios, cable - casts, broadcasts, internet, film, new media or other likenesses of me and my horse taken during the course of the competition for the promotion, coverage or benefit of the competition, sport, or the Federation. Those likenesses shall not be used to advertise a product and they may not be used in such a way as to jeopardize amateur status. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropriation. The construction and application of Federation rules are governed by the laws of the State of New York, and any action instituted against the Federation must be filed in New York State. See GR908.4

Federation Release. Assumption of Risk, Waiver and Indemnification

This document waives important legal rights. Read it carefully before signing.

I AGREE in consideration for my participation in this Competition to the following: I AGREE that “the Federation” and “Competition” as used herein includes the Licensee and Competition Management, as well as all of their officials, officers, directors, employees, agents, personnel, volunteers and Federation affiliates. I AGREE that I choose to participate voluntarily in the Competition with my horse, as a rider, driver, handler, vaulter, longeur, lessee, owner, agent, coach, trainer, or as parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sports 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 hold harmless and release the Federation and the Competition from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm of any nature caused by me or my horse to others, even if the Harm arises or results, directly or indirectly, from the negligence of the Federation or the Competition. I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of the Federation or the Competition. I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the Federation and the Competition and to hold them harmless with respect to claims for Harm to me or my horse, and for claims made by others for any Harm caused by me or my horse while at the Competition. I have read the Federation Rules about protective equipment, including GR801 and, if applicable, EV114, and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that the Federation strongly encourages me to do so 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 represent that I have the requisite training, coaching and abilities to safely compete in this competition. I AGREE that if I am injured at this competition, the medical personnel treating my injuries may provide information on my injury and treatment to the Federation on the official USEF accident/injury report form.

BY SIGNING BELOW, I AGREE to be bound by all applicable Federation Rules and all terms and provisions of this entry blank. NO ENTRY IS COMPLETE WITHOUT ALL REQUIRED SIGNATURES! (WRITING “SAME” IS NOT A SIGNATURE!) Rider/Handler (Mandatory)

Owner/Agent/Lessee(Mandatory)

Trainer (Mandatory)

Coach (If Applicable) (include USEF#)

(parent/guardian if under 18) Signature

Signature

Print Name

Parent/Guardian Signature: (Req’d if rider is a minor) _____________________________________ Print Name:_______________________________________ RIDER EMERGENCY CONTACT INFORMATION (Mandatory) in case of injury to rider Name of Contact/Relationship to Rider

Telephone Number

Bridle #

Great Southwest Equestrian Center

NOTES

www.gswec.com

Competition Name: GSEC Platinum Classic II Competition Date(s): October 9, 2011 Closing Date: September 12, 2011 (postmarked date) Name of Horse

Previous Name (if any)

Breed

Sex

Sire

Color Dam

Height

USDF # _____________________

Class #

USDF #

Year

Dam Sire

OWNER: _________________________________________________ USEF # ____________________

USEF #

Coggins (Blood drawn on date)

Country of Birth

Div

For Sale?

Breeder

Qual Y/N

Class Description

Fee

Class & Qualifying Total:

USDF # _____________________

Birthdate_______________

Office Fee Mandatory for each horse/rider entry USEF Fee Mandatory for each horse competing

$7 Drug / $8 USEF Fee = $15 Stall Fee ____ Stall @ $99 (2 bags bedding incl)

$30 $15

Tack Stalls ____ Stall(s) @ $75 per stall Bedding _____Bags @ $11 per Bag USEF Non-Member $30 per rider/owner/trainer

TRAINER:________________________________________________ USEF # ____________________

Fees

Other Required Fees

USDF Non-Member Fee $25 per rider/owner

USDF # _____________________

Address: _________________________________________________

USDF Affidavit Fee $5 if reqâ&#x20AC;&#x2122;d Non-Compete Horse $30 (must pay Office Fee)

City: __________________________ State: ______ Zip: __________

Grounds/Haul in Fee $35 (if no stall)

Tel: ________________________ Cell: ________________________

Late Fee $35 / Change Fee $15

Email: ___________________________________________________

Incomplete Entry Fee $20 Other _______________________________

COACH:_________________________________________________ USEF # ____________________

Other _______________________________

TOTAL FEES:

USDF # _____________________

Tel: ________________________ Cell: ________________________

REMEMBER to attach copies of cards & coggins. Reverse side must be SIGNED! Stabling Information & Special Requests: Please list only one group name (either individual or barn) for entire group. Group/Farm/Self Horse Stall (Horse Name) Barn/Stall Preference Group Name:

Wed

Thu

Fri

Sat

Tack Stall(s) Contact:

Tel:

Sun

Mon

Federation Entry Agreement

Federation Release. Assumption of Risk, Waiver and Indemnification

This document waives important legal rights. Read it carefully before signing.

Owner/Agent/Lessee(Mandatory)

Trainer (Mandatory)

Coach (If Applicable) (include USEF#)

(parent/guardian if under 18) Signature

Signature

Print Name

Telephone Number