ENTRY FORM
Checks payable to: GSEC 2501 South Mason Rd., Ste. 100 Katy, TX 77450 Fax # 281-578-6651
Great Southwest Equestrian Center Open Horse Show July 3, 2011
NAME OF HORSE
OWNER _________________________________ Name
COGGINS Acc. #:____________ Date: _______ Lab:________ Horses GSEC number________
_________________________________ Address
_________________________________ City, State, Zip
CLASSES
RIDER ___________________________ ____ Name
Age
_________________________________ Address
_________________________________ City, State, Zip 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
Entries received before NUMBER (office use only) Wednesday 6/29/2011 will receive a $10 ENTRY FEES credit. Entries received after Friday, 07/01/2011 ______STALLS @ $30.00 Includes one bag of shavings will pay $10.00 late fee. _____GROUNDS FEE $30.00 ______CLASSES @ $10.00 ALL DAY FEE @ $50.00 PAYMENT IS NOT NON—SHOWING FEE @ $20.00 MUST ALSO PAY GROUNDS/STALL REQUIRED UNTIL BACK FEE NUMBER IS PICKED UP OFFICE FEE @ $10 per entry FROM SHOW ANNUAL (ONE TIME) GSEC SECRETARY ASSOCIATIONFEE @ $20
___ADDITIONAL SHAVINGS $11.00 PLEASE STABLE WITH:
RV HOOKUP @ $30.00/NIGHT LATE FEE @ $10.00
EARLY DISCOUNT $10.00 TOTAL Trainer’s Name Trainer’s Signature
Where a minor exhibitor has no trainer, parent or guardian must sign and assume responsibility
Exhibitor Signature
Emergency Contact Cell Phone No
(Must be signed by exhibitor, owner or his agent.)