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(FOR OFFICE USE: Coggins _____ Rabbies _____ NUMBER ASSIGNED _______________)
The Sandwich Fair 2012
GYMKHANA ENTRY FORM
ENTRY FEE $9.00 per class. Stake Classes $10.00
Entries received after September 30th - 11.00 per class. Stake Classes $12.00
Please make checks payable to SANDWICH FAIR Gymkhana.
(PLEASE PRINT)
NAME OF RIDER:_____________________________________________________________AGE:_______
MAILING ADDRESS_______________________________________________________________________
CITY___________________________________________STATE___________________ZIP______________
PHONE__________________________________NAME OF HORSE________________________________
E-Mail:_________________________________________________
(Incomplete entry forms will forfeit premium payments)
CIRCLE ALL CLASSES ENTERED
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Adult Classes
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Youth Classes
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2.
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Dash Race
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3
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Dash Race
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6.
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Pole Bending
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7.
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Pole Bending
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12
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Barrel Race
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13
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Barrel Race
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16
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Speed Barrels
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17
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Speed Barrels
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Open Classes
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Pairs Classes
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1.
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Key Hole Race
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4.
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Pony Express Race
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5
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Big T Race
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9
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Texas Poles
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10
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Sandwich Poles
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11
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Ribbon Race
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18
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Sit-A-Buck
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15
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Fox and Hound Barrells
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$100 Stake Classes*
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*14
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$100 Barrel Race
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*8
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$100 Pole Bending
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* Must enter at least four other classes to enter the $100 stakes classes.
CURRENT COGGINS AND RABIES NEEDED TO COMPETE
ATTENTION
Under New Hampshire Law, a participant in equine activities assumes the risk of any injury, harm, damage, or death and any legal responsibility that may occur to participant resulting from the inherent risks associated with equine activities. Pursuant to R.S.A. 508:19, equine professionals are not liable for damages resulting from inherent risks of equine activities.
NOTE: The State of New Hampshire will be randomly appearing and selecting animals to test.
I understand that riding horses can be a dangerous activity. Therefore, I agree to hold blameless for any accidents that may occur at this activity the organizers and sponsors of the activity, including but not limited to the Sandwich Fair Association, and the Sandwich Fair Gymkhana Committee. I further agree to abide by the rules for the show and by all policies and decisions of the Sandwich Fair Gymkhana Committee.
EXHIBITOR SIGNATURE___________________________________ DATE________________________
PARENT OR GUARDIAN ___________________________________ DATE________________________
$5 office fee + (# classes ___X fee_____) + (Stake @ $12 X) = TOTAL FEE _________
PAID _____________ Check Number____________
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