Keystone Saddle Club 2009 Pleasure Show Series Entry Form ONE ENTRY PER HORSE/RIDER COMBINATION Back Number:__________ KSC  member: yes   no        Date:___________
Name of Horse:		Gender:	Age of Horse:
Breed:		Reg #:
Exhibitor’s Name:		Phone #:	Age of Jan 1st:
Address:		City:	State:
		Zip:	Email:
Owner’s Name:		Phone #:	Age of Jan 1st:
Address:		City:	State:
		Zip:	Email:

 

 

 

 

 

 

 

 

 

 

 

Regular Non Jackpot Classes- $3.00 per class Please circle or place an X to the classes you are entering. 2. 3. 4. 5. 6. 7. 8. 9. 10. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 28. 29. 31. 32. 34. 35. 36. 37. 38. 39. 40. 41. 42. 43. 44. 45. 46. 47. 48. 49. 50. 51.

100% Jackpot Classes-$10.00 per class 1. 6. 11. 30. 33.   $500 W/T Jackpot Class-$25.00 entry fee 27. SHOW FEES _______classes @ $3.00 $______________ _______classes @ $10.00 $______________ _______class @ $25.00 $______________ Grounds Fee $ 2.00 Office Fee $ 3.00 Total Fee $______________ Paid By: Cash Check #__________________ Received by:______________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

Keystone Saddle Club Release, Assumption of Risk, Waiver and Indemnification Entry Agreement, must be signed

I AGREE that I choose to participate voluntarily in the competition as a rider, coach, handler, driver, lessee, owner, trainer, or as a 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 "Harm"

I AGREE to release Keystone Saddle Club for all claims for money damages or otherwise for any Harm to me or my horse and for any Harm caused by me or my horse to others, even if the Harm resulted directly or indirectly from the negligence of Keystone Saddle Club 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 competition or Keystone Saddle Club. I AGREE that Keystone Saddle Club strongly suggests using ASTM/SEI approved helmets for safety. If I am the parent or guardian of a junior exhibitor, I consent to the child’s participation and AGREE to assume all of the obligations of this Release on the child’s behalf. I AGREE that the Keystone Saddle Club and "Competition" as used above includes all of their officials, affiliated organizations, officers, volunteers, members, and employees.

BY SIGNING BELOW, I AGREE to be bound by all applicable Keystone Saddle Club rules and all terms and provisions of this entry form.