Roanoke Valley Pony Club

Intent To Rate Form

I, __________________________, a member in good standing of Roanoke Valley Pony Club, wish

to be considered for the rating test for ________, scheduled for .

Rating Level Date

• I have turned in this Intent to Rate form at least 30 days prior to the rating date.

• I verify that I will take responsibility for demonstrating competency in all requirements of this rating level by submitting my flow sheet, initialed by the DC, Jt. DC, or pony club instructor, with this intent to rate form.

• I promise to be present in a prepared fashion on the date I am invited to rate.

• I understand that I may be responsible for payment for this rating by the date of the rating, even if I must back out of the rating due to lameness, illness, etc., at the discretion of the DC.

____________________________________

Signature of RVPC Member Date

______________________________________________________

Signature of RVPC Parent of Guardian Date

______________________________________________________

Signature of RVPC DC or Jt. DC Date