Barre Riding and Driving Club Scholarship Horse Show June 25th 2017 Pre-Entry Form
To be considered a pre-entry you must complete the two following requirements:

1. Complete the following pre-entry form no later than Friday, June 23th.
(You can still complete the paper copy of the pre-entry form and mail that if you prefer)

2. Mail or deliver payment to Jill Poulin no later than Saturday, June 24th.
(Any entry submitted that DOES NOT deliver payment on or before Saturday will not be counted as a pre-entry and the $10 post entry fee will be included when paying on the day of the show.)

A copy of the show class list and the rules and regulations can be found on the Barre Riding and Driving Club Website http://www.barreridingdrivingclub.com/ (links can be found below)

PLEASE TAKE INTO CONSIDERATION ALL OF THE WORK THAT GOES IN TO ADDING PRE-ENTRIES, PLEASE DO NOT SUBMIT A FORM UNLESS YOU ARE CERTAIN YOU WILL BE ABLE TO COME TO THE SHOW AND THAT YOU ARE ABLE TO GIVE THE PAYMENT BY SATURDAY! THANK YOU!!

To be considered a pre-entry you must submit this form no later than Friday, June 23th. Payment must be mailed or delivered to Jill Poulin (351 Old Petersham Rd., Barre, MA 01005) no later than Saturday, June 24th. In the event that payment is not received by Saturday, June 24th the rider is responsible for paying the post entry fee of $10 on the morning of the show. *
Required
RIDER INFORMATION
Rider Name (First and Last - as you want it announced on the day of the show) *
Your answer
Horse Name (to be announced on the day of the show) *
Your answer
Rider Mailing Address (Street Address &/or PO Box) *
Your answer
Rider Mailing Address (Town, State & Zip) *
Your answer
Rider (or Parent/Guardian) email address *
Your answer
Farm Name (if applicable)
Your answer
Class/Division Selection Section. Select all of the classes you will participate in on the day of the JUNE 25 show. (these are split by ring number, time of day, and division)
RING ONE AM Class Selections
Please select the classes the rider will participate in by checking the box next to the class number/name)
Regular Classes $10
Championship Classes $12
Please Select the classes you will compete in.
RING ONE PM Class Selections
Please select the classes the rider will participate in by checking the box next to the class number/name)
Regular Classes $10
Championship Classes $12
Please Select the classes you will compete in
RING TWO AM & PM Class Selections
Please select the classes the rider will participate in by checking the box next to the class number/name)
Regular Classes $10
Please select the classes you will compete in
Barre Mini Prix
$15.00 Class Fee
Prize Money Awarded (please see the class list for amounts)
RING TWO Barre Mini Prix
Total Amount you owe
RIDER NUMBER FEE: A Non-refundable number fee of $1.00 is due with the entry fee (paid once unless the rider number is lost.) *
Required
Secretary Fee: A $5.00 non-refundable secretary fee is due with the entry fee *
Required
TOTAL AMOUNT DUE: Please write the total amount to be paid for the entire Entry. (Each Regular Class is $10 per a class, each Championship Class is $12 per a class, number fee $1 and Secretary fee $5) *
Your answer
ALL RIDERS MUST COMPLETE THIS SECTION
Please read the following statements and check the box indicating your understanding and acceptance of each statement. A check in the box will be used as an electronic signature of the rider or the parent/guardian if the rider is under 18 years of age.
Warning - Under Massachusetts Law, an equine Professional is not liable for any injury to, or death of, a participant in equine activities, resulting from the inherent risks of equine activities, pursuant to Chapter 128, Section 2D of the General Laws, I hereby enter the above horse at my own risk. I understand that horses can be excitable, unpredictable, and difficult to control. I do hereby release, today and forever, The Town of Barre, Felton Field Commission, Horse Show Committees, The Barre Riding & Driving Club, Central N E Equine Rescue, and New England Equestrian Center of Athol and it's representatives from any suits or charges from any accident. *
Required
The Barre Riding and Driving Club takes photographs of all events which may include photographs of attendees and participants. By completing and submitting this form, you hereby give permission to Barre Riding and Driving Club to use your name and photographic likeness, and the name and photographic likeness of your minor child(ren), if any, in all forms and media for advertising, trade, and other lawful purposes. *
Required
COGGINS
ALL ENTRIES MUST INCLUDE A COPY OF THE HORSE'S CURRENT COGGINS TEST

Please send a copy of the current coggins to barnesj4@yahoo.com. (You still need to bring your coggins with you on the day of the show.)

Coggins Number *
Your answer
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