Schooling Dressage Show
White Rose Equestrian, 1966 Magnolia Grove Road, Iron Station, NC 28080
(704) 559-9122
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Date of event *
Rider's Name *
Jr./Sr. *
Age if under 18
Amateur/Professional *
Street Address
Email *
Phone Number *
Horse/Pony's Name *
Tests to be ridden ($35 per class) *
Total money owed ($35 per class) *
Method of payment *
Coggins *
NOTICE: All entrants participate at their own risk and must complete an Equine Activities Waiver. This form can be found on our website at or completed on the day of the event. In the event of an emergency: By completing this form I understand that horseback riding and equestrian related activities can be dangerous. I hereby give permission that I, or my minor child/charge, maybe administered first aid by any representative of White Rose Equestrian should the need arise. I also give permission that I, or my minor child/charge, may be transported to a hospital chosen by any White Rose Equestrian representative, treated by a medical professional, given injections, medication, and/or anesthesia and/or surgery as deemed necessary. I agree to be responsible for any cost that may occur as a result of being treated for any medical condition. *
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