Event Derby Registration Form
Join us on Saturday, July 11, 2020 at Herron Park!
Please complete this form, print and sign the required Liability Release (
), and send your payment (checks made out to HPE) to show secretary:
Cindy Covington124 LaDoux Drive
Kalispell, MT 59901
Payment should be postmarked or delivered by Tuesday, July 7, 2020 to avoid $15 late fee. Riders will not be given a ride time if fees are not received within two days before the show. You will need to complete one form for each horse. Make sure you click "submit" when you finish filling out the form. All proceeds from this event go to maintaining the jumps and dressage arenas at the park.
*USEF rules will apply as guidelines for all HPE events. ALL riders while mounted must wear ASTM/SEI approved helmet. Body protector vests are strongly encouraged. Every participant must sign release form or have parent/guardian sign if they are less than 18 years old.
Please contact Cindy Covington (
/ 206-551-2113) with any questions or if you would like to volunteer.
Rider's Mailing Address
Rider's Phone Number
Enter N/A if rider is an adult.
Horse Owner's Name and Phone Number
"Kick" Start (ground rails-12" crossrails) Only ground rails and terrain changes for XC; Leadlines welcome! Intro Dressage Test B
Smurf (18"-2') with water option; Intro Dressage Test C
Beginner Novice (2'6"-2'9") with water and ditch options; Beginner Novice Dressage Test B
Novice (2'9"-2'11") with water and ditch; Novice Dressage Test B
Training (2'11"-3'3") with all XC obstacles; Training Dressage Test B
Preliminary (3'3"-3'7") with all XC obstacles; Preliminary Dressage Test C
Individual/Additional Dressage Tests
$20/test for dressage tests only. Current tests for 2019.
USDF Intro Test B
USDF Intro Test C
USEA Beginner Novice Test B
USEA Novice Test B
USEA Training Test B
USEA Preliminary Test B
Repeat/Practice Dressage test
Additional Jumping Rounds
$15/any level, just indicate the number of additional rounds requested (Must be entered in derby to add additional rounds.)
Are you a current FCTA member?
$15 non-member fee or $35/individual to join or $50/family
No, I'll pay the non-member fee.
No, but I'd like to join!
$20/stall/night payable to Flathead County Parks & Recreation
Yes, 1 night
Yes, 2 nights
Camp site needed
$20/night/site payable to Flathead County Parks & Recreation
Yes, 1 night
Yes, 2 nights
Total Amount of Payment Sent
If you are planning on camping and/or using a stall, please send a SEPARATE check made payable to Flathead County Parks and Recreation. Payment needs to be postmarked by Tuesday, July 7th to avoid the $15 late fee. *Remember to add your division ($45), additional dressage/jumping rounds, non-member fee (or new membership), and stabling/camping (separate check).
A copy of your responses will be emailed to the address you provided.
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