GRS CBHSA Jumper Show Entry Form
Saturday, June 12th, 2021
Email *
Name of Rider *
Rider's CBHSA Number
Name of Mount *
Mount's CBHSA Number
Trainer (Name and Phone Number)
Emergency Contact (Name and Phone Number) *
Division *
Release Acknowledgement: I knowingly, willingly, and voluntarily acknowledge the inherent risks associated with the sport of equestrian and know that horseback riding and related equestrian activities are inherently dangerous, and that participation in any Glendale Riding School Event involves risks and dangers including, with-out limitation, the potential for serious bodily injury (including broken bones, head or neck injuries), sickness and disease (including communicable diseases),trauma, pain & suffering, permanent disability, paralysis and death; loss of or damage to personal property (including my mount & equipment) arising out of the unpredictable behavior of horses; exposure to extreme conditions and circumstances; accidents involving other participants, event staff, volunteers or spectators; contact or collision with other participants and horses, natural or manmade objects; adverse weather conditions; facilities issues and premises conditions; failure of protective equipment (including helmets); inadequate safety measures; participants of varying skill levels; situations beyond the immediate control of the Glendale Riding School Event organizers and competition management; and other undefined, not readily foreseeable and presently unknown risks and dangers (“Risks”). Please click "I agree" below. *
Glendale Riding School requests that all participants abide by farm rules. Your cooperation not only ensures the success of this event, but also ensures that everyone on the property remains as safe as possible. Please acknowledge the following: I understand that, due to social distancing requirements and for the safety of others, I must limit the number of people accompanying me to the show to a maximum of two (2) people. I, and anyone accompanying me, agree to wear a mask while unmounted. We will also maintain a minimum of 6' distance between others on the show grounds at all times. *
We strongly encourage and appreciate online payment for your entries. Our pre-entry window is now closed. All entries submitted June 10th - 12th are $60/division + $25 office fee ($85 total). Payment can be sent to: Click "Chip In" to pay. You can also pay as a guest if you do not have a PayPal Account. Please leave the rider and mount names in the comment box when checking out. **Refunds will be issued for any classes the horse/rider do no participate in.** *
A copy of your responses will be emailed to the address you provided.
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