Stone Gate Farm Jumper Show  ~  Entry Form
Competition Dates:           Sat. Oct 3    

Tues. Sept 29                                                                                            
                                         
This is the official on-line entry form for the Jumper Show
ALL fields with a RED * must be filled out or you will not be able to submit your entry form
                                                       
Pre-entries close the Tues before the competition          

NOTE: Post entries are an additional $5/class
Additional 'hors concours' rounds (not for competition rounds can be added for $10 each
More information can be found at www.stonegatefarm.org 
ALL Credit Card Payments will be sent an invoice
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Entry Form ~ ONE Horse / Rider per form
PLEASE NOTE: entries received after closing date will be $5 more /class
First Name *
Last Name *
Horse's Name *
Address: *
E-mail *
by giving e-mail you agree to receiving informatin from Stone Gate Farm.  If no e-mail list 'none'
Home Phone *
Cell Phone *
if no cell phone enter 'none'
Emergency Contact Info *
Person to contact in case of energency: Name, Cell #, relationship
Entries
Intro Classes - Cross Rails to 1'
check all that apply
Starter Classes - Fences approximately 2'
check all that apply
Beginner Novice Classes - Max height 2'7"
check all that apply
Novice Classes - Max height 2'11"
check all that apply
Training Classes - max height 3'3"
check all that apply
Preliminary Classes - max height 3'7"
check all that apply
Bareback Gambler's Choice - fences raning in height from 2'3" - 2'9"
check all that apply
Stabling
Please be advised that no bedding will be provided.  All orders for bedding must be reserved by the Wed before the competition
Stable with ....
If you want to stable with a group please use ONE name for the group
Fees
Cross Country Schooling - Sat Oct 5th
Jumper Entries
     Pre-entry ~ $10/class
Derby Entry Fee: $25

Post Entry ~ $5/class for any entry received after the Tues Oct 1st preceding the competition
Additional Rounds ~ (not in competition) $10/round
Stabling: $25
Bedding:
         Straw $3/bale
         Shavings $7 / bag
Stall Cleaning Service: $10
Transaction Fee: $7 required if paying on-line

Jumper Classes - Pre-entry May 13 or before
Enter Amount ~ # of classes x $10
Jumper Derby  - Pre-entry May 13 or before
Entry fee $25
Post Entry Jumper Classes - After May 21st Closing Date
Enter Amount ~ # of classes x $15
Post Entry Jumper Derby - after May 21st  Closing Date
Enter Amount ~ # of classes x $30
Additional Rounds (not in competition)
Enter $10
Stabling
Enter $25
Bedding - Shavings
Enter Amount ~ Number bags x $7
Bedding - Straw
Multiply the number of bales x $3
Stall Cleaning Service
Enter $10 to have your stall stripped so you don't have to
Transaction Fee:
Enter $7 for those paying via PayPal or Credit card or $0 if mailing fees
Total fees: *
Payment Options
You may pay on-line via Pay Pal or Credit Card (you do not have to have a Pay Pal account) OR submit the registration form electronically and mail a check payable to Stone Gate LLC and mail to:
                                                                                     Jackie Smith 31407 Schneider Rd.
                                                                                     Hanoverton, OH 44423

Method of Payment *
For those Paying by Credit Card; an Invoice will be e-mailed
Required
Release Form
Release: I understand that this is a high-risk sport and am participating at my own risk. I hereby assume the risk and further do hereby release and hold harmless the Organizer, Organizing Committee, employees, volunteers, and the hosts of the event, Dave and Jackie Smith, from all liability for negligence resulting in accidents, damage, injury, or illness to myself, my property, including the horse or horses which I will ride in this clinic.
Electronic Signature AND Date *
By entering name you agree with the above release. If under 18, must be entered by a parent or guardian
Notes:
- $20 stall cleaning check is required of stabled horses (separate check - do NOT pay on line)
- Not required if paying for the stall cleaning service.
- This is a very relaxed competition / clinic and braiding and formal attire is NOT required
- Safety vests are required for Cross Country
- Medical armbands are recommended and are required by any junior whose parent is not on the premisses or an adult traveling alone

More information will be available @ www.stonegateafrm.org 
If you are having any problem with this form or if you have any questions please contact:
organizer@stonegatefarm.org  or call 330-222-2089
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