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Pre-Registration for September 9, 2017 Keezlenutten Beginner Show

To pre-register for the September 9, 2017 beginner show, please fill out the following form for each horse/rider combination.

*Current negative Coggins form MUST be presented for each horse/pony entered*

Rider Name

Owner Name

Address

City  State  Zip

Phone

Person Responsible for Payment

Email address - MAKE sure to fill this out or you will get an error. This will allow a copy of your registration to be sent to you as well.

Classes Entered

1. Just Starting Jumpers

2. Just Starting Jumpers

3. Just Starting Jumpers

4. Puddle Jumpers - 2'-2'3"

5 . Puddle Jumpers - 2'-2'3"

6. Puddle Jumpers - 2'-2'3"

7. Novice Jumpers - 2'3" - 2'6"

8 . Novice Jumpers - 2'3" - 2'6"

9. Novice Jumpers - 2'3" - 2'6"

10. Low Jumpers 2'9" - 3'

11. Low Jumpers 2'9" - 3'

12. Low Jumpers 2'9" - 3'

13. Just Starting Equitation

14 . Just Starting Equitation

15. Just Starting Equitation

16 . Beginner Equitation

17 . Beginner Equitation

18 . Beginner Equitation

19. Intermediate Equitation A (Walk/Trot/Individual Canter)

20. Intermediate Equitation A (Walk/Trot/Individual Canter)

21. Intermediate Equitation A (Walk/Trot/Individual Canter; 4 jumps)

22 . Intermediate Equitation B (Walk/Trot/Canter in small groups)

23. Intermediate Equitation B (Walk/Trot/Canter in small groups)

24. Intermediate Equitation B (Walk/Trot/Canter in small groups; 8 jumps)

25. Intermediate Equitation B (Walk/Trot/Canter in small groups; 8 jumps)

26. Beginner Pleasure W/T

27. Beginner Pleasure W/T

28. Beginner Pleasure W/T/C

29. Open Equitation

30. Open Equitation

31. Open Equitation

32. Open Pleasure

33. Open Pleasure

34. Open Pleasure

35. Beginner Hunter

36. Beginner Hunter

37. Beginner Hunter

38. Hopeful Hunter

39. Hopeful Hunter

40. Hopeful Hunter

Entry Fees:

Classes are $10.

I AGREE in consideration for my participation in this competition to the following:

I AGREE that I choose to participate voluntarily in the competition with my horse, as rider, driver, handler, lessee, owner, agent, coach, trainer, or as parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sports and the Competition involve inherent dangerous risk of accident , loss and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death (“harm”).

I AGREE to release Keezlenutten Farm, LLC from all claims for money, damages or otherwise for any “harm” to me or my horse for any “harm” caused by me or my horse to others, even if the “harm” resulted, directly or indirectly, from the negligence of Keezlenutten Farm, LLC and the Competition.

I AGREE to indemnify (that is, to pay any losses, damages or costs incurred by) Keezlenutten Farm, LLC and the Competition and to hold them harmless with respect to claims for “harm” to me or my horse, and for claims made by others for any “harm” caused by me or my horse at the competition.

If I am a parent or guardian of a junior exhibitor, I consent to the child’s participation and AGREE to all of the above provisions and AGREE to assume all of the obligations of the Release on the Child’s behalf.

I AGREE that Keezlenutten Farm, LLC and the Competition as used above includes all of their officials, officers, directors, employees, agents, personnel, volunteers and affiliated organizations.

BY SUBMITTING THIS FORM, I further AGREE to be bound by all of the Keezlenutten Farm, LLC and the Competition Rules and all terms and provisions of this entry blank.

 

 

 

 

 
   

 

 
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Keezlenutten Farm, LLC 
Lessons: 3442 Keezlenutten Lane, Keezletown, VA 22832
Trails: 3224 Caverns Drive, Keezletown, VA 22832
Send us an email * (540) 269-2227