Norwegian Fjord Horse Registry

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1 Norwegian Fjord Horse Registry Evaluation Entry Form Herndon, Virginia August 10 th & 11 th, 2013 * * ENTRY CLOSING DATE: June 21, 2013 * * Payment in full with completed and signed entry forms are required for participation and must be received by the NFHR Registrar post-marked no later than June 21, ENTRIES POST-MARKED AFTER June 21, 2013 MAY NOT BE ACCEPTED. Complete BOTH pages in full. Only one horse per entry form. Please make extra copies as needed. Please type or print the following information: NFHR Registered Name of Horse NFHR Registration Number ( ) Owner s Telephone Numbers: Owner Name (must be NFHR member in good standing) ( ) Owners Fax Number Owner s Street Address Owners City State/Prov Postal Code Owners address Exhibitor Name Signature of Owner is Required for Entry If Exhibitor not Owner, Signature of Exhibitor is Required for Entry I hereby enter my horse into the NFHR Evaluation at my own risk and agree to abide by the rules and regulations of this event. I agree that if any injury occurs to me, my attendants, my horse or my equipment, I will make no claim against the NFHR, the local sponsoring group, or any of the Officers, Directors, Officials or Trustees of either. Further, I will hold them harmless from any liability claims, suits or damages of whatever kind that may be occasioned by the horse owned by me or the person in charge of such horse and I agree to indemnify and hold harmless these organizations and individual agents of any and all liability, claims, suits and expenses including any attorney fees incurred arising out of any injury to any person or damage to property caused by me, my horse, equipment, or attendants. I give my permission for the evaluation results, photographs and/or videos of my horse to be published by the NFHR. Horses being evaluated are required to be DNA typed & microchipped for positive identification. If your horse is not DNA typed or microchipped then please order on the next page. No microchipping or DNA typing will be done at the Evaluation site. Coggins: A copy of a negative Coggins test, current within 12 months of the date of the Evaluation, must be received by the NFHR Registrar post-marked no later than August 1, Copy of negative Coggins attached: Yes No To follow

2 NFHR Registered Name of Horse: Stabling: Two bags of shavings for the horse stalls will be provided. Additional shavings will not be available on site please pre order. Stalls will be cleaned after the event by the site personal you do not need to strip your stall before you leave. Entry Fees: (No Post Entries) Conformation Evaluation < 36 months old Conformation Evaluation > 36 months old Introductory Performance Tests (Each) Advanced Performance Tests (Each) Family Fjord Tests (Each) $45.00 $60.00 Please Circle Tests Entering: $60.00 Ride-W Ride-E Drive Draft X # of Tests $60.00 Ride-W Ride-E Drive Draft X # of Tests $60.00 Foundation Ground Driving X # of Tests Totals: NFHR Processing Fee (One fee per horse, includes recording fee photo for Record Book & required Insurance) $30.00 $30.00 Additional Items that may be required: DNA Type Kit $60.00 Microchip $25.00 Printed Evaluation Handbook (can be downloaded from NFHR web site for free) $25.00 Site Fee: $50.00 One fee per horse. $50.00 Stall Fee for Evaluation (Friday Sunday; see cover letter) - $60.00 Tack Stall for Evaluation (Friday $45.00 Sunday; see cover letter) Please make all checks payable to NFHR. TOTAL FEES: Evaluation Application Checklist: Application Form Mail application materials & fees in US funds to: (Checks or credit cards accepted. Please return the credit card payment form if using a credit card.) Check for Entry Fees Current Coggins NFHR Evaluation - Herndon 1801 W. County Rd 4 Berthoud, CO registrar@nfhr.com

3 Norwegian Fjord Horse Registry Credit Card Payment Form Credit Card Type (Circle One): Name as it appears on Card: Credit Card Number: Credit Card Expiration Date (Month/Year): Security Code(Three-digit code on the signature panel): Credit Card Billing Adddress: City: State: Zip Code: Amount to be charged (U.S. Dollars):_$ Description of Purchase: I, the undersigned, guarantee that I am the authorized bearer of credit card listed above and hereby authorize the Norwegian Fjord Horse Registry to charge this card for the amount listed above. Furthermore, I understand that my authorization for this charge constitutes an agreement, solely between myself and the credit card issuing company, to fully pay the amount charged. I therefore indemnify and hold the Norwegian Fjord Horse Registry harmless against any liability pursuant to this authorization. I understand that this information will be securely maintained by the NFHR solely for the purpose of authentication by the credit card issuing company and will be properly destroyed upon verification of the receipt of funds. Signature: Date:

4 NFHR Virginia Fjord Horse Evaluation Contact: Curtis Pierce Margaret Bogie 537 Fjord Ridge Dr 4632 Sutton Oaks Drive Mathias WV Chantilly, VA Phone: (304) Phone: (540) Enclosed is your entry form for the Norwegian Fjord Horse Registry (NFHR) Evaluation at the Frying Pan Park in Herndon, Virginia the weekend of August 10-11, If you are bringing more than one horse, feel free to copy the entry form or download more copies from Please complete an entry form for each horse you are bringing. ALL ENTRIES MUST BE POSTMARKED BY June 21, 2013 IN ORDER TO PARTICIPATE. To be eligible for Evaluation, a Fjord must: be owned by an NFHR member, be registered with the NFHR have been DNA typed, be microchipped, and have a negative Coggins report. The DNA typing kits and microchips are available from the Registrar, Jeanne Poirier, and she is the person to contact if you have questions regarding your Fjord s status on any of the first five items. Jeanne s phone number is and his is registrar@nfhr.com. There are some important evaluation documents on the NFHR website's Evaluation Program page, including the Evaluation Handbook. All owners and handlers are responsible for knowing and following the rules as described in the Revised 2008 NFHR Evaluation Handbook. The handbook may be downloaded FREE from the site, or if you prefer, Jeanne can mail you a printed copy for a fee of $25. The officials at this time are: (If needed, substitutions may be made.) Evaluators: TBD Technical Delegate: Jeanne Poirier Host Committee: Curt Pierce, Margaret Bogie, Marsha Korose, Tom Snyder and Sue Freivald Veterinary on Call: Deepwood Veterinary Service Farrier on Call: Brian Porter Official Photographer: Erin DeSantis, Reflections of Light Photography,

5 Location Frying Pan Park is located at 2705 West Ox Road, Herndon, VA It s about 25 miles west of Washington, DC. Directions from the North: Take I-95 South to 495 toward Northern Virginia, exit onto Rt. 267 West (toll), exit Elden Street west, left at light on West Ox Road, left into Frying Pan Park. Directions from the West: Take I-66 East to Rt. 28 North, exit Rt 668 (McLearen Road) east, left on Centreville Road, right on West Ox Road, left into Frying Pan Park. Directions from the South: Take I-95 North to Rt. 123 (Ox Road) to Rt (Fairfax County Parkway) west, exit left on West Ox Road, turn right into Frying Pan Park. Directions from the East: Take I-66 West to Rt. 28 North, exit Rt. 668 (McLearen Road) east, left on Centreville Road, right on West Ox Road, left into Frying Pan Park. Hotels and Food Frying Pan Park offers limited RV hook-ups and no camping facilities. However, there are many hotels to choose from within 5 miles of the park in Herndon, Reston and Chantilly, VA. Recommended hotels include: Crowne Plaza Dulles Airport Candlewood Suites Staybridge Suites 2200 Centreville Road Sunrise Valley Drive Coppermine Road Herndon, VA Herndon, VA Herndon, VA ($80 - $170 per night) ($55 - $105 per night) ($70 - $180 per night) These hotels are within 2 miles of Frying Pan Park and is the closest hotels to the facility. The Crowne Plaza has a full service restaurant and bar, heated indoor swimming pool, health club, and free wi-fi service. The two Suites hotels offer kitchens and continental breakfast. Be sure to ask for the Frying Pan Park rate when making your reservation. Most local hotels give discounts for people attending horse shows at the Park on weekends. There will be an on-site food concession stand at the Evaluation on Saturday and Sunday. Frying Pan Park is located within a short driving distance from several shopping centers which includes a grocery stores, fast food establishments and restaurants. Stabling Your stabling fee ($60 for the Evaluation), includes a departure stall clean-out. Stabling anticipates arrival from noon on Friday and departure by 6 p.m. on Sunday. All stalls will be assigned. Tack stalls are available for $45 for the Evaluation period. Stalls are matted. Aisle space is limited and not secure. Shavings and hay can be pre-ordered for delivery to the Park. Please contact Margaret Bogie (mabogie@aol.com) for more information. There are no nearby vendors for shavings or hay; please order delivery or bring your own. Frying Pan Park features a recently built modern barn with wash stalls. It has two outdoor rings, an indoor ring, and a cross country course. Evaluation participants may use the facilities at no additional cost while attending the evaluation.

6 Schedule of Events Tentatively, the Evaluation will be start on the morning of Saturday, August 10, with conformation tests and some performance tests. The remaining Performance tests are scheduled for Sunday, August 11. However, the number and type of entries will determine the final schedule.. A FINAL SCHEDULE AND EXHIBITORS PACKET WILL BE ED TO ALL PARTICIPANTS AFTER ENTRIES CLOSE. If you have special scheduling and stabling, please contact Margaret Bogie (mabogie@aol.com) as she will be assembling the stabling assignments and schedule. We will try to accommodate everyone s requests where we can do so. On Saturday at 8 a.m., there will be a meeting of the participants. This is primarily an informational session to review the day s schedule and answer any questions. The Evaluators and TD will attend this meeting. Please encourage anyone you know who is interested in the breed to come to the Evaluation. It is an educational event that is open to the public. There will be an audience for the tests. We are looking forward to seeing you in August. Please contact us if you need more information about the evaluation. Curt Pierce (304) cepinwv@yahoo.com Margaret Bogie (540) mabogie@aol.com

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