A MIDSUMMER DAY S DRESSAGE SHOW

Transcription

1 A MIDSUMMER DAY S DRESSAGE SHOW OPPORTUNITY CLASSES NOW OFFERED! CASH PRIZE AT EACH LEVEL! TRAINING - FEI FOR ALL DIVISIONS CDS USDF USEF Level 2 Rated CDS Pomona Chapter Sponsored Show Maverick Ridge Riders Arena 330 South Citrus Street West Covina, CA Judges: David Schmutz (S) & Kathy Pavlich (R) Contact: Dhana Holck, (714) August 5, 2018 Entries Must be Received by July 26, 2018 Featuring: Freestyle Test of Choice & Pas de Deux Dressage Seat Equitation Classes 2018 CDS-Pomona Chapter Year-End Awards Qualifier O-A-Jr High Score Awards Materiale Classes

2 A MIDSUMMER DAY S DRESSAGE SHOW Sunday, August 5, 2018 Maverick Ridge Riders Arena West Covina, California 2018 CDS-Pomona Chapter Year-End Awards Qualifier DRESSAGE SHOW JUDGES Judge: David Schmutz...(S)... California Judge: Kathy Pavlich...(R)... California Doris North...Technical Delegate... California SHOW OFFICIALS Show Manager:...Dhana Holck... (714) Show Secretary:...Diana Muravez... (760) Day of Show:...Diana Muravez... (951) Show Approvals: CDS USDF USEF Level 2 Rated Show Volunteers:...Dhana Holck... (714) Video...Kingdom Video:... (310) Veterinarian (on call):...dr. Don Vrono, DVM... (909) Farrier (on call):...tba EMT...Amanda Waterfield-Gibson... (909) All entries close and must be RECEIVED by Thursday, July 26, 2018 Entries received after this date will be subject to the $20.00 late fee. Entries changed after this date will be subject to the $35.00 change fee. Mail entries to: Diana Muravez 2552 Los Cerritos Lane Fallbrook, CA Make Checks Payable To: CDS-POMONA CHAPTER

3 RULES AND INFORMATION All Pomona Chapter Dressage Shows and every class offered herein which is covered by the rules and specifications of the current USEF Rule Book and will be conducted and judged in accordance therewith. ENTRY PROCEDURE: Entries must be made on an official entry form and must be filled out completely, including all classes entered, all signatures, organization membership numbers and fees. Make copies of both sides if you need more than one entry form. Only one horse/rider combination per entry form. Please make checks payable to CDS-POMONA CHAPTER. Please be sure to put correct class numbers on entry form. Any entry errors will not be changed after closing date. Please include a photocopy of current CDS, and if applicable, USEF, and USDF membership cards. Entries are accepted on a first-come, first-served basis until classes are filled. All entries received after the closing date will be accepted only if schedule permits. Each late entry shall be assessed a late fee of $ Any entry changed after the closing date will be accommodated at Horse Show Management s sole and absolute discretion and will incur a $35.00 change fee. Riders will ride with their classes, unless riding multiple horses, in accordance with Federation rules. Each competitor is responsible for supplying Horse Show Management with Rider s full name and CDS, USDF, USEF numbers; Horse s name and USDF, USEF number(s); Owner s full name and CDS, USDF, USEF numbers; Trainer s full name; Coach s full name & copies of each applicable membership card, BEFORE the day of competition. The scores of competitors who fail to supply correct numbers may not be counted toward year-end awards (see CDS Omnibus). CONDITION OF ENTRY: Every horse entered for competition will be under the control of the Horse Show Management, but the Horse Show Management will, in no case, be responsible for any loss or damage that may occur, and it shall be a condition of entry that each exhibitor shall hold the Horse Show; its Directors and Employees, and CDS Pomona Chapter; its Directors and Employees, harmless for any loss or accident, to his horse, horses or equipment which may occur from accident, sickness, fire or otherwise. CLOSING OF ENTRIES: Entries close and must be received by July 26, 2018, (the Closing Date ). Entries are accepted on a first-come, first-served basis until classes are filled. All entries received after the closing date will be accepted only if schedule permits. Each late entry received after July 26, 2018 shall be assessed a late fee of $ REFUSAL OF ENTRIES: Horse Show Management reserves the right to refuse, accept conditionally, or cancel any entries of any exhibitors. REFUNDS: A refund will be given for any reason until the Closing Date of the show. Absolutely no refunds after the Closing Date. Scratches or class changes accepted until closing date. Changes will incur a $35.00 change fee and will be made only in the sole and absolute discretion of Horse Show Management. RETURNED CHECKS: Checks returned by the bank for any reason will be charged an additional 10% penalty ($25.00 minimum). Accounts will be given ten (10) calendar days to be paid in full with cash or cash equivalent or they will be turned into the Federation and/or CDS for further disciplinary action. RESPONSIBILITY: All owners will be held responsible for any damage incurred by them, and their agents or employees, to buildings and other properties on the show grounds, and shall be handled accordingly. DISCIPLINE: Exhibitors are warned that any act of discourtesy or disobedience to the officials of this show on part of the owner, exhibitor, agent, lessee, trainer, coach, groom, rider, handler or family of the above, will disqualify the horse from adjudication. The Horse Show Management reserves the right to remove a horse, owner, exhibitor, agent, lessee, trainer, coach, groom, rider or handler from the show without being liable for compensation or damages. MANAGEMENT: The Horse Show Management reserves the right to interpret all questions and conditions in regard to or arising out of incident to the show without claims for damages or recourse of any kind. All questions not covered in these rules and regulations shall be decided by the Horse Show Management, with their decision to be final. The Horse Show Management reserves to itself the right to: refuse, accept conditionally or cancel any entries, disqualify riders or exhibitors, prohibit entries and cancel award prizes without claim for damages, cancel or combine any classes, reschedule classes and rotate judges in order to facilitate the time schedule. CANCELLATION: In the event of rain or inclement weather prior to the show, it is the competitor s responsibility to call the Horse Show Management to determine whether the show is canceled. Shows are not canceled due to rain unless footing is deemed unsafe. If this show is canceled for any reason, a $30.00 per day fee will be retained from each entry fee. SHOW OFFICE: Exhibitors are encouraged to check-in promptly upon first arrival on the show grounds. The show office will be open approximately 1 hour before start of show and until approximately 1 hour after the last ride of the day. Horse Show Management can be reached at (714) or on day of show at (951)

4 RULES & INFORMATION (continued): TESTS: Current USDF, USEF, and FEI tests will be used. FEI and Musical Freestyle are offered. SCORED TESTS will only be distributed to riders, or their authorized representatives, after the results have been finalized and the awards presented. READING TESTS: Reading tests is perfectly acceptable at our shows. However, we want to make sure everyone is safe and this includes our readers as well as our riders. After a few narrow misses with exuberant horses, we ve decided that readers should be a MINIMUM of 6 feet away from any perimeter of the dressage court. Readers may stand near E or B, but if two courts are present then the reader should stand OUTSIDE the fence as to be at least 6 feet away from the perimeter of the court. NUMBER OF TESTS: Horses may compete in no more than one Recognized Competition on the same day(s) and are limited to a maximum of three Dressage rides per day at Fourth Level and below or two Dressage rides per day above Fourth Level. Dressage Seat Equitation and Materiale classes are excluded from the maximum limit of rides per day and horses in these classes may compete at any level for which they are otherwise eligible during the same competition. RIDING TIMES: Ride times will be available on the Chapter website by the Wedenesday of the week of the show. Please call Show Management for times if you are unable to access the website. Ride times will also be posted on the show grounds at the show office during the show. Be sure to check your times at the show office on the morning of the show to make sure nothing has changed. RIBBONS & AWARDS: In each class, the first place winner will recieve an award. Ribbons are given first to fifth place. Prize money will be paid to the highest scoring horse of the highest test at each level, Training - FEI, for all divisions (Open, Amateur, and Junior). JUDGES: If for any reason a judge fails to attend the show or to perform his duties, the Horse Show Management reserves the right to substitute a judge for one who was officially designated in the Premium. JUNIORS: All minors/juniors must be supervised by their parent/guardian or authorized agent at all times while at or on the show grounds, whether riding or on foot. The parent/guardian or authorized agent shall assume all responsibility to protect juniors from any injury, damage, harm and/or loss and shall identify, defend and hold CDS, USDF, USEF and Horse Show Management harmless there from. All juniors must wear properly fitted protective headgear (ASTM/SEI) while riding anywhere on the grounds at any CDS, USDF, USEF recognized event. Harness must be secured and properly fitted. It is the responsibility of the rider, or the parent or guardian of the junior exhibitor to see to it that the headgear worn complies with appropriate safety standards for protective headgear intended for equestrian use and is properly fitted and in good condition. Horse Show Management and licensed officials are not responsible for checking headgear worn for such compliance. CDS, USDF, USEF makes no representation or warranty, express or implied, that any protective headgear and cautions riders that death or serious injury may result despite wearing such headgear as all equestrian sports involved inherent dangerous risk and as such no helmet can protect against all foreseeable injuries. AMATEUR & JUNIOR CERTIFICATION: Every person who has reached his/her 18th birthday and competes in classes for amateurs under Federation rules must possess current amateur certification issued by the Federation. This certification must be available for inspection or the competitor must have lodged with the competition secretary, at least one hour prior to such class, an application for such certification provided by the Federation. Forms may be obtained from the Federation. Certification will be issued only on receipt of the application properly signed and is revocable at any time for cause. Any person who has not reached his/her 18th birthday is an amateur and does not require amateur certification. (See USEF GR1306 and GR1307) For purposes of competition in the Dressage Division: Individuals are eligible as Juniors until the end of the calendar year in which they reach the age of 18. Individuals are eligible as Young Riders from the beginning of the calendar year in which they reach the age of 22. Competitors shall compete as adults from the beginning of the calendar year in which they reach the age of 22. Individuals possessing current amateur certification are only eligible as Adult Amateurs from the beginning of the calendar year in which they reach the age of 22. (See USEF DR119.3) You must specify on the entry which section you are entered in A (Am) or J (Junior)/Young Rider (YR). USEF FEDERATION RULES: Life, senior active and junior active members shall be eligible to participate in all classes at Regular Competitions, Eventing Competitions at the Preliminary Level or above and Combined Driving Competitions at the Advanced Level, Dressage, Reining and Vaulting Competitions and Endurance Rides. A nonmember may participate as a handler, rider, driver, owner, lessee, agent, coach or trainer at Regular Competitions, Eventing Competitions, Dressage Competitions, Reining Competitions and Combined Driving Competitions upon payment of a $45 Show Pass fee. Participants in thefollowing classes are exempted from the Requirements of this rule: 1) leadline; 2) exhibitions; 3) games and races; 4) classes for 4-H members; 5) walk trot (exception: Friesian performance FR222) and academy classes (academy classes are classes limited to horses used regularly in a lesson program); 6) USDF introductory level tests, pas de deux and quadrille classes; 7) NRHA Endorsed Reining Competitions. 8) Opportunity classes, 9) citizens of other nations who have proof, in English, of current membership in good standing of their own National Federation, 10) USEA beginner novice division; and 11) assistant handlers in Dressage Sport Horse Breeding classes.

5 RULES & INFORMATION (continued): DRESSAGE SEAT EQUITATION: Junior/Young Rider class open to those riders 21 years and under. Adult Amateur class open to adult amateur riders 22 years and older. This is a rail class. Multiple horses/riders will be in the ring together. PAS de DEUX: Riders may compete in costume (boots and helmet still required) for this class only. MATERIALE: The Materiale class is intended to give young horses and ponies an opportunity to be shown and judged under saddle and to evaluate their potential as a sport horse. Horses and ponies at least 36 months of age may be entered in the Materiale Class. Entrants will be evaluated according to the criteria listed on the USDF Materiale Class Scoresheet, which shall include the walk, trot and canter in both directions of the arena with no more than six to canter at the same time. 4 & 5 year old horses and ponies may be asked to lengthen stride at the trot and at the canter, but not if 3 year olds are in the same class. If entries warrant, the class may be split into separate classes for 3 year olds and for 4 & 5 year olds. Rider s dress must conform to USEF DR 120. STABLE AVAILABILITY: No stabling is available at this show. SHARPS CONTAINER LOCATION: The sharps container will be located in the show office. ARENA DIMENSIONS AND FOOTING: Show arena is 20 m x 60 m. Warm-up arena is at least 150 ft x 80 ft. Footing consists of mainly sand, crumbled rubber, and DG in the show arena and in the warm-up arena. Only those horses entered in the show are permitted use of the show facilities, warm-up arena and show area. All horses in the warm-up arena must wear competition numbers. No lunging in the warm up arena. DOGS: All dogs must be on a leash. No exceptions. PARKING: Please note that only vehicles with horse trailers are allowed to park inside of the gates. All solo vehicles (that is, not hitched to a horse trailer) are asked to park outside of the gates nearest the show arena. There is a limited amount of available horse trailer space and we want our show to be safe and competitor friendly. In addition, we must have clear access for emergency vehicles. There is a limited amount of parking near the show office for those with special needs. Prior arrangements must be made with the Horse Show Management by calling (714) Thank you in advance for your cooperation in making this a safe and competitor friendly show. DRIVER LICENSE STATEMENT: Minors who do not have a valid driver s license which allows them to operate a motorized vehicle in the state in which they reside will not be permitted to operate a motorized vehicle of any kind including, but not limited to, golf carts, motorcycles, scooters, or farm utility vehicles on the competition grounds of licensed competitions. Minors who have a valid temporary license may operate the above described motorized vehicles as long as they are accompanied by an adult with a valid driver s license. The parent(s), legal guardian(s), or individual who signs the entry blank as a parent or guardian of a minor operating a motorized vehicle in violation of this rule are solely responsible for any damages, claims, losses or actions resulting from that operation. Violations of this rule will be cause for sanctions against the parent(s), guardian(s) and/or trainer(s) who are responsible for the child committing the offense. Penalties may include exclusion of the child, parent(s), guardian(s), and/or trainer(s) from the competition grounds for the remainder of the competition and charges being filed against any of the above individuals in accordance with Chapter 6. Wheelchairs and other mobility assistance devices for individuals with disabilities are exempt from this rule (GR901.29). AMERICAN TRAKEHNER ASSOCIATION HIGH SCORE RIBBON: We will offer a high score ribbon to all ATA registered horses and winner will be the single horse with the highest percent score. Winner must submit a copy of the horses registration papers with the class registration form. PROTECTIVE HEADGEAR: (Effective April 1, 2013) From the time horses are officially admitted to the competition grounds by competition management, anyone mounted on a horse at any time on the competition grounds, including non-competing riders, riders on non-competing horses, and those competing in all classes and tests, including Para-Equestrian tests, must wear protective headgear as defined by this rule and otherwise in compliance with GR801. Any rider violating this rule at any time must immediately be prohibited from further riding until such headgear is properly in place. Protective headgear is defined as a riding helmet which meets or exceeds ASTM (American Society for Testing and Materials)/SEI (Safety Equipment Institute) standards for equestrian use and carries the SEI tag. The harness must be secured and properly fitted.

6 SHOW FEE SCHEDULE USDF Introductory Level... each $35.00 Opportunity Classes... each $45.00 Training Level through Fourth Level... each $50.00 FEI, Freestyle, Pas de Deux... each $60.00 Dressage Seat Equitation... each $25.00 Materiale... $25.00 USDF Regional Championships Qualifying (per class)... $15.00 Office Fee (per entry)... $30.00 USEF Fee (per horse)**... $23.00 Grounds Fee (per horse)... $25.00 CDFA Drug Fee (mandatory per horse)... $ 5.00 CDS Travel Grant (mandatory per horse)... $ 3.00 Carol Plough Scholarship...Donation Sharon Carpenter Scholarship...Donation Non-Competing Horse Fee (per horse)***... $20.00 Late Fee (per entry)... $20.00 Change Fee (any change)... $35.00 Returned Check Fee (10% of Check)... $25.00 min Non-Member Fees (per entry): USDF Non-Member Fee $35.00 (for each different rider and owner) USEF Non-Member Show Pass $45.00 (for each different rider and owner and trainer) Opportunity Classes: Opportunity Classes are designed for entry level riders and young horses seeking more show experience. These classes are open to all Horse and Riders regardless of USEF or USDF or CDS membership status, without having to pay non-member fees. Opportunity classes do not count twoards any USDF or USEF Horse of the Year Awards or in High Point considerations for this show. CDS will use Opportunity Class scores for CDS Qualifying for current CDS members. Rider/Horse will be allowed to cross enter into other rated/recognized classes (CDS/USDF/USEF). Membership rules will apply and nonmember fees will be charged. Horses entered in the Opportunity Classes are still subject to and must comply with the Drugs & Medications rule and are subject to drug testing. **USEF Fee: For every horse participating in any competition licensed by the Federation, a $23 Federation fee will be collected ($8 shall be an Equine Drugs and Medication fee to provide for research, inspection, and enforcement of rules regarding use of medications and drugs; see GR407.1,.2 and.3). Exception: Horses entered in classes exempted from the Equine Drugs and Medication fee are also exempt from the balance of the Federation fee. ***Non-competing horses must pay the $20 non-competing horse fee as well as the Office Fee ($30), all Drug Fees ($28), and the Grounds Fee ($25). If not specified as Open (O), Adult Amateur (AA) or Junior/Young Rider (JR/YR) on the entry form, you will be entered in the OPEN division. VOLUNTEERS NEEDED! Volunteers are what make our shows run so well. We are always in need of helpful people to do various jobs at our shows. Examples of positions are: scribe, runner, warm up arena steward, show arena steward, set up, and tear down of the courts. Remember that Pomona Chapter members, and non-members who have paid the nominating fee, need to have volunteered for 4 hours per horse/rider combination this show season in order to be eligible for Year End Awards. If you would like to volunteer to help at this show, please contact Dhana Holck (714)

7 Pomona Chapter Members, 2018 YEAR-END AWARDS QUALIFICATIONS: Please be aware of the following changes to qualify for 2018 Year End Awards. To be eligible for any Pomona Chapter Year End Awards, the rider must comply with the following: Be a Pomona Chapter active member in good standing at the time the scores are earned OR pay a nominating fee of $25 to the Pomona Chapter. The nominating fee allows non Pomona Chapter members to be eligible for year end awards. The fee must be paid on or before August 31st of the competition year. Donate four hours of volunteer service for each horse/rider combination ie) a rider showing 3 horses must have a total of 12 volunteer hours to be eligible for CDS Pomona Chapter Year End Awards. Hours can only be donated to a rider by an immediate family member or the owner of the horse that is being ridden. The Champion horse/rider combination at any given level may NOT be won in two (2) consecutive years. The Reserve Champion horse/rider combination at any given level is eligible to compete for Championship at the same level in consecutive years. For Introductory through Fourth Level, the horse/rider combination must compete at a MINIMUM of two Chapter recognized shows and obtain a MINIMUM of three scores at the same level/division. For Prix St. Georges through Grand Prix, the horse/rider combination must compete in a MINIMUM of two Chapter recognized shows and obtain a MINI- MUM of two scores at the same level/division. The scores will be averaged and the highest percentage will be Champion, the second highest percentage will be Reserve Champion in each division, as described above. Dressage Seat Equitation Awards are available as Adult Amateur and Junior/Young Rider and based on RIDER ONLY. The rider must compete at a MINIMUM of two Chapter recognized shows and obtain a MINIMUM of two scores in the Dressage Seat Equitation classes offered at any Pomona Chapter recognized show. The scores will be averaged and the highest percentage will be Champion and the second highest percentage will be Reserve Champion. Prior year Pomona Chapter Champion and Reserve Champion at a given level may win a Season High Score Award at the same level in successive years. Horse/rider combinations are only eligible for awards in consecutive levels (i.e. Training and First, but not Training and Second) The complete set of Standing Rules can be found on our website It takes a lot of time and energy to run our horse shows and keep our Chapter humming! These changes will increase membership involvement in the day-to-day running of the Chapter and give each competitor a fair opportunity for an award. Thank you for your support and good luck in 2018!! SHARON CARPENTER-POMONA CHAPTER SCHOLARSHIP FUND: The Sharon Carpenter-Pomona Chapter Scholarship was started to honor the life of Sharon Carpenter after her death in September 2006 following her long battle with cancer. Sharon s fierce determination to live became evident to all who knew her. As well as her determination to defy the cancer at every turn, Sharon never lost her dedication to her horses or her ability to see the possibilities of overcoming challenges. The phrase I can t was never an option for her. As a CDS Pomona Chapter member, Sharon celebrated the successes of her Dutch Warmblood, Salute, during his first show season. Sharon took every opportunity to ride Salute and enjoy all of the pleasures of being near her horses. Sharon was also an amazing volunteer for Children s Hospital of Orange County and several other charities. The criteria for receiving the scholarship are based upon Sharon s goals and commitments of loving and learning with her horses while also giving back to people through volunteer work at multiple charities. The Sharon Carpenter-Pomona Chapter scholarship is intended for Pomona Chapter members, over the age of 21, who have shown training level or above within the last three years and also contributed to the chapter as a volunteer within the last three years. Each year, the interest from the scholarship fund will be given out in increments of $500. If the amount of interest allows, more than one scholarship will be awarded. Chapter members have to send in their applications to the scholarship committee by April of each year. When CDS updates their website you can apply for the scholarship in 2019 by downloading the form from

8 Maverick Ridge Riders Arena is located in the City of West Covina at 330 South Citrus St. near the 10 FWY. DIRECTIONS: From the 10 Fwy West: Take the Citrus Street Exit. Go South on Citrus Street (Left turn back under/over freeway). Turn left into Maverick Baseball Field and Ridge Riders Arena driveway. Follow road back passed baseball field. Trailer parking lot is on left side before chain link gate. From the 10 Fwy East: Take the Citrus Street Exit. Go South on Citrus Street. Turn left into Maverick Baseball Field and Ridge Riders Arena driveway. Follow road back passed baseball field. Trailer parking lot is on left side before chain link gate. Nearby Restaurants/Fast Food: Subway Sandwiches & Salads Starbucks 2848 E. Workman Avenue # E. Workman Ave #1 West Covina West Covina IHOP Del Taco 702 S. Citrus Avenue, Covina 459 S Citrus Ave, Covina McDonald s In-N-Out 3030 E. Garvey Ave South 2940 E. Garvey Ave

9 A MIDSUMMER DAY S DRESSAGE SHOW CLASS LIST Sunday, August 5, 2018 EVERY CLASS OFFERED HEREIN WHICH IS COVERED BY THE RULES AND SPECIFICATIONS OF THE CURRENT FEDERATION RULEBOOK WILL BE CONDUCTED AND JUDGED IN ACCORDANCE THERE WITH. INTRODUCTORY LEVEL all classes $35.00 Class# Class Name Section Fee 100 USDF Introductory Level Test A A-J $ USDF Introductory Level Test B A-J $ USDF Introductory Level Test C A-J $35.00 OPPORTUNITY CLASSES all classes $45.00 Class# Class Name Fee 105 Training Level Test 1- Opportunity O-A-J $ Training Level Test 3 - Opportunity O-A-J $ First Level Test 1 - Opportunity O-A-J $ First Level Test 3 - Opportunity O-A-J $45.00 TRAINING LEVEL - FOURTH LEVEL all classes $50.00 Class# Class Name Section Fee 110 Training Level Test 1 O-A-J $ Training Level Test 2 O-A-J $ Training Level Test 3 O-A-J, *Q $ First Level Test 1 O-A-J $ First Level Test 2 O-A-J $ First Level Test 3 O-A-J, *Q $ Second Level Test 1 O-A-J $ Second Level Test 2 O-A-J $ Second Level Test 3 O-A-J, *Q $ Third Level Test 1 O-A-J $ Third Level Test 2 O-A-J $ Third Level Test 3 O-A-J, *Q $ Fourth Level Test 1 O-A-J $ Fourth Level Test 2 O-A-J $ Fourth Level Test 3 O-A-J, *Q $ Training - Fourth Level - Test of choice (Materiale & Freestyle excluded) O-A-J $50.00 FEI DIVISION - all classes $60.00 Class# Class Name Section Fee 130 Prix St. Georges O-A-J, *Q $ Intermediate A O-A-J $ Intermediate I O-A-J, *Q $ Intermediate B O-A-J $ Intermediate II O-A-J, *Q $ Grand Prix O-A-J, *Q $ Grand Prix Special O-A-J $ FEI - Test of choice (Freestyle excluded) O-A-J $60.00 MISCELLANEOUS CLASSES Class# Class Name Section Fee 140 Dressage Seat Equitation JR/YR $ Dressage Seat Equitation A/A $ USDF Freestyle Test of Choice (First - Fourth Level) O, *Q $ FEI Freestyle Test of Choice O, *Q $ USDF Pas de Deux Freestyle O-A-J $ Materiale - 3 yr old and 4 & 5 yr old Fillies and Mares O-A-J $ Materiale - 3 yr old and 4 & 5 yr old Colts, Geldings, & Stallions O-A-J $25.00 *Q = USDF Regional Championships Qualifying Class (please add $15 per class)

10 CDS Pomona Chapter Entry Form - CDS USDF USEF Level 2 RATED SHOW COMPLETE BOTH PAGES - ENCLOSE COPIES OF ALL CARDS - SIGN! - Entrant/Signer is responsible for knowledge of all Show Rules and of all applicable rules from recognizing authorities. Mail to: Diana Muravez SHOW: A Midsummer Day s Show SHOW DATE: August 5, 2018 ENTRIES CLOSE: July 26, Los Cerritos Lane Fallbrook, CA HORSE INFORMATION OWNER INFORMATION CLASS # / FEE (add Q and $15 if applicable) : Name: Breed/Breed Registry Initials: Sex: Height: Color: Sire: Dam: Damsire: Country of Birth: Breeder: Passport No.: USDF HID OR LIFE #: USEF HID, ANNUAL OR LIFE #: Name: Address: Year Born: RIDER INFORMATION City: State: Zip: Phone: Fax: Citizenship: Rider Status (check one): OPEN ADULT AMATEUR JR/YR Adult Amateur - USEF Amateur card is MANDATORY JR/YR Date of Birth: CDS #: USDF GM, PM OR Non-Member #: USEF MEMBERSHIP #: Name: Address: City: State: Zip: Phone: Fax: USDF GM, PM, BM or NON-MEMBER #: CDS #: USEF MEMBERSHIP #: TRAINER INFORMATION Name: Address: City: State: Zip: Phone: Fax: USEF MEMBERSHIP #: COACH INFORMATION Name: USEF MEMBERSHIP #: PRIZE MONEY INFO Prize Money is to be paid to: TIN/SSN: USDF FEES: TOTAL CLASS FEES: USDF Non-Member (pay if not a $35 (applies to each different Rider and Owner) USDF $35 Manadatory for horses not already recorded with USDF USDF Affidavit $5 USEF FEES: USEF Drug & Medication ($15) + Administration ($8) $23 USEF Non-Member Show $45 (any non-member and/or members who cannot produce proof of membership) MISCELLANEOUS ORGANIZATION FEES: CDFA (all shows, regardless of $5 $5 CDS Travel Grant (all shows, regardless of $3 $3 STALL/GROUNDS FEES (refer to Premium): Grounds, Haul-in or Day Use Fee (per horse) $25 MISCELLANEOUS (refer to individual Premium): CDS Junior Donation Region VII YR Donation Carol Plough Scholarship Donation Sharon Carpenter Scholarship Donation Advertising or Sponsorhip Non-competing (schooling) $20 Change $35 Late $20 Office Fee (per entry) $30 GRAND TOTAL FEES: CHECK PAYABLE TO: CDS Pomona Chapter

11 UNITED STATES EQUESTRIAN FEDERATION, INC. ENTRY AGREEMENT I have read the United States Equestrian Federation, Inc. (the Federation ) Entry Agreement (GR906.4) as printed in the Prize List for this Competition and agree to all of its provisions. I understand and agree that by entering this Competition, I am subject to Federation Rules, the Prize List, and local rules of the competition. I agree to waive the right to the use of my photos at the competition, and agree that any actions against the Federation must be brought in New York State. Release, Assumption of R isk, Waiver and I ndemnification This document waives impor t ant legal rights. Read it carefully before signing. I AGREE in consideration for my participation in this Competition to the following: I AGREE that the Federation and Competition as used above includes all of their officials, officers, directors, employees, agents, personnel, volunteers and affiliated organizations. I AGREE that I choose to participate voluntarily in the Competition with my horse, as a rider, driver, handler, vaulter, longeur, 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 risks of accident, loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death ( Harm ). I AGREE to hold harmless and release the Federation and the Competition from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm of any nature caused by me or my horse to others, even if the Harm arises or results, directly or indirectly, from the negligence of the Federation or the Competition. I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of the Federation or the Competition. I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the Federation 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 while at the Competition. I have read the Federation Rules about protective equipment, including GR801 and, if applicable, EV114 and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that the Federation strongly encourages me to do so while WARNING that no protective equipment can guard against all injuries. 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 this Release on the child s behalf. I represent that I have the requisite training, coaching and abilities to safely compete in this competition. I AGREE that if I am injured at this competition, the medical personnel treating my injuries may provide information on my injury and treatment to the Federation on the official USEF accident/injury report form. BY SIGNING BELOW, I AGREE to be bound by all applicable Federation Rules and all terms and provisions of this entry blank and all terms and provisions of this Prize List. If I am signing and submitting this Agreement electronically, I acknowledge that my electronic signature shall have the same validity, force and effect as if I affixed my signature by my own hand. RIDER/DRIVER/HANDLER/ OWNER/AGENT TRAINER COACH Vaulter/Longeur (mandatory) Signature: Print Name: (mandatory) Signature: Print Name: (mandatory) Signature: Print Name: (if applicable) Signature: Print Name: Parent/Guardian Signature: (Required if Rider/Driver/Handler/Vaulter/Longeur is a minor) Print Parent//Guardian Name: Emergency Contact Phone No. Is Rider/Driver/Vaulter a U.S. Citizen: Yes No

12 California Dressage Society 2018 Membership Form Active Membership...$70.00 Additional Family Member...$60.00 Life Membership...$1, Name Address City State Zip Phone ( ) Cell ( ) Address Chapter Preference Would you like to use your Visa or MC? Card # Expiration Date: v-code visa mastercard Signature Would you like to make an additional donation and be a Patron of Dressage? CDS Supporter $25-$500 ; Silver Supporter $501-$2,000 ; Gold Supporter $2,001 - $5,000 ; and Patron $5,000 + Would you like to add $25 to qualify for the Regional Adult Amateur Competition There will be a competition offered for Adult Amateurs each year in each CDS Region, check website for qualifying Would you like to add $25 to be on the Trainers List in the Roster (not available after Dec 1) Would you like to add $100 to support Club 100 Junior Programs Group membership in the United States Dressage Federation (USDF) is included with CDS membership. All CDS memberships go from December to December. Anyone joining after Oct. 1 will be a member for the following year. Please check any of the following that apply: Renewing member New member Birthdate if under 22 ( / / ) TD EMT Judge Amateur Trainer / Instructor Qualified Riding Member (QRM) California Dressage Society P O Box 417 Carmel Valley, CA (831) fax (831) paula@california-dressage.org

13 USDF Membership Benefits: USDF is dedicated to education, the recognition of achievement, and promotion of dressage. For details on member benefits, including educational programs, awards, and other opportunities, refer to the USDF Member Guide or the USDF website at This competition is recognized by USDF for 2018 Membership Requirements for USEF-licensed/USDF-recognized Competitions: Owners and riders, including foreign riders and owners who are not residents of the US, wishing to participate in a USEF-licensed/USDF-recognized competition as a rider or owner/lessee, must have either a USDF Group Membership (GM), Participating Membership (PM), or have a USDF Non-Member (NM) identification number and pay the USDF Non-Member (NM) fee. (Note: USDF Business Members can own horses but cannot compete as riders with their USDF Business Membership.) Individuals cannot compete at a USEF-licensed/USDF-recognized competition with a USDF Education Membership. Horses competing at USEF-licensed/USDF-recognized competitions must have either a USDF Horse Identification (HID) number or a USDF Lifetime Horse Registration (LHR). Proper credentials or verification certificates must be presented to the competition secretary. Riders and owners wishing to participate in a USEF-licensed/USDF-recognized competition, and not able to present the competition secretary with verification of a USDF membership or NM identification, and USDF LHR or USDF HID, must complete a USDF Competition Affidavit Form and pay the $5 affidavit filing fee. A copy of a completed affidavit form from another competition may also be used for verification purposes for up to 60 days. (Exception: Affidavits cannot be used at Great American Insurance Group/USDF Regional Dressage Championships.) Exceptions: Horses competing only in Individual Breed Classes (IBCs) at DSHB competitions, sires and dams of horses in DSHB group classes, where those sires or dams are not actually competing in the same competition, horses competing only in breed restricted dressage or DSHB classes at Regular Competitions (e.g. all Arabian, all Friesian, or all Morgan classes), or in USDF Introductory Level tests, pas de deux or quadrille, are exempt from this requirement. Also exempt are horses ridden in leadline, exhibitions, games and races, classes for 4-H members, walk-trot, academy, and opportunity classes. Riders and owners/lessees competing only in classes which are exempt from the USDF HID requirements are also exempt from the USDF NM identification number and NM fee requirements. Also exempt are handlers of horses competing in DSHB In-Hand or Group classes. Memberships Defined Participating Membership (PM): A membership issued to an individual directly by USDF. The membership year is December 1 through November 30. PMs are available for 1-year ($90), 5-years ($360), or life ($1,800). A USDF Youth Participating Membership (YPM) is available for individuals who have not reached their 21 st birthday by December 1 of the current membership year ($72). A PM allows the member to compete at USEF-licensed/USDF-recognized competitions and to participate as a rider and/or owner/lessee for all Adequan /USDF Year-End Awards, USDF Breeders Championship Series Finals and the Great American Insurance Group/USDF Regional Dressage Championship program. Group Membership (GM): A membership issued to an individual by USDF when the member name and dues are submitted to USDF through an affiliate Group Member Organization (GMO). The GM year begins December 1 and ends November 30. A GM allows the member to compete at USEF-licensed/USDF-recognized competitions and participate in the USDF Rider Awards program. Business Membership (BM): A membership that runs December 1 through November 30 and is issued to a business or organization directly by USDF. The USDF BM ($240) offers a wider variety of advertising benefits. BMs satisfy requirements of horse ownership only. Education Membership (EM): A membership issued to an individual directly by USDF. This online education only membership expires 12 months after the date joined. This membership type does NOT allow an individual to compete at a USEF-licensed/USDF-recognized competition. Non-Member (NM) Identification Number: For each USDF NM owner/lessee and USDF NM rider there will be a USDF NM fee of $35 per competition that must be collected by the show secretary and submitted to USDF, along with the USDF Report of Fees document and the $5 affidavit fee and Competition Affidavit Form if the person cannot provide a copy of their USDF NM card. Owners/lessees or riders exempt from the NM number requirements are also exempt from paying the USDF NM fee. If there are multiple owners of a horse and all are NMs, only one of the owners must pay the NM fee. If the horse has at least one owner who is a current USDF PM, GM, or BM there is no NM fee assessed. Competition management will be invoiced for all applicable USDF NM fees not received with the USDF postcompetition paperwork, along with a report listing all USDF NMs. Competition management is then required to submit the NM fees within 30 days to the USDF. An individual with a USDF NM identification number is not eligible for any USDF membership benefits. Once a USDF NM number has been assigned, a USDF NM card can be obtained from the USDF website. Horse Identification (HID) Number: A one-time tracking number for horses ($35). Scores earned by a horse with an HID number will be recorded, but will NOT be counted towards Adequan /USDF Year-End Awards. A horse with an HID number is not eligible to compete in Great American Insurance Group/USDF Regional qualifying or championship classes or USDF Breeders Championship Series Finals. An HID number can be upgraded to a Lifetime Horse Registration (LHR) for a fee of $80. If a horse has a USDF LHR it does not need an HID number. An HID number is a one-time fee that does not need to be renewed. Lifetime Horse Registration (LHR): A horse with an LHR ($115) is eligible for Adequan /USDF Year-End Awards, and eligible to compete at USDF Breeders Championship Series Finals and Great American Insurance Group/USDF Regional qualifying and championship classes, assuming requirements for the owner and rider are met. If a horse has an LHR it does not need an HID number. An LHR does not need to be renewed. How to Join USDF Applications for USDF Participating Membership (PM), Business Membership (BM), Horse Identification (HID) number, and Lifetime Horse Registration (LHR) may be found in the following locations: On the USDF website: You can submit the application online or download the form and fax or mail it to the USDF office. In the show office at USEF-licensed/USDF-recognized competitions classified by USEF as Dressage Competitions, and Regular Competitions which are open to all breeds. By calling or writing the USDF office at (859) , 4051 Iron Works Parkway, Lexington, KY The effective date of membership is the date the form and correct fees are received in the USDF office or, if applying at a competition, the date accepted by the competition secretary, provided the application is signed and dated by the competition secretary, member, and/or horse owner on that same day. 01/17

14 2018 Great American Insurance Group/USDF Regional Dressage Championships A single Regional Dressage Championship program organized by the United States Dressage Federation (USDF), and recognized by the United States Equestrian Federation, Inc. (USEF), will be held in each of the nine USDF regions. In addition, Alaska and Hawaii may each hold state championships if an official request from a Group Member Organization (GMO) is received by April 1 of the prior year. The Regional Championship Program Rules can be found on the USDF website at Please refer to the 2018 USDF Member Guide for the comprehensive list of rules and requirements for this program. Membership/Registration Requirements for Qualifying and Championships All memberships and registrations/recordings must be correct and current at the time qualifying scores are earned and at the time of the championships. Rider: Must have a USDF Participating* Membership (PM). Must have a USEF membership (Junior Active, Senior Active, or Life). Horse: Must have a USDF Lifetime Horse Registration (LHR). Must have a USEF (Annual or Lifetime) Horse recording. USDF horse registration and USEF horse recording must be in the name(s) of the current owner(s) or lessee(s) of record. A horse is not required to have breed registry papers. Owner: Must have a USDF Participating or Business Membership and a USEF membership (Junior Active, Senior Active, Life, or Recorded Farm (with Active Farm Owner)). If the horse has more than one owner, at least one owner must have both active USEF membership and active USDF Participating or Business Membership. For a business or farm to be the valid owner under this requirement, it must be listed as an owner of the horse with both USEF and USDF. * PMs are USDF members who join USDF directly. USDF Group Members (GM) are ineligible. Minimum Qualifying Scores: One set of nationally-standardized qualifying scores has been established for all USEF/USDF Regional Championships, for Training Level through Grand Prix, in three divisions: open, adult amateur and junior/young rider. FEI Junior and FEI Young Rider classes have only one respective division. Freestyles have only open divisions. The minimum percentages are as follows: OPEN AA JR/YR Training Level (Test 3) 68% 63% 63% First Level (Test 3) 66% 62% 62% Second Level (Test 3) 64% 61% 61% Third Level (Test 3) 62% 60% 60% Fourth Level (Test 3) 62% 60% 60% FEI Junior (Team Test) 60% FEI Young Rider (Team Test) 60% Prix St. Georges 60% 60% 60% Intermediate I 60% 60% 60% Intermediate II 60% 60% 60% Grand Prix 60% 60% 60% FREESTYLE OPEN AA JR/YR First Level 63% Second Level 63% Third Level 63% Fourth Level 63% Intermediate I 63% Grand Prix 63% Rev Aug 2017

15 Regional Adult Amateur Equitation Program The USDF Regional Adult Amateur Equitation Program recognizes adult amateurs competing in equitation and promotes correct seat, position, and use of the aids in dressage. An Adult Amateur Equitation Regional Final class will be held at each of the nine USDF Regional Dressage Championship competitions, providing adult amateurs with additional opportunity for recognition. Adult amateurs wishing to qualify to compete in an Adult Amateur Equitation Regional Final may do so by meeting the following requirements. Qualifying Requirements To be eligible for the USDF Adult Amateur Equitation Regional Final class, rider must have a) Earned a score of 70% or higher in any dressage seat equitation class (except walk/trot) at a USEF/USDF-recognized Dressage competition within the qualifying period of the applicable regional championship. or b) Qualified to compete in any regional dressage championship class (excluding freestyles). Membership Requirements Rider must have a USDF Participating Membership at the time the qualifying score is earned, and at the time of the Regional Final class. Rider must be an adult amateur, in accordance with GR1306 of the USEF rules, and be designated with USEF as an adult amateur when the score is earned, and at the time of the Regional Final class. Owner must have a USDF Participating or Business Membership when the qualifying score is earned, and at the time of the Regional Final class. Horse must have a USDF Lifetime Horse Registration when the qualifying score is earned, and at the time of the Regional Final class. The USDF Regional Adult Amateur Equitation Program rules and information can be found on the USDF website. USDF Statement on Animal Welfare The United States Dressage Federation, Inc. (USDF), a federation of over 100 independent organizations throughout the United States with a membership of nearly 30,000 members, supports the concept of ethical treatment of animals. Dressage is a classical method of training horses, based upon the horse s natural responses, as carried out in a gradual, planned program during which the horse s athletic abilities are improved in a systematic manner. As a result, the horse becomes capable, comfortable, and responsive in partnership with the rider without the use of force. Dressage competition at various levels of achievement is the ultimate test of the training program to determine whether the desired harmony between horse and rider has been achieved. The rules pertaining to dressage competition prohibit the use of artificial appliances, training aids, and drugs, which would force the horse to submit. Instead, the emphasis is upon training and a cooperative partnership with the rider. Major competitions are carefully monitored to assure that there is no unnecessary force or harshness displayed. Unlike other horse sports in which horses enter training at a relatively immature state, dressage training is usually not seriously begun until the horse is three or four. The top levels of achievement require five or more years of progressive training and it is not unusual to see horses in international competition in their late teens. This, in itself, places a premium on good care and soundness throughout the horse s life. While supporting the concept of animal welfare in its broadest form, the United States Dressage Federation, Inc., also recognizes that it is unrealistic to ascribe human emotions and responses to the horse which in its wild state is a creature of flight, living a hard and precarious existence. Under domestication, the horse is assured of ample food, water, and shelter, as well as protection against infectious diseases and damaging parasites, thus leading a longer and healthier life with a high rate of survival. As an educational organization, USDF has numerous programs, which teach people how to pursue the accepted, humane training methods. A program of certifying instructors also emphasizes protecting the horse s welfare in pursuit of dressage training. United States Dressage Federation 4051 Iron Works Parkway, Lexington, KY Phone: , Fax: , usdressage@usdf.org,

16 2018 USEF MEMBERSHIP APPLICATION SAVE MONEY SAVE $5 when you elect auto renewal and your 2019 membership auto-renews. See back for details. The effective date of membership is the date on which the application and correct dues are received by the USEF office (exceptions see USEF Rule Book). To be eligible for USEF Awards including the USEF Horse of the Year Program, you must be an Active or Life Member and USHJA Active Member (if applicable). By submitting this application, you agree all information is correct and you agree to abide by all USEF rules and the policies contained in the Safe Sport Policy. 1. UNITED STATES EQUESTRIAN MEMBERSHIP A. USEF COMPETING MEMBERSHIP Competing members are those individuals who are eligible to participate in USEF Licensed Competitions as an owner, rider, driver, handler, vaulter, longeur, lessee, agent, coach, trainer, competition manager, or competition secretary or serving as a USEF committee member (exceptions found in USEF Rule Book). 1-Year Active $80 Active Membership is effective for 12 months from the start date Life Member (no expiration date) $2,500 B. FAN MEMBERSHIP (NON-COMPETING) Support the Sport & Receive USEF Perks If you own a horse(s) competing at USEF Licensed Competitions you need to have a Competing Membership, Section A above. 1-Year Fan Membership $25 USEF Fan Membership is effective for 12 months from the start date 2. OPTIONAL US EQUESTRIAN MEMBER INSURANCE Members in Section A or B are eligible to purchase this coverage. Excess Personal liability/ad&d insurance - Under 18yrs old* $18 Excess Personal liability/ad&d insurance - 18yrs old and over* $25 The coverage benefits for USEF Members in good standing who purchase coverage start when your membership is processed and your dues and fees are paid in full. The coverage ends 12 months later. *see USEF General Information on reverse side. 3. DATE OF BIRTH REQUIRED (MM/DD/YY): / / 4. BREED/DISCIPLINE AFFILIATION REQUIRED Please designate a primary breed/discipline affiliation. Please designate the primary breed/discipline affiliation as (1). You may also select a secondary choice as (2). EXAMPLE: Hackney 1 Welsh 2 Andalusian/Lusitano Arabian/Half-Arabian/Anglo-Arabian Carriage Driving Combined Driving Connemara Dressage Driving Endurance English Pleasure Eventing Friesian Hackney Hunter Jumper Morgan National Show Horse Para-Equestrian Parade Paso Fino Reining Roadster Saddlebred Saddle Seat Shetland Vaulting Welsh Western Western Dressage Bringing the joy of horse sports to as many people as possible. PAYMENT (Total of 1A or 1B, 2, and 6) Do not send cash. $ 5. PERSONAL INFORMATION TITLE: Mr. Mrs. Ms. Miss Other NAME: ADDRESS: CITY, STATE, ZIP: PHONE: MOBILE: U.S. CITIZEN: YES NO IF NO, WHAT COUNTRY? USEF MEMBER #: CHECK HERE IF THIS IS A NEW ADDRESS 6. UNITED STATES HUNTER JUMPER ASSOCIATION MEMBERSHIP In order to compete as a rider, trainer, owner, or his/her agent(s) at non-breed restricted USEF-licensed competitions in any Hunter, Hunter Breeding, Jumper or Hunter Seat Equitation classes, a person must be an Active/Competing member of the United States Hunter Jumper Association, Inc. (Exceptions found in USEF Rule Book) USHJA 3-YEAR ACTIVE (competing membership) $240 (Effective for 36 months from the start date) USHJA ACTIVE MEMBER (competing membership) $85 (Effective for 12 months from the start date) USHJA LIFE MEMBER (no expiration) $1,500 USHJA ASSOCIATE (non-competing membership) $35 (Effective for 12 months from the start date) 7. HELP USEF GO GREEN! RENEWAL: No, I do not wish to receive a paper renewal form in I will renew online. MEMBERSHIP CARD: I do not need a hard copy membership card and will access the online card. 8. REQUIRED SIGNATURE REQUIRED Every member is required to check the appropriate box denoting their status in the sport, and sign below (see status information on reverse side): AMATEUR PROFESSIONAL JUNIOR (Individuals who have not yet reached their 18th birthday on 12/1/2017) By signing below, I (or guardian if under 18 years of age) certify that the above status selected is appropriate per GR 1306 and have read and agree to be bound by the Forum Selection Clause, Federation Release, Assumption of Risk, Waiver and Indemnification (on the reverse side of this form). (Sign in ink) Exp. Date: / Billing Zipcode: Check / Money Order (Payable to USEF) Card Number: Credit Card Card Holder Name (Print): Card Holder Signature: UNITED STATES EQUESTRIAN FEDERATION : 4047 IRON WORKS PARKWAY : LEXINGTON, KY : : FAX : USEF.ORG

17 UNITED STATES EQUESTRIAN FEDERATION MISSION STATEMENT To provide access to and increase participation in Equestrian Sports at all levels by ensuring fairness, safety, and enjoyment. USEF GENERAL INFORMATION The insurance coverage entitles you to $1 million in Excess Personal liability insurance for horse-related accidents that cause bodily injury or property damage to third parties. In addition, you are entitled to personal accident insurance that insures you for death or permanent disability resulting from horse-related accidents. The benefit amount is determined by where the accident occurred and the result, with a maximum benefit of $35,000. This insurance is not prorated and is non-refundable. You can view the entire USEF Rule Book and Safe Sport Policy on our website, usef.org. By submitting this application, you agree that all information is correct and you agree to abide by all USEF rules and the policies contained in the Safe Sport Policy. AUTO RENEWAL For the convenience of our members, we now offer the ability to opt into automatic renewal for any memberships listed in your MyUSEF account. Visit usef.org for details. USHJA GENERAL INFORMATION As a USHJA member, you have access to educational and competitive programs, as well as sport governance. The USHJA aims to keep its members informed through the USHJA In Stride magazine ($9 value), newsletters and other resources, all of which are benefits included in your membership fee. By submitting this application you agree to abide by all USEF rules. The USHJA offers memberships to suit every equestrian s need. Visit ushja.org/membership for more information on World Championship Hunter Rider, Outreach, Affiliate, Collegiate, and Scholastic memberships. MEMBER PERKS As a USEF member, you ll reap the rewards all year long with the Member Perks Free Enrollment Program featuring a special collection of companies that support equestrian sport. See current Member Perks list at usef.org. UNITED STATES OLYMPIC COMMITTEE REQUESTED INFORMATION The United States Olympic Committee is required to submit data to Congress and the President concerning the participation of women, individuals with disabilities, and racial and ethnic minorities in the amateur athletic and administration activities of national governing bodies. As a result, we have included the following questions so that we may fulfill our required reporting to the United States Olympic Committee. This data is for analysis only. Submission is voluntary. Failure to supply this information will not jeopardize or adversely affect your membership status with USEF. The following categories are defined and named by the U.S. Government. Please check one: Race / National Origin (check all that apply): American Indian or Alaskan Native Asian Black/African America (not of Hispanic origin) Hispanic or Latino Native Hawaiian or Pacific Islander White (not of Hispanic origin) Two or More Races Unknown Other: I elect not to identify my racial origin or ethnicity. Disability Status: Are you an individual with a mental or physical disability? Yes No Gender: Female Male Military Veteran: Yes No AMATEUR/PROFESSIONAL STATUS To compete in amateur classes or divisions at USEF Licensed Competitions, you are required to check the Amateur box in Section 8 and confirm that you have not engaged in any activities described in GR (Amateur Rule) of the USEF Rule Book. Please Note: Any individual who has signed as a Professional with the USEF is required to complete the amateur reinstatement process in the USEF Rules prior to competing in any amateur classes or divisions (see GR1307.9). PRIVACY INFORMATION USEF reserves the right to share member data (including but not limited to membership numbers, horse ID numbers, horse recording numbers). FORUM SELECTION CLAUSE By submitting and signing this membership application, I hereby acknowledge and agree that any court action must be brought solely and exclusively in the United States District Court for the Southern District of New York or in the Supreme Court of the State of New York, County of New York, to the exclusion of the courts of any other jurisdiction. Furthermore, I acknowledge and agree that if the Federation prevails in a lawsuit brought against it by me, or on behalf of my minor child or a minor over whom I am legal guardian, the Federation shall be entitled to recover its costs and expenses, including reasonable attorneys fees, incurred in connection with such action. Such payment must be made within thirty (30) days following the court s order approving the amount of recovery. FEDERATION RELEASE FEDERATION RELEASE, ASSUMPTION OF RISK, WAIVER AND INDEMNIFICATION. THIS SECTION WAIVES IMPORTANT LEGAL RIGHTS. READ IT CAREFULLY BEFORE SIGNING. I AGREE in consideration for my participation in any and all Federation licensed and/or endorsed competitions to the following: I AGREE that the Federation as used herein includes all United States Equestrian Federation licensed officials, officers, competition licensees, directors, employees, agents, personnel, volunteers, and Federation affiliates. I AGREE that I choose to participate voluntarily in competitions with my horse, as a rider, driver, handler, vaulter, longeur, lessee, owner, agent, coach, trainer, or as parent or guardian of a junior exhibitor. I am fully aware and acknowledge that horse sports and competitions involve inherent dangerous risks of accident, loss, and serious bodily injury including broken bones, head injuries, trauma, pain, suffering, or death ( Harm ). I AGREE to hold harmless and release the Federation from all claims for money damages or otherwise for any Harm to me or my horse and for any Harm of any nature caused by me or my horse to others, even if the Harm arises or results, directly or indirectly, from the negligence of the Federation. I AGREE to expressly assume all risks of Harm to me or my horse, including Harm resulting from the negligence of the Federation. I AGREE to indemnify (that is, to pay any losses, damages, or costs incurred by) the Federation 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 while at competitions. I have read the Federation Rules about protective equipment, including GR801 and, if applicable, EV114, and I understand that I am entitled to wear protective equipment without penalty, and I acknowledge that the Federation strongly encourages me to do so while WARNING that no protective equipment can guard against all injuries. 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 this Release on the child s behalf. I represent that I have the requisite training, coaching, and abilities to safely compete in this competition. I AGREE that if I am injured at any competition, the medical personnel treating my injuries may provide information on my injury and treatment to the Federation. BY SIGNING IN SECTION 8 ON PAGE ONE, I AGREE to be bound by all applicable Federation Rules and all terms and provisions of this Federation Release, Assumption of Risk, Waiver and Indemnification Agreement.

18 USEF Competition Name: Midsummer Day s Dressage Show USEF#: Competition Division(s) and Rating(s): CDS, USDF, USEF Level 2 Rated WAYS TO SAVE AS A US EQUESTRIAN MEMBER Save 10% online and in stores Protect yourself with discounted liability and AD&D insurance Save 15% off your first ride and 5% off all other rides Buy 10 bags of feed and get one free! Save up to 28% on equipment like Gators (TM) and lawnmowers PLUS MANY MORE!