2016 North Central District 4-H Youth Horse Show Entry Form Saturday & Sunday May 21 & 22, 2016

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1 0 North Central District -H Youth Horse Show Entry Form Saturday & Sunday May &, 0 Complete entries must be postmarked by April 5, 0 to avoid a late fee ONLY HORSE / RIDER COMBINATION PER ENTRY FORM, EXHIBITORS MUST BE 8 OR UNDER ON JANUARY, 0 Exhibitor Name: Age (as of Jan, 0) Street Address: City: Zip: Phone: ( ) - County: Horse or Pony Name: -H Club: Leader s Name & Phone #: CLASS # CLASS NAME (No entry fee for Cloverbud or Adaptive Rider Classes) COST ($ / Class) ENTRY COST $5.00 non-stabling fee if you will be working out of your trailer and are not getting a stall $0.00 Late Fee (if applicable) TOTAL COST Stalls are only available as a -night package for Fri. & Sat. nights. Please use the separate Stall Request Form to order stalls. Class adds during the show are $8 /class & must be done before class starts. No refunds after May 0 th without excuse from MD or DVM. Complete entries must be postmarked by April 5, 0 or a $0 late fee will be charged. If you wish to pay by credit card, please check here. The card must be presented upon check-in, before the rider will be allowed to pick up his or her show packet. The card will be charged the amount due at that time and must be presented each time a rider adds a class. The following items MUST be mailed with your entry form for it to be considered complete: ) Check made out to North Central District -H OPEN CHECKS NOT ACCEPTED DO NOT SEND VIA REGISTERED MAIL ) Show entry form signed by exhibitor (if 8 or older), otherwise by parent or legal guardian. Mail entries via regular mail only to: ) Copy of notarized 0 -H Medical Release (completed & signed) Nan Guldenschuh ) Copy of 0 N.C. -H Horse Eligibility Card (completed & signed) 5 Julian Oakley Rd 5) Copy of USEF or NCHJA Permanent pony card (if applicable) Rougemont, NC 757 ) Adaptive Riding form questions? Call Pam Holland (-9-) "This event or activity is operating under the -H Code of Conduct & Disciplinary Procedure. The NC -H Code of Conduct & Disciplinary Procedure is a condition of participation in -H events & activities." Under North Carolina law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 99E of the North Carolina General Statutes Signature (exhibitor if 8 or older, otherwise parent or legal guardian): $0 will be charged for checks returned for insufficient funds. Fines for Coggins violations will be passed on to the exhibitor.

2 North Central District -H Horse Show - Sat & Sun, May &, 0 Gov. James B. Hunt Jr. Horse Complex Raleigh, NC SATURDAY, May, 0-8:00 AM - COVERED ARENA 57 * Adaptive Riders W/T, Assisted/Unassisted Level SUNDAY, May, 0-8:00 AM - ARENA IN FRONT OF E BARN 50 Jr Rider, H&P Non-Trotting Showmanship (all seats) 58 * Adaptive Riders Eq W/T, Assisted/Unassisted Level Both 58 & 589 start at 8:00, 587 & 588 follow 58, 590 follows Sr Rider, H&P Non-Trotting Showmanship (all seats) 59 * Trail for Therapeutic Riders - Level 58 Short Stirrup Showmanship 50 Jr/Sr Rider, H&P - Saddle Seat Showmanship 550 * Cloverbud Saddle Seat & Non-trotting GAYP 587 Jr Rider Horse Hunt Seat Showmanship 0 MINUTE BREAK 55 * Cloverbud Saddle Seat & Non-trotting Equitation 588 Jr Rider Pony Hunt Seat Showmanship 50 Jr Rider, H&P GAYP, Other Non-trotting ( Gait) 55 * Cloverbud Western & Hunt Seat GAYP 589 Sr Rider Horse Hunt Seat Showmanship 505 Sr Rider, H&P GAYP, Other Non-trotting ( Gait) 55 * Cloverbud Western & Hunt Seat Equitation 590 Sr Rider Pony Hunt Seat Showmanship 50 *Jr/Sr Rider H&P GAYP English Pleasure (no Cantering) 55 Little Britches Western (Walk/Jog) Class 59 starts 5 minutes after the end of class 588 or 590, 507 Jr Rider, H&P English Non-trotting ( Gait) Walking & 555 Little Britches Western Pleasure (Walk/Jog/Lope) Whichever ends last, but at least 0 minutes after Class 590 Racking 55 Little Britches Stock Seat Equitation (Walk/Jog) 59 Sr. Rider Horse Working Hunter Under Saddle 508 Sr Rider, H&P English Non-trotting ( Gait) Walking & 557 * Jr/Sr Riders, H&P, Western GAYP 59 Jr. Rider Horse Working Hunter Under Saddle Racking 558 Jr/Sr Riders, Pony Western Pleasure 59 Sr Rider Horse Bridle Path Hack 509 Jr/Sr Riders, H&P, Saddeseat English Pleasure 8, 559 Jr Riders, Horse Western Pleasure 59 Jr Rider Horse Bridle Path Hack 50 Academy Riders English Pleasure (Walk/Trot) 50 Sr Riders, Horse Western Pleasure 595 Sr Rider Horse Hunt Seat Equitation on the Flat 5 *Jr/Sr Riders, H&P, Gaited Plantation Pleasure 5 Jr Riders, H&P Western Show Hack 59 Jr Rider Horse Hunt Seat Equitation on the Flat 5 *Jr/Sr Riders, H&P, Gaited Plantation Pleasure 5 Sr Riders, H&P Western Show Hack 597 Short Stirrup Bridle Path Hack 5 Jr/Sr Riders, H&P Saddle Seat Equitation 5 Jr/Sr Riders, Pony, Western Horsemanship 598 Short Stirrup Hunter Under Saddle 5 Academy Riders Equitation (walk/trot) 5 Jr Riders, Horse, Western Horsemanship 599 Short Stirrup Hunt Seat Equitation on the Flat 55 Jr/Sr Riders H&P Country English Pleasure 0, 55 Sr Riders, Horse, Western Horsemanship 00 Jr. Rider Pony Working Hunter Under Saddle 5 Jr/Sr Riders H&P Hunter Pleasure English Type 8, 5 * Ranch Riding 0 Sr. Rider Pony Working Hunter Under Saddle 57 Jr Riders, H&P Gait Non-Trot/Walk/Racking Equitation 57 Little Britches Western Trail 0 Jr Rider Pony Bridle Path Hack 58 Sr Riders, H&P Gait Non-Trot/Walk/Racking Equitation 58 Jr/Sr Riders, Pony, Western Trail 0 Sr Rider Pony Bridle Path Hack 59 *Jr/Sr Riders, H&P- Gait Non-Trot/Walk/Rack Equitation 7 59 Jr Riders, Horse, Western Trail 0 Jr Rider Pony Hunt Seat Equitation on the Flat 50 Jr Rider, H&P, Walking Horse Pleasure ( Gait) 570 Sr Riders, Horse, Western Trail 05 Sr Rider Pony Hunt Seat Equitation on the Flat 5 Sr Rider, H&P, Walking Horse Pleasure ( Gait) 57 Jr/Sr Riders, H&P, Western Riding 9 Jumping in Indoor Arena, Class 0 starts 5 min after class 588 ends 5 Jr Rider, H&P, Racking Horse Pleasure ( Gait) 57 Jr/Sr Riders, H&P, Western Reining 9 but at least 0 min after Class 58 ends. No open cards. 5 Sr Rider, H&P, Racking Horse Pleasure ( Gait) 0 Short Stirrup Working Hunter Over Fences 5 Jr Rider, H&P, Other Non-trotting Pleasure ( Gait) 0 MINUTE BREAK FOR TACK CHANGE 07 Short Stirrup Hunt Seat Equitation Over Fences 55 Sr Rider, H&P, Other Non-trotting Pleasure ( Gait) 57 Jr Riders, H&P, Stock Type Hunter Under Saddle 08 Jr Rider Pony Restricted Working Hunter O/F 5 Jr/Sr, Riders, H&P Western Pleasure English Type 8 57 Sr Riders, H&P, Stock Type Hunter Under Saddle 09 Jr Rider Pony Restricted Hunt Seat Equitation O/F 57 Jr Riders, H&P Western Non-Trotting ( Gait) 0 Sr Rider Pony Restricted Working Hunter O/F 58 Sr Riders, H&P Western Non-Trotting ( Gait) Class 575 starts 5 minutes after Class 57 ends but will not Sr Rider Pony Restricted Hunt Seat Equitation O/F 59 * Trail Only for Hunt Seat, Gaited & Saddle Seat Sr. Riders begin before 5:0 PM Jr Rider Pony Working Hunter Over Fences 50 * Trail Only for Hunt Seat, Gaited & Saddle Seat Jr. Riders 575 * Cloverbud Barrel Racing Jr Rider Pony Hunt Seat Equitation Over Fences 5 Little Britches Showmanship 57 Jr. Rider, H&P, Barrel Racing Sr Rider Pony Working Hunter Over Fences 5 Jr/Sr Riders, Pony Western Showmanship 577 Sr. Rider, H&P, Barrel Racing 5 Sr Rider Pony Hunt Seat Equitation Over Fences 5 Jr Riders, Horse Western Showmanship 578 Jr. Rider, H&P, Texas Barrels Sr Rider Horse Working Hunter Over Fences 5 Sr Riders, Horse Western Showmanship 579 Sr. Rider, H&P, Texas Barrels 7 Sr Rider Horse Hunt Seat Equitation Over Fences 55 * Ranch Ground Handling 580 Jr. Rider, H&P, Pole Bending 8 Jr Rider Horse Working Hunter Over Fences 5 * Cloverbud Showmanship 58 Sr. Rider, H&P, Pole Bending 9 Jr Rider Horse Hunt Seat Equitation Over Fences 57 * Adaptive Riders Showmanship - open - all levels 58 Jr. Rider, H&P, Stakes Race 0 Jr Rider Horse Restricted Working Hunter O/F 0 MINUTE BREAK 58 Sr. Rider, H&P, Stakes Race Jr Rider Horse Restricted Hunt Seat Equitation O/F 58 * Adaptive Riders Walk, Assisted/Unassisted Level 58 Jr. Rider, H&P, Flag Race Sr Rider Horse Restricted Working Hunter O/F 59 * Adaptive Riders W/T, Assisted/Unassisted Level 585 Sr. Rider, H&P, Flag Race Sr Rider Horse Restricted Hunt Seat Equitation O/F 50 * Adaptive Riders Eq W/T, Assisted/Unassisted Level * Open Hunter Over Fences: open to all Riders, H&P 5 5 * Trail for Therapeutic Riders - Level 0 Minute Break for Course Change 5 * Adaptive Riders Walk, Assisted/Unassisted Level 5 Sr Rider Horse Hunter Hack 5 * Adaptive Riders W/T, Assisted/Unassisted Level Jr Rider Horse Hunter Hack 5 * Adaptive Riders Eq W/T, Assisted/Unassisted Level 7 Sr Rider Pony Hunter Hack 55 * Trail for Therapeutic Riders - Level * Indicates non-qualifying class for the 8 Jr Rider Pony Hunter Hack 5 * Adaptive Riders Walk, Assisted/Unassisted Level State -H Horse Show 9 Short Stirrup Hunter Hack

3 NORTH CENTRAL DISTRICT -H HORSE SHOW Sat & Sun May &, 0 Gov. James B. Hunt Jr. Horse Complex Raleigh, NC Classes may run at the same time in the same or different arenas. It is the exhibitor s responsibility to be aware of where and when their class is being held. Class list foot notes: = Walking Horses may not enter both walking and racking classes. Exhibitors must pick one or the other. Other Non-Trotting horses may not enter walking and racking classes. = Walking, Racking and Spotted Saddle Horses, may not enter Other Non-Trotting classes. = Cloverbud classes are for youth who are between the ages of 5 and 8 as of January of the current year. No cantering allowed in Cloverbud classes. All Cloverbuds receive blue ribbons. Cloverbuds may not enter non-cloverbud classes. = A horse (or pony) & rider combination entered in Restricted Working Hunter Over Fences or Restricted Hunt Seat Equitation Over Fences may not enter Working Hunter Over Fences or Hunt Seat Equitation over Fences 5 = Class judged on participation. Class satisfies requirement for exhibitor to complete course of 8 fences at -H District Horse Show to enter Combined Training classes at State -H Horse Show. Horses and ponies may wear protective equipment in this class. = To be eligible for Adaptive Rider classes, exhibitors must meet the requirements in the NC -H Horse Program Rules & Regulations Manual, Chapter, Section K. For more information, call Pam Holland -9-7 = Exhibitors in this class are required to canter. 8 = Horses will not have set tails. 9 = Exhibitors are allowed to qualify and show one horse and one pony in this class. 0 = Non-padded horses only = Saddle Seat horses may not cross-enter between English Pleasure and Country English Pleasure classes = Ranch Classes are by invitation only at the State Horse Show. District Horse Show Ranch Classes are non-qualifying and open to all youth holding an eligibility card. Minimum / Maximum Fence Height Ranges: Equitation over Fences: Working Hunter over Fences: Sr Horse: Min 9 / Max Sr Horse: Min 9 / Max Jr Horse: Min 9 / Max Jr Horse: Min / Max Large Pony: Min / Max Large Pony: Min / Max Medium Pony: Min / Max Medium Pony: Min / Max Small Pony: Small Pony: Short Stirrup: Short Stirrup: Restricted Pony: Restricted Pony: Restricted Horse: Restricted Horse: No schooling allowed in the over fences ring once the jumping patterns are posted. No lunging in the schooling or class rings after 7 a.m. There is a new designated lunging area behind the ring behind Barn E. Effective //00 the NC -H Horse Program requires ALL riders to wear protective headgear that meets or surpasses current ASTM/SEI standards while riding during any -H Horse Program sponsored event or activity. Headgear must be properly fitted, worn on the top of the head, and with the harness securely fastened. Age Requirements: Short Stirrup are hunt seat classes open to youth ages 9 to who are in their first two years of showing over fences. May not cross-enter into other hunt seat divisions. Little Britches are western classes open to youths, ages 9 to, who are in their first two years of showing, excluding Cloverbud Classes. May not cross-enter into other western divisions. Junior Rider classes are open to those youths who have not reached age before January of the current year. Senior Rider classes are open only to those youths who have reached age as of January of the current year and who have not reached age 9 as of January of the current year Adults are prohibited from riding a horse unless it has become DANGEROUS for the youth to do so. An adult riding a horse MUST BE CLEARED WITH THE SHOW OFFICE BEFORE THE ADULT MOUNTS THE HORSE. Failure to do this will result in disqualification of the horse. The show is governed in accordance with the NC -H Horse Program Rules & Regulations Manual (Revised December 05) which is on the web at: Vehicles and equipment such as scooters, motorcycles, bicycles, mopeds, skateboards, roller blades, and roller skates may not be used or operated on the show grounds. Only licensed drivers 8 or older may operate golf carts or other motorized vehicles. All horses on the grounds must have a current negative Coggins. Once a show official verifies a horse s Coggins the exhibitor will be given a card allowing them to pick up their show packet. Coggins must be posted outside horse s stall or trailer at all times for inspection by the state vet. Fines for Coggins violations will be passed onto the exhibitor. Show management reserves the right to adjust the schedule as needed to address safety concerns. SHOW MANAGEMENT RESERVES THE RIGHT TO DISQUALIFY FROM SHOWING ANY HORSE OR PONY THAT IS UNMANAGEABLE AND DANGEROUS OR ANY YOUTH WHO EXHIBITS UNSPORTSMANLIKE OR INAPPROPRIATE BEHAVIOR!!! THE DECISION OF THE JUDGE IS FINAL. ACTS OF DISCOURTESY TO THE JUDGE OR SHOW PERSONNEL WILL BE HANDLED APPROPRIATELY. In order to enter Combined Training in the Dressage division at the State -H Horse Show, exhibitors must jump a complete course of 8 fences at the -H District Horse Show. ******* State -H Horse Show dressage packets will be available at the show office during the district show. ******* Exhibitors qualifying for the State -H Horse Show must pick their packets up at the show office during the -H District Horse Show. ******* Each exhibitor and horse must earn one or more qualifying points in a division at the -H District Horse Show in order to be eligible to participate in that division at the State -H Horse Show. Class Placing & State -H Horse Show Qualifying Points # Of Horses in Class ******* Ponies in Jr/Sr Hunter & Western Pony classes must be measured at the show unless they have a USEF or NCHJA Permanent Pony Card. Measurement times will be posted at the show office. Ponies in Short Stirrup, Little Britches, Non-trotting, Saddle Seat, Ranch, and Cloverbud classes DO NOT need to be measured. NC -H Horse Program Rule I-F.7. Finality of Decisions The decision of the judge is final. All horses and ponies cannot win, so the judge s decision, on whatever it may be, should be accepted in the true spirit of sportsmanship and -H membership. When an exhibitor or exhibitor s parent, leader, or agent is guilty of unsportsmanlike conduct, the show management may suspend such exhibitor s rights to participate in future classes or shows for such period as judged appropriate. The exhibitor s parent, leader, friend, or agent can and will be barred from the show grounds for unsportsmanlike conduct or improper behavior. Protests:I-G..Form A verbal protest, accompanied with $50 cash, must be filed with the paddock coordinator by the complaining party within the time the protested class is announced or until the gate is closed for the next class, whichever comes first. A written protest must be submitted within 5 minutes. If the appeals committee upholds the protest, the deposit will be refunded. If the protest is overruled, the deposit shall be forfeited to the N.C. -H Horse Program Fund.

4 Exhibitor Name: Mailing Address: STALL REQUEST FORM Wake County All Youth Show & North Central District -H Horse Show May &, 0 Birthdate (mm/dd/yyyy) Phone: ( ) - *(Required) Exhibitor is showing in: Wake County Show North Central District Show Both Shows Required for -H Members only: County (where club is registered): H Club Name: Leader Name & Phone #: NOTES:. Coggins will be checked at the barn by an individual designated by the show committee & must be posted outside horse s stall for inspection by the state vet. Fines for violations will be passed on to the exhibitor.. Stall fee of $0 covers both Friday & Saturday nights. There is not a different rate for a one-night stay.. Bagged shavings will be available at the show grounds, please order in advance below. Pre-ordered shavings will be delivered to your stall. Extra shavings purchased during the show must be paid for at the shavings trailer.. There are no refunds on pre-ordered shavings. 5. Stall fee will be refunded if the stall is never used and the show office is notified by p.m. on Friday May 0 th. # $ 0 each = # Bags $.50 / bag = Total = Stall request forms postmarked by April 5, 0 will receive priority in determining stall assignments. Group stabling requests will be honored as much as possible under fairground rules concerning stabling. Checks should be made payable to: North Central District -H Horse Program Open checks are not accepted. A fee of $0 will be charged for checks returned for insufficient funds. Sign below and mail (no registered mail accepted) completed stall request form & check to: Nan Guldenschuh, 5 Julian Oakley Rd., Rougemont, NC 757 (DO NOT mail to Wake County) Under North Carolina law, an equine activity sponsor or equine professional is not liable for an injury to or the death of a participant in equine activities resulting exclusively from the inherent risks of equine activities. Chapter 99E of the North Carolina General Statutes Signature (exhibitor if 8 or older, otherwise parent or legal guardian): ** SHOW OFFICE USE ONLY: Check Number Club Barn Stall # # Bags Shavings

5 North Central District -H Horse Show Sponsorship Form 00 % of the proceeds benefit the North Central District -H Horse Program Your donation of $0.00 to sponsor a class in our North Central District -H horse show scheduled for May st and nd, 0 will benefit the North Central District -H horse program. If you would like to sponsor a specific class, please list it below. We will make every effort to honor your request. Your name/business name will be listed in the show program and announced during the class. Class(s) you would like to sponsor: Name to be listed in the show program and announced during the class: Contact name and phone number is case of questions: FORMS MUST BE POSTMARKED BY MAY, 0 IN ORDER TO BE INCLUDED IN THE SHOW PROGRAM. Make Checks Payable to: North Central District -H Horse Program Mail checks and sponsorship forms to: Nan Guldenschuh 5 Julian Oakley Rd Rougemont, NC 757 Sponsorship Sold By: -H Member: Club: County: (Bottom Portion for Sponsor s Receipt) =================================================================================== Received From: $ For sponsorship of classes at the 0 North Central District -H Horse Show, proceeds to benefit the North Central District -H Horse Program: Received by: Thanks for your support! Date: / /

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