Opening Date: January 25, 2014 Closing Date: February 17, 2014 (postmarked or on line) Emerald Classic I and II March 15 16, 2014 Great Southwest Equestrian Center 2501 South Mason Road Katy, TX 77450 Official Qualifying Competitions for the 2014 Great American Insurance Group USDF Regional Dressage Championship and the 2014 Southwest Dressage Championship Dover/USDF Adult Amateur Medal Program AQHA Recognized USEF Level 1 Dressage Shows Two One Day Shows Recognized by: United States Equestrian Federation and United States Dressage Federation Competition 331700 & 331701, Southwest Dressage Championships applied for Free Competitor Party/Dinner Saturday night! Entertainment! Show Manager/Secretary/Licensee Contact Judges Marilyn Kulifay Sue Kolstad S Florence, KY P.O. Box 3452 Sandy Osborn S Bishop, GA Houston, TX 77253 (713) 861 0761 Technical Delegate Email: marily2004@yahoo.com Sarah Jane Martin R Montgomery, TX Braider Bree Bell 512 826 7551 Braider Jennifer Bertnick 713 504 0035 Check www.gswec.com for updates, stabling chart, ride times This is an official EqEntries Perfect Entry Contest Show! All perfect entries submitted using EqEntries are eligible to win. Winner receives an EqEntries embroidered saddle pad & goes in the EqEntries drawing for a $150 EqEntries Gift Certificate. Go to www.eqentries.com for details on the Perfect Entry contest. Warning: Under Texas Law (Chapter 87, Civil Practices and Remedies Code), a livestock show sponsor or farm animal activity sponsor is not liable for an injury to or the death of a participant in a livestock show resulting from the inherent risks of livestock show activities. Rule Enforcement: All rules are in effect and will be enforced from the time a competitor arrives on the show grounds.
Tentative Schedule: All standard dressage classes will be offered. See following class list. Indicate Division on entry form, i.e. Open, AA or JR/YR. Class Number Class Division 4 Intro A O, AA, JR/YR 5 Intro B SWDC Qual for JR/YR O, AA, JR/YR 6 Intro C O, AA, JR/YR 7 Dressage Eq 13 & under JR/YR 8 Dressage Eq 14 18 JR/YR 51 Training 1 O, AA, JR/YR 52 Training 2 O, AA, JR/YR 53Q Training 3 Great Am/USDF/SWDC Qual O, AA, JR /YR 53P Training 3 Pony SWDC Qual O, JR/YR 55Q Training Freestyle SWDC Qual O 11 First 1 O, AA, JR/YR 12 First 2 O, AA, JR/YR 13Q First 3 Great Am/USDF/SWDC Qual O, AA, JR/YR 13P First 3 Pony SWDC Qual O 15Q First Freestyle Gr Am/USDF/SWDC Qual O 21 Second 1 O, AA, JR/YR 22 Second 2 O, AA, JR/YR 23Q* Second 3 Gr Am/USDF/SWDC Qual/AA Dover Medal O, AA, JR/YR 25Q Second Freestyle Gr Am/USDF/SWDC Qual O 31 Third 1 O, AA, JR/YR 32 Third 2 O, AA, JR/YR 33Q Third 3 Gr Am/USDF/SWDC Qual O, AA, JR/YR 35Q Third Freestyle Gr Am/USDF/SWDC Qual O 41 Fourth 1 O, AA, JR/YR 42 Fourth 2 O, AA, JR/YR 43Q Fourth 3 Gr Am/USDF/SWDC Qual O, AA, JR/YR 45Q Fourth Freestyle Gr Am/USDF/SWDC Qual O 63Q (Sat only) FEI Young Rider Team Gr Am/USDF Q YR 64Q (Sun only) FEI Young Rider Freestyle SWDC Qual YR 68Q (Sat only) FEI Junior Rider Team Gr Am/USDF Q JR 69Q (Sun only) FEI Junior Rider Freestyle SWDC Qual JR 70Q Prix St. Georges Gr Am/USDF/SWDC Qual O, AA, JR/YR 71Q Intermediate I Gr Am/USDF/SWDC Qual O, AA, JR/YR 72Q Intermediate I Frstyle Gr Am/USDF/SWDC Qual O 76 Intermediate A O, AA, JR/YR 77 Intermediate B Gr Am/USDF/SWDC Qual** O, AA, JR/YR 73Q Intermediate II Gr Am/USDF/SWDC Qual** O, AA, JR/YR 74Q Grand Prix Great Am/USDF/SWDC Qual O, AA, JR/YR 75Q Grand Prix Freestyle Gr Am/USDF/SWDC Qual O * This class is designated as the USDF/Dover Medal class for Adult Amateurs ** Intermediate II and Intermediate B are both qualifiers for Great American/USDF Championships and SWDC championship class. Competitors may qualify by riding either test; Intermediate B will be the test ridden at Championships. Note that the FEI Young Rider/Junior Team tests only qualify for Great Am/USDF and SWDC qualifying (not NAJYRC). Note: If competitor intends to enter a Great American/USDF Qualifier class as a qualifier include the qualifying fee of $10.00. If competitor intends to enter a Southwest Dressage Championships Qualifier class as a qualifier, include the qualifying fee of $8.00. Qualifying classes held concurrently with the class of the highest level. 80 Materiale Fillies 3 year old O 81 Materiale Mares 4 & 5 year old O 82 Materiale Colts/Geldings 3 year old O 83 Materiale Stallion/Geldings 4 & 5 year old O
101 Training Level Test 1 Opportunity Class O 102 Training Level Test 2 Opportunity Class O 211 First Level Test 1 Opportunity Class O 212 First Level Test 2 Opportunity Class O 300 Rider Test Training Level O 301 Rider Test First Level O 302 Rider Test Second Level O FEE SCHEDULE (all fees are per entry per show unless noted otherwise): Class/Qualifying Fees Intro thru Fourth, Opportunity, Equitation & Rider Classes $40.00 FEI, Freestyle, Materiale & ParaEquestrian Classes $45.00 Pas de Deux (per pair per level) $65.00 Great American/USDF Qualifying Fee (addl) $10.00 SWDC Qualifying Fee (addl) $ 8.00 USDF/USEF Fees USEF Drug/Medication Fee (D/M $8, USEF $8) $16.00 USEF Show Pass (Non member fee, per rider, owner, trainer) $30.00 USDF Non member Fee $25.00 USDF No Proof of Membership Affidavit Fee $ 5.00 Stabling & Grounds Fees Two Day Stall Fee (Fri noon Sun 6 PM)(2 bgs shavings) Gold Barn** $110.00 Two Day Tack Stall Fee (Fri noon Sun 6 PM) Gold Barn** $90.00 Two Day Stall Fee (Fri noon Sun 6 PM)(2 bgs shavings) Silver Barn* $100.00 Two Day Tack Stall Fee (Fri noon Sun 6 PM) Silver Barn * $80.00 One Day Stall Fee (24 hours check in @office, plus 1 bag shavings) $65.00 (no one day stalls in Gold Barn) Early (Thurs) Arrival/Late Departure (per night) $35.00 Grounds Fee (per day if not stabling) $50.00 Additional Shavings/Bag $11.00 Office Fees Office Fee (per entry per show) $30.00 Change after Closing Date (per chg) $20.00 Substitution of Horse or Rider (per show) see rules below $25.00 Late Entry Fee (per entry per show if space & schedule avail. & discr. of mgmt) $40.00 Amount Owed Billing Fee $35.00 Incomplete Entry Fee (per entry) $25.00 Returned Check Fee $25.00 + bank fees Miscellaneous Fees Pony Measurement arranged with vet RV Hook Up (per night must specify RV make & license no.) $40.00 Extra Dinner ticket for non competitor $10.00 Non Compete fee per show $45.00 (Horses not competing in classes must have an entry form for each show, with signatures, current Coggins, and pay a non compete fee, office fee and either grounds or stall fee.) **Gold Barn includes Barn A or C, *Silver Barn includes Barn B, D, E or AA. We will accommodate barn requests as we can, depending on number of entries and which arenas are utilized. No one day stalls available in Gold Barn. Note: There is no additional (non member) fee if you are not a member of a GMO (i.e. DDC, HDS, CTDS, etc.). RULES AND GENERAL INFORMATION
1. All standard dressage, individual and group classes will be offered on Saturday and Sunday. Every class offered herein is covered by the rules and specifications of the current US Equestrian Federation Rule Book and will be conducted and judged in accordance therewith. 2. 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 $30 Show Pass registration fee. Participants in the following 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 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. 3. Amateurs, Juniors & Young Riders: Amateurs are defined by the rules and specifications of the current USEF Rule Book. All riders entering the Amateur classes must possess or have applied for an USEF Amateur Card prior to riding in the class. All riders in Amateur Divisions must present a USEF Amateur Card when picking up their number or they will not be allowed to show in the Amateur Division. Cards may be applied for at the show office. Jr/YR: May compete as Junior until the end of the calendar year in which they reach the age of 18. Young Riders may compete in FEI Young Rider classes from 16 until the end of the calendar year in which they turn 21. Horse age: Horse is considered to be 1 year old on the first day of January following the actual date of foaling. For under saddle classes, horse must be at least 36 months of age at time of competition. 4. CONDITIONS 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 Management, Facility, and Licensee, harmless for any loss or accident to his horse, horses or equipment which may occur. 5. ENTRY PROCEDURES: PLEASE READ CAREFULLY!! Management requests that all entries be created on EqEntries.com. If you do not already have a user account with EqEntries.com, please sign up! As a first time user, you can get $5 off your first paid online entry submission. Input the following in the Coupon Code in the payment section: FIRSTENTRY You can print and mail your entry with a personal check, or pay online with a credit card. If you choose to pay online, there is a 3% fee plus a $5.00 handling charge. There is no charge to join EqEntries, create an entry, or print an entry. So, if you choose to pay by personal check (and mail in), the service is free. We appreciate your using the preferred entry method. Online entries at www.eqentries.com Questions regarding EqEntries, their services, of help can be attained by emailing: Helpme@eqentries.com A. Entries and Fees for Shows: 1. Mail In Entries: Fill out a separate entry form for each show. (You can create these entries online at www.eqentries.com see above.) For each horse entered, send your completed entry form, including USDF & USEF membership cards (print from www.eqverification.com one sheet), Coggins and a check for each show day entered, made payable to Marilyn Kulifay (no credit cards accepted using mail in entries). Mail to Marilyn Kulifay, Entry Secretary, P.O. Box 3452, Houston, TX 77253. No postdated checks accepted. 2. On Line Entries (credit card payments): Go to www.equestrianentries.com register, and select classes, fees, stabling & pay. Send Coggins & signature pages to Marilyn for on line entries or upload to your EquestrianEntries account. Fill out a separate entry form for each show. Horse not officially entered until completed entry and payment received. B. Horse Show Office: Open at noon on Friday and one hour before first ride each show day. C. At the Show: No bridle numbers will be issued without full payment and completed entries, including signatures and emergency contact information. D. Entry Acceptance: Entries will be accepted on a first come first serve basis based on On Line Entry or postmark date until classes are filled. Entries received after classes are filled will be notified and, if desired, put on a waiting list (in the order of postmark or on line entry date). Those entries postmarked after closing
will be accepted at the discretion of the show management, based on a space available basis and charged a $40.00 late fee per show. Those on the waiting list who entered show prior to closing date and did not get into the show will have all fees refunded. NO PHONE entries, FAX entries or entries attached to emails will be accepted. All entries must be made on official entry blanks or on line and filled out completely as to classes, exhibitors, owners, trainers, coaches, horse names, addresses, phone numbers, association numbers, USEF & USDF cards and signatures and include a copy of current Coggins. Parents or guardians must sign the official entry blank of a minor before a number will be released. Make sure that Emergency Contact information is complete. Management reserves the right to refuse any entry. Entries close & MUST BE ENTERED ON LINE or POSTMARKED BY Feb. 17, 2014. E. A copy of horses Coggins pulled within 12 months of the show date must accompany each entry (draw date on or after 3/17/2013). Horse s name on Coggins must match name on entry form and cards. Original Coggins must be available for inspection during the show. Failure to include Coggins prior to show may result in incomplete entry fees per show, and may result in elimination without return of fees. Any horse that develops a communicable disease may be removed at management s discretion. Competition Management will assume no responsibility for the health of horses being stabled. Owners are warned that they enter their horses at their own risk. F. Each competitor is responsible for supplying management with the correct association numbers (USDF, USEF) for horse, owner, rider, and trainer, before the day(s) of the competition. The scores of competitors who fail to supply correct numbers may not be counted toward national awards. Horse name and owner on entry blank must match USEF and USDF documentation. G. Opportunity Classes: These classes do not require USEF & USDF memberships for the horse, rider or owner. USEF drug fees do not apply. If horse, rider or owner has memberships, please indicate so on entry. Riders may not cross enter into other classes. H. Any and all handlers, assistant handlers, drivers, riders, trainers, owners, agents, lessees, parent or guardian of a junior exhibitor, and coaches of horses (or riders) are required to sign an entry blank and with the exception of a parent or guardian of a junior exhibitor, must be USEF members or pay a Show Pass (non member) fee. I. Show management reserves the right to limit entries, add, combine or divide classes, modify the schedule, add, substitute or change officials, modify or cancel awards and prizes and/or make whatever changes are required by circumstances to the competition specifications listed herein. Show management reserves the right to cancel classes insufficiently filled and to refuse or require withdrawal of an entry for cause deemed sufficient by show management. J. Management reserves the right to cancel any classes due to hazardous weather, Acts of God, accident, or emergency. Every effort will be made to reschedule with priority given to any qualifying classes being offered. No refunds for cancellations due to hazardous weather, Acts of God, accidents or emergencies. Refunds will be made in accordance with scratch policy (See #6.) 6. SCRATCHES & SUBSTITUTIONS: Exhibitors have the responsibility of informing the Show Secretary of their intention to scratch in writing. Please keep your receipt of notification of scratching for proof. No refunds given at the show will be mailed. A. Scratches of the whole show made in writing to Show Entry Secretary on or before the closing date may be made for any reason and all fees except office fee will be refunded. B. Scratches of the whole show made in writing to Show Entry Secretary after the closing date but before 5:00 PM on Thursday, March 6, 2014 will be refunded one half stall fees or grounds fees, and all shavings, drug & medication/usef fee and any qualifying fee (GAIG/USDF or SWDC ) paid. Scratches made after 5:00 PM on Thursday, March 6, 2014 but before 5:00 PM on Wednesday, March 12, 2014, will receive shavings, drug & medication/usef fee and qualifying fees paid only. Scratches of the whole show made after 5:00 PM on Wednesday, March 12, 2014 will be refunded drug & medication/usef fee and qualifying fees paid. Scratches of the show that are no shows with no notification given to show secretary will not receive any refund. C. Any scratches of the whole show after the closing date are liable for all unpaid fees, including but not limited to entry and office fees, and will be billed accordingly.
D. Scratches of a class will receive no refund, unless it was a qualifying ride, then GA/USDF or SWDC qualifying fees paid will be refunded. Scratches of a class must be made in writing, and if at the show, with the show secretary. E. All no shows that have not contacted the show office prior to first ride will be considered a scratch for the rest of the shows (both I & II) and time slots may be filled. F. After closing date, one horse may be substituted for another for a $25.00 substitution fee (per show) if horse status (USDF/USEF memberships) and classes and divisions (O, AA, Jr) entered are the same and a note is provided from a veterinarian that the entered horse has been injured or is ill. New separate entry form per show must be filled out with substituted horse s information, cards, Coggins and signatures. Riders may be substituted for one another for a $25.00 substitution fee, if the rider s status (and division) is the same regarding memberships and they are able to ride in the class that was entered by the original rider (i.e. open, amateur or junior) with a doctor s note that the entered rider became ill or injured. Must be same classes & divisions. See above must fill out new entry blanks with Coggins, signatures, etc. A horse or rider may be substituted, but not both. 7. LATE ENTRIES: All entries must be entered online on or postmarked before the closing date or will be considered a late entry. Each late entry will be charged a late fee of $40.00 per show. Late entries will be accepted and given a ride time only as schedule permits and at management s discretion. 8. UNPAID CHARGES: Any exhibitor leaving the show with an unpaid balance of entry fees or other fees due, will be billed for these charges and a $35.00 billing fee will be added to the total due. Until these charges are settled, all future entries of horse, rider and owner will be returned AND USEF Rule 913 will be invoked. 9. RETURNED CHECKS: A $25.00 fee plus bank charges will be assessed for each returned check. All fees must be made good prior to packet pick up. 10. RIDE TIMES: Preliminary ride times will be e mailed about three days before the show and ride times may be posted on www.gswec.com if they can accommodate. Official ride times will be posted at the show grounds by noon on Friday, March 14. Any updates for Show II will be posted by 6:00 PM on Saturday. It is the responsibility of the rider to inform the management of any time conflicts as soon as possible. Any changes after closing date initiated by rider or owner will incur a $20.00 per change fee. 11. BRIDLE NUMBERS: Bridle numbers for the show entered must be worn at all times when a horse is out of its stall even on non show days. Each horse/rider combination is considered a separate entry and must fill out a separate entry form and will be issued a different number. 12. FREESTYLES: A photocopy of a test (score 60% at highest test of level) verifying eligibility must accompany entry. Music for all freestyles on CD must be given to show office on Friday. Sound check time will be announced/posted. Competitors are responsible for picking up their music before the end of show. 13. FACILITIES & ARENAS: All tests and warm up will be ridden in either indoor or outdoor arenas with sand/clay or OttoSport footing. Competition arenas are 20m x 60m (outdoor or covered). No one on foot is allowed in designated warm ups. Lunging permitted in designated outdoor areas only. All horses in the warm up arenas must wear their competition numbers. All arenas must be vacated while equipment is being used. Arenas close at 8:30 PM. Schedule for schooling will be posted at the show grounds. 14. SIGNAGE: No staples or nails are allowed to be affixed to any Great Southwest Equestrian Center property, except for stall cards. Individuals wanting to tape advertisements or flyers to walls, must first obtain permission in writing from Great Southwest Equestrian Center. Permission agreement must be shown to Show Management prior to display and/or taping or flyers/advertisements will be removed. 15. RIBBONS AND AWARDS: Award to 1 st place winner and ribbons awarded to sixth place for Intro through FEI. Qualifying classes will be run concurrently and not be pinned separately. Champion and Reserve Champion ribbons will be awarded for overall high point for Open, Amateur and Junior (excludes Freestyles, Pas De Deux, Equitation, Rider Test, and Materiale classes). 16. SCORES: It is the Competitors responsibility to verify the accuracy of scores. Scoring errors must be reported to the Show Secretary within ONE hour of official posting of the scores from the last class of the show day during which the score was earned. 17. MANAGEMENT: Horse Show Management reserves the right to itself to interpret all questions and conditions in regard to or arising out of any incident in 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; their decision will be final. The Horse Show Management reserves itself the right to refuse, accept conditionally, or to cancel any entries, disqualify riders or exhibitors, prohibit exhibition of entries and cancel award prizes, without claim to damages; to change, cancel or combine any classes, to reschedule classes after due notice to exhibitors, or to change rings or rotate judges, and assess fees/penalties. 18. BEDDING: Only shavings provided by facility for bedding. No outside shavings permitted. If outside shavings are brought in, there is a $100.00 penalty per horse stall. Determination to be made by GSWEC. 19. STABLING A. Permanent stalls are wood, 10' X 10 with doors. Limited number of 12 X 12 stalls available enter early for best availability. Two bags of shavings are included. Stabling requests accepted and will be granted if possible. There are no one day stalls in the 12 X12 size. Additional stabling days will be charged $45.00 per day (both horse and tack stalls). If not stabling, $50.00 per day grounds fee. All stallions must be stabled. B. Electrical requirements must not exceed 2.5 amps per stall. Stall charts will be posted and check in will start at 1 PM on Friday, March 14. Early arrivals and late departures are only available by arrangement with Show Entry Secretary at $35/night/horse. Stalls must be vacated by 6 PM Sunday, except by prior arrangement with show management. Anyone using (without having paid) an unassigned stall or tack stall, even temporarily, will be charge one half a weekend stall fee or $60.00, whichever is greater. Anyone who has moved stalls after arrival at the show grounds must clean the stall from which they moved to the satisfaction of show committee/management, or will be charged one half a weekend stall fee or $60.00, whichever is greater. Anyone who places manure in an empty or unused stall will be charged one half a weekend stall fee or $60.00, whichever is greater. C. No smoking in the barns & offices. Smoking areas will be designated. D. Horses not to be tied to trees. No unattended trailer tying. 20. SCHOOLING HORSES: Horses not entered in the show must be registered with the Horse show office and will be given a number to be worn at all times outside of the stall. Appropriate stall or ground fees and a noncompete and office fee per show must be paid. Any person(s) riding a schooling horse must have signed an official entry blank and/or release form and have provided a current Coggins PRIOR TO UNLOADING HORSE. Schooling of non compete horses are allowed in the warm up area during competition hours if there is ample room in the arena. Non compete horses may be requested to move to a different area or arena, as determined by Show Management or the Technical Delegate. Entry to include the correct number of stabling days. 21. Anyone mounting, getting on, riding or trying a horse at the facility during the weekend of the show (including Friday) must sign a show release and wear a helmet. 22. VETERINARIAN/FARRIER: Vet and farrier on call each show day. Phone numbers and information will be posted at the show grounds and in the show secretary s office prior to the start of the show. 23. PONY MEASUREMENT: Please notify Show Entry Secretary with entry if pony needs to be measured at the competition. If there are ponies to measure, measurement will take place on Friday and those competitors will be notified as to time & location. A pony does not exceed 148 cm without shoes and 149 cm with shoes. Any pony competing in classes limited to ponies must submit a copy of a USEF measurement certificate with its entry. 24. DOGS: Dogs are not permitted to be loose on competition grounds and must be on a leash or otherwise contained. Individuals must not lead dogs on a leash while mounted. Dog owners are solely responsible for any damages, claims, losses or actions resulting from their dogs behaviors. Dog owners failing to comply with this rule may be subject to penalty under Chapters 6 and 7of the USEF General Rules, as well as issuance of warning cards. Loose dogs will be impounded and the owner may be assessed a fine up to $200.00. 25. CONCESSIONS: Concessions are available at the show grounds. 26. PARKING: Parking is allowed in designated areas only. Trailers are to be parked in designated trailer parking area. RV parking is available and will be assigned by show secretary. Please designate electrical requirement on entry blank. Violators improperly parked, including NO PARKING ZONES and FIRE LANES, will be issued citations and/or towed from premises at the owner s expense. Please do not park in front of a trailer, blocking access to the hitch, unless it is your trailer. 27. MOTORIZED VEHICLES: 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. 28. SHARPS CONTAINERS: Management will provide Sharps containers in the barns for competitors use. Competition management may fine any individuals including trainers, owners, exhibitors, or their agents up to $100 for improper disposal of needles or other sharp disposable instruments. If local law has different requirements, local law will prevail. 29. PROTECTIVE HEADGEAR: Anyone mounted on a horse must wear protective headgear. 30. LODGING: Make reservations early! Deadline Feb. 28, 2014 to ensure special room rate. Fairfield Inn & Suites, 15111 Katy Freeway, Houston, TX 281 646 0056 Westchase Hilton, 9999 Westheimer Rd, 713 974 1000 Show rate until 2/28 $79. Code: Horse Show La Quinta, 15225 Katy Fwy, Houston, TX 281 646 9200 Holiday Inn Express, 21010 Katy Fwy, 281 392 1010 31. COMPETITOR PARTY/DINNER: Saturday night approximately 1 hour after end of show. Competitors free, volunteers free, guests $10.00 paid with entry or by 4:00 PM Friday. United States Equestrian Federation (USEF) Entry Agreement By entering a Federation licensed Competition and signing this entry blank as the Owner, Lessee, Trainer, Manager, Agent, Coach, Driver, Rider, Handler, Vaulter or Longeur and on behalf of myself and my principals, representatives, employees and agents, I agree that I am subject to the Bylaws and Rules of The United States Equestrian Federation, Inc. (the Federation ) and the local rules of the competition. I agree to be bound by the Bylaws and Rules of the Federation and the competition. I will accept as final the decision of the Hearing Committee on any question arising under the Rules, and agree to release and hold harmless the competition, the Federation, their officials, directors and employees for any action taken under the Rules. I represent that I am eligible to enter and/or participate under the rules, and every horse I am entering is eligible as entered. I also agree that as a condition of and in consideration of acceptance of entry, the Federation and/or the competition may use or assign photographs, videos, audios, cable casts, or other likenesses of me and my horse taken during the course of the competition for the promotion, coverage or benefit of the competition, sport, or the Federation. Those likenesses shall not be used to advertise a product and they may not be used in such a way as to jeopardize amateur status. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropriation. The construction and application of Federation rules are governed by the State of New York, and any action instituted against the Federation must be filed in New York State. See GR908.4. USDF DOVER MEDAL ADULT AMATEUR MEDAL The USDF/Dover Saddlery Adult Amateur Medal Program is designed to specifically recognize and encourage adult amateurs riding at Second Level. Awards: 1. USDF/Dover Saddlery Medal Recipient: The eligible rider with the highest score of 60 percent or better in the designated Second Level Test Three class or applicable test of choice USDF/Dover Saddlery Adult Amateur Medal class at a participating competition will receive a handcrafted USDF/Dover Saddlery pewter medal and neck ribbon. Winners will receive a $20 Dover Saddlery gift certificate for the first three USDF/Dover Saddlery Medals they win during the competition season. 2. USDF/Dover Saddlery National Merit Award: A USDF/Dover Saddlery National Merit Award will be awarded to riders winning three USDF/Dover Saddlery Medals in the same competition year. 3. Year End Awards: The USDF/Dover Saddlery Medal National Champion and Reserve Champion are determined from the average of the top three winning ride scores during
the competition year. The champion receives a $1000 Dover Saddlery gift certificate and the reserve champion receives a $500 Dover Saddlery gift certificate. Rider Eligibility: 1. Rider must have a current USDF Participating or Group Membership and be a member in good standing of USDF when the scores are earned. 2. Rider must be an adult amateur in accordance with Article GR1306 of the USEF rules and be designated with USEF as an adult amateur at the time the scores are earned. Additional Information: For additional information and an updated list of competitions offering the USDF/Dover Saddlery Adult Amateur Medal Program, please visit http://www.usdf.org/awards/performance/adultmedalprogram.asp Southwest Dressage Championship 2014 Qualifying Percentages Level AA JR/YR OPEN Walk Trot (USDF Intro B Test) 63% Training Level 61% 61% 64% First Level 60% 60% 63% Second Level 59% 59% 62% Third Level 58% 58% 60% Fourth Level 57% 57% 58% Prix St Georges* 57% 57% 58% Intermediate I 57% 57% 58% Intermediate B ** or I 2 57% 57% 58% Grand Prix 57% 57% 58% Musical Freestyle Training Level 62% Musical Freestyle 1st Level 62% Musical Freestyle 2nd Level 62% Musical Freestyle 3 rd Level 62% Musical Freestyle 4 th Level 62% Musical Freestyle FEI 60% Pony Championship Training Level 56% Pony Championship First Level 56% Competitors may check scores by checking www.swdressage.org web site or by sending an email to the SWDC Qualifying Secretary, at qualifying@swdressage.org. To permit recording, scores will not be available until at least three weeks after the competition. Southwest Dressage Championship Qualifying Classes will be governed by the rules on web site (www.swdressage.org). Look for changes on the website. **Competitors may qualify for the Intermediate B division with either the Intermediate II or Intermediate B test. Scores must meet the open division percentages and the rider must state the intention to qualify for those classes and pay qualifying fees PRIOR TO THE RIDE. *PSG Open IS SPONSORED BY an Anonymous Sponsor. Sponsorships are $500 per level/division. Please contact SWDC Chairman for specifics. Rules for Qualifying 1. A horse/rider combination may qualify for the SWDC Championship by earning two qualifying scores in qualifying classes at SWDC recognized shows during the 2013 SWDC qualifying year. Qualifying classes are the highest test at each level, or freestyle at that level. The only exception is Walk Trot which will use Intro test B. Winning or placing in the class is not necessary as long as the score is earned. These scores must be earned at two different competitions from two different judges. 2. An $8.00 fee is added to the regular entry fee when entering a Qualifying Class at an SWDC recognized competition. $5.00 dollars of this fee is allocated for prize money at the Championships, $1.00 of the fee is to provide for the volunteers services at the Championships, and the remaining $2.00 will be used to help pay for awards. 3. The 2014 SWDC qualifying is 30 September 2013 until 14 days before 2014 SWDC.. 4. One score may be earned at a show that is not approved by the SWDC as long as: a. The show is outside of Region 9 and recognized by USEF/USDF.
b. The rider submits the score (a copy of the front of a signed dressage test) and a fee of $25.00 to the SWDC Qualifying Secretary within two weeks after the show. If the score is not received within the two weeks, it will not apply. 5. A horse/rider combination having won the Championships at a certain level and division may not compete at that level and division or below in the Championships in subsequent years (except Grand Prix). However, the horse may compete at any level with a different rider. 6. The SWDC Qualifying Secretary will notify all qualified horse/rider combinations by posting on the SWDC website (www.swdressage.org) as the shows send in their score reports. If the rider does not find their name within 45 days of qualifying, they should contact and confirm their scores with the SWDC Qualifying Secretary. 7. A horse/rider combination may move up a level during the year but at the Championship show may only compete at two consecutive levels including both the Open Show and the Championships. 8. Each rider must declare the division in which they are competing prior to each attempt at a qualifying ride at SWDC qualifying shows or for a score submitted under Rule 4 (Amateur, Open, or Junior/Young Rider) and must provide proof of eligibility in the case of Amateur and Junior/Young Rider. Adult Amateur and Junior/Young Riders may also qualify for the Open division. Separate qualifying scores must be earned for each division. At the SWDC Championships, riders must enter each division separately and will ride in each division separately. 9. In qualifying classes with more than one judge, scores among the judges of the ride will be averaged. For purposes of obtaining qualifying scores from two judges, so long as one judge in the judging combination is changed, it will constitute a different judge. 10. Qualifying rides must be ridden in an unmodified standard 20m x 60m arena. 11. Competitors wishing to qualify for the Training or First Level Open Pony Championships may ride a qualifying test at Training or First Level in any division. These qualifying scores do not have to be earned in classes restricted to ponies but the competitor must declare prior to the start of the ride their intent to qualify for the SWDC Pony Championship class. 12. Junior and Young Riders may qualify for the SWDC Freestyle Championship classes using qualifying scores obtained from Junior Rider Freestyle and Young Rider Freestyle classes. Junior Rider Freestyle class scores will serve to qualify the horse/rider combination for the SWDC Third Level Freestyle Championship class and the Young Rider Freestyle class scores will qualify the horse/rider combination for the SWDC FEI Level Freestyle class. Scores must meet the open division percentages for those levels and the rider must state the intention to qualify for those classes and pay qualifying fees PRIOR TO THE RIDE.
2014 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 www.usdf.org. Please refer to the 2014 USDF Member Guide for the comprehensive list of rules and requirements for this program. Membership/Registration Requirements for Qualifying and Championships Rider: Must have a USDF Participating* Membership (PM) at the time qualifying scores are earned and at the time of the championships. Must have a USEF membership (Junior Active, Senior Active, or Life) at the time the qualifying scores are earned and at the time of the championships. Horse: Must have a USDF Lifetime Horse Registration (LTR) at the time qualifying scores are earned and at the time of the championships. Must have a USEF (Annual or Lifetime) Membership recorded at the time qualifying scores are earned and at the time of the championships. 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 membership (PM* or Business Member (BM)) at the time the qualifying scores are earned and at the time of the championships. Must have a USEF membership (Junior Active, Senior Active, or Life) at the time qualifying scores are earned and at the time of the championships. * 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 levels 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% 2014 RC
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 www.usdf.org. This competition is recognized by USDF for 2014 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, Participating Membership (PM), or have a USDF Non-Member (NM) identification number and pay the USDF NM fee. (Note: USDF business members can own horses but cannot compete as riders with their USDF BM.) Individuals cannot compete at a USEFlicensed/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, quadrille, FEI Para-Equestrian classes, 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 ($75), 5-years ($300), or life ($1,500). 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 ($60). 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, Great American Insurance Group/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 ($200) 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 $25 and a USDF NM form 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 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 member there is no NM fee assessed. Competition management will be invoiced for all applicable USDF NM fees not received with the USDF post competition 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 ($25). 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 Great American Insurance Group/USDF Breeders Championship Series Finals. An HID number can be upgraded to a Lifetime Horse Registration (LHR) for a fee of $70. 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 ($95) is eligible for Adequan /USDF Year-End Awards, and eligible to compete at Great American Insurance Group/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: www.usdf.org. 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) 971-2277, 4051 Iron Works Parkway, Lexington, KY 40511 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. 06/13
2014 Competition Name: Emerald Classic (specify show I or II) PLEASE FILL OUT SEPARATE Competition Date(s): Mar., 2014 (specify day) ENTRY FOR EACH SHOW Closing Date: Feb. 17, 2014 (postmark or on-line) Credit card payment online only Bridle # NOTES Name of Horse Previous Name (if any) USEF # USDF # For Sale? Breed Sex Color Height Year Coggins (Blood drawn on date) Sire Dam Dam Sire Country of Birth Breeder OWNER: USEF # USDF # Address: City: State: Zip: Tel: Cell: Email: Class # Div Class Description Qual Fee Y / N RIDER: Class & Qualifying Total: USEF # USDF # Other Required Fees Fees Address: Office Fee Mandatory for each horse/rider entry $30 City: State: Zip: USEF Fee Mandatory for each horse competing $16 $8 Drug / $8 USEF Fee = $16 Tel: Cell: Stall Fee Stall @ $110 or $100 (2 bgs shvg incl) Email: Tack Stalls Stall(s) @ $90 or 80 per stall Open AA JrYR Birthdate Can Volunteer? Bedding Bags @ $11 per Bag TRAINER: USEF # USDF # Address: City: State: Zip: Tel: Cell: Email: COACH: USEF # USDF # USEF Show Pass (nonmember) $30 per rider/owner/trainer USDF Non-Member Fee $25 per rider/owner USDF Affidavit Fee $5 if req d Non-Compete Horse $45 (must pay Office Fee) Grounds/Haul in Fee $50 (if no stall) Late Fee $40 / Change Fee $20 per change Incomplete Entry Fee $25 RV Hook-Up Fee $40 per night Other TOTAL FEES: Tel: Cell: REMEMBER to attach copies of cards & coggins. Reverse side must be SIGNED! Stabling Information & Special Requests: Please list only one group name (either individual or barn) for entire group. Group/Farm/Self Wed Thu Fri Sat Sun Mon Horse Stall (Horse Name) Barn/Stall Preference Tack Stall(s) Group Name: Contact: Tel: Please indicate if you are attending Competitor Party/Dinner (circle) YES or NO
WARNING UNDER TEXAS LAW A LIVESTOCK SHOW SPONSOR, FARM ACTIVITIES SPONSOR OR EQUINE PROFESSIONAL IS NOT LIABLE FOR INJURY TO, OR THE DEATH OF A PARTICIPANT IN EQUINE ACTIVITIES RESULTING FROM THE INHERENT RISK OF EQUINE ACTIVITIES. I hereby agree to release, indemnify, and hold harmless, USDF, its instructors, officers, directors, agents, and volunteers from and against any and all loss, liability or damage arising from or because of, or in connection with participation in this competition or related activities. I also hereby agree to release, indemnify, and hold harmless, the competition licensees, show management, show staff, show committee and members, officers, directors, agents, and volunteers from and against any and all loss, liability or damage arising from or because of, or in connection with participation in this competition or related activities. MEMBERSHIP STATEMENT 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 $30 Show Pass registration fee. Participants in the following 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 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. Federation Entry Agreement By entering a Federation-licensed Competition and signing this entry blank as the Owner, Lessee, Trainer, Manager, Agent, Coach, Driver, Rider, Handler, Vaulter or Longeur and on behalf of myself and my principals, representatives, employees and agents, I agree that I am subject to the Bylaws and Rules of The United States Equestrian Federation, Inc. (the Federation ) and the rules of the competition. I agree to be bound by the Bylaws and Rules of the Federation and of the competition. I will accept as final the decision of the Hearing Committee on any question arising under the Rules, and agree to release and hold harmless the competition, the Federation, their officials, directors and employees for any action taken under the Rules. I represent that I am eligible to enter and/or participate under the Rules, and every horse I am entering is eligible as entered. I also agree that as a condition of and in consideration of acceptance of entry, the Federation and/or the Competition may use or assign photographs, videos, audios, cable - casts, broadcasts, internet, film, new media or other likenesses of me and my horse taken during the course of the competition for the promotion, coverage or benefit of the competition, sport, or the Federation. Those likenesses shall not be used to advertise a product and they may not be used in such a way as to jeopardize amateur status. I hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to compensation, invasion of privacy, right of publicity, or to misappropriation. The construction and application of Federation rules are governed by the laws of the State of New York, and any action instituted against the Federation must be filed in New York State. See GR908.4 Federation Release. Assumption of Risk, Waiver and Indemnification This document waives important 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 herein includes the Licensee and Competition Management, as well as all of their officials, officers, directors, employees, agents, personnel, volunteers and Federation affiliates. 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. NO ENTRY IS COMPLETE WITHOUT ALL REQUIRED SIGNATURES! (WRITING SAME IS NOT A SIGNATURE!) Rider/Handler (Mandatory) Owner/Agent/Lessee(Mandatory) Trainer (Mandatory) Coach (If Applicable) (parent/guardian if under 18) (parent/guardian if under 18) (parent/guardian if under 18) (include USEF#) Signature Signature Signature Signature Print Name Print Name Print Name Print Name Parent/Guardian Signature: (Req d if rider is a minor) Print Name: RIDER EMERGENCY CONTACT INFORMATION (Mandatory) in case of injury to rider Name of Contact/Relationship to Rider Telephone Number