Margaret River & Districts Horseman's Association & Pony Club Inc. ABN: 29 554 298 810 The Sue Clarke Memorial 'Go Pink' Gala Breed Show Entry Form Phone entries will NOT be accepted under any circumstances. Pre-entries close on 21st November 2013. Any entries received that are post marked after this date will be classed as a late entry. Late entries will be taken via email until Thursday 28 th November but will incur a late fee. One Horse/Pony per Entry Form Page 1 Please print or write very clearly so that correct spelling of names etc can be easily ascertained. Exhibitors Name: Exhibitor/Rider EWA Membership Number: if applicable. Address: Town: PIC #: Phone Number/s: Email Address: HELPER JOBS These events are unable to run without helpers on the day. Exhibitors are asked to nominate a helper for completing a job number 1 through 5 in order of preference Saturday Sunday Either Helpers Name: Mobile contact on day: Marshall Penciller SJ set up Rail Crew Canteen Horse/Pony Name: Date of Foaling: Registration # Breed Association Registered With Copies Enclosed Registration Copies Enclosed Membership High Point Trophy Nomination Leading rein riders are ineligible for the junior trophy. Junior 16 years and under. Rider s Name: OR Senior 17 years and over. Rider s Name: Class # Class Description Halter Class (eg Welsh A gelding 3 years & under) Breed Ridden Class (eg Smartest on Parade) Breed Ridden Class (eg ridden pony ne 12hh) Breed Ridden Class (eg ridden gelding) Dressage x 1 Ridden Handy Pony or In Hand Agility Working Hunter No changes to your nominated classes after closing date. No trophy nominations taken on the day.
6.30 pm Come and enjoy a quality BBQ dinner of Steak and Sausages with fresh salads and delicious desserts. Bring along some drinks or maybe bid on some lovely local wines at the Auction. Make sure you fill in meal requirements on your entry form. Adults $25 & Kids $15 Don't forget to bring along some extra cash so you can snap up some beautiful Auction items.
One Horse/Pony per Entry Form - Page 2 Horses Name: Halter Classes - $10 per class or $40 day ticket (pre-entry only prior to closing date) HIGHLAND MINIATURE HORSE WALER 1 Smartest on Parade - incl. Pink 64 Smartest on Parade - incl. Pink 127 Smartest on Parade - incl. Pink 2 Colt 3 years and under 65 Colt 3 years and under 128 Colt 3 years and under 3 Stallion 4 years and over 66 Stallion 4 years and over 129 Stallion 4 years and over 4 Filly 3 years and under 67 Filly 3 years and under 130 Filly 3 years and under 5 Mare 4 years and over 68 Mare 4 years and over 131 Mare 4 years and over 6 Gelding 3 years and under 69 Gelding 3 years and under 132 Gelding 3 years and under 7 Gelding 4 years and over 70 Gelding 4 years and over 133 Gelding 4 years and over CONNEMARA MINIATURE PONY BRUMBY 8 Smartest on Parade - incl. Pink 71 Smartest on Parade - incl. Pink 134 Smartest on Parade - incl. Pink 9 Colt 3 years and under 72 Colt 3 years and under 135 Colt 3 years and under 10 Stallion 4 years and over 73 Stallion 4 years and over 136 Stallion 4 years and over 11 Filly 3 years and under 74 Filly 3 years and under 137 Filly 3 years and under 12 Mare 4 years and over 75 Mare 4 years and over 138 Mare 4 years and over 13 Gelding 3 years and under 76 Gelding 3 years and under 139 Gelding 3 years and under 14 Gelding 4 years and over 77 Gelding 4 years and over 140 Gelding 4 years and over PART BRED CONNEMARA RIDING PONY AUSTRALIAN STOCKHORSE 15 Smartest on Parade - incl. Pink 78 Smartest on Parade - incl. Pink 141 Smartest on Parade - incl. Pink 16 Colt 3 years and under 79 Colt 3 years and under 142 Colt 3 years and under 17 Stallion 4 years and over 80 Stallion 4 years and over 143 Stallion 4 years and over 18 Filly 3 years and under 81 Filly 3 years and under 144 Filly 3 years and under 19 Mare 4 years and over 82 Mare 4 years and over 145 Mare 4 years and over 20 Gelding 3 years and under 83 Gelding 3 years and under 146 Gelding 3 years and under 21 Gelding 4 years and over 84 Gelding 4 years and over 147 Gelding 4 years and over WELSH A ANY OTHER PURE BRED APSB REG. PONY QUARTER HORSE 22 Smartest on Parade - incl. Pink 85 Smartest on Parade - incl. Pink 148 Smartest on Parade - incl. Pink 23 Colt 3 years and under 86 Colt 3 years and under 149 Colt 3 years and under 24 Stallion 4 years and over 87 Stallion 4 years and over 150 Stallion 4 years and over 25 Filly 3 years and under 88 Filly 3 years and under 151 Filly 3 years and under 26 Mare 4 years and over 89 Mare 4 years and over 152 Mare 4 years and over 27 Gelding 3 years and under 90 Gelding 3 years and under 153 Gelding 3 years and under 28 Gelding 4 years and over 91 Gelding 4 years and over 154 Gelding 4 years and over WELSH B ARABIAN WARMBLOOD 29 Smartest on Parade - incl. Pink 92 Smartest on Parade - incl. Pink 155 Smartest on Parade - incl. Pink 30 Colt 3 years and under 93 Colt 3 years and under 156 Colt 3 years and under 31 Stallion 4 years and over 94 Stallion 4 years and over 157 Stallion 4 years and over 32 Filly 3 years and under 95 Filly 3 years and under 158 Filly 3 years and under 33 Mare 4 years and over 96 Mare 4 years and over 159 Mare 4 years and over 34 Gelding 3 years and under 97 Gelding 3 years and under 160 Gelding 3 years and under 35 Gelding 4 years and over 98 Gelding 4 years and over 161 Gelding 4 years and over WELSH C ARABIAN DERIVATIVE ANDALUSIAN 36 Smartest on Parade - incl. Pink 99 Smartest on Parade - incl. Pink 162 Smartest on Parade - incl. Pink 37 Colt 3 years and under 100 Colt 3 years and under 163 Colt 3 years and under 38 Stallion 4 years and over 101 Stallion 4 years and over 164 Stallion 4 years and over 39 Filly 3 years and under 102 Filly 3 years and under 165 Filly 3 years and under 40 Mare 4 years and over 103 Mare 4 years and over 166 Mare 4 years and over 41 Gelding 3 years and under 104 Gelding 3 years and under 167 Gelding 3 years and under 42 Gelding 4 years and over 105 Gelding 4 years and over 168 Gelding 4 years and over WELSH D STANDARDBRED FRESIAN 43 Smartest on Parade - incl. Pink 106 Smartest on Parade - incl. Pink 169 Smartest on Parade - incl. Pink 44 Colt 3 years and under 107 Colt 3 years and under 170 Colt 3 years and under 45 Stallion 4 years and over 108 Stallion 4 years and over 171 Stallion 4 years and over 46 Filly 3 years and under 109 Filly 3 years and under 172 Filly 3 years and under 47 Mare 4 years and over 110 Mare 4 years and over 173 Mare 4 years and over 48 Gelding 3 years and under 111 Gelding 3 years and under 174 Gelding 3 years and under 49 Gelding 4 years and over 112 Gelding 4 years and over 175 Gelding 4 years and over PART BRED WELSH PART BRED STANDARDBRED CLYDESDALE 50 Smartest on Parade - incl. Pink 113 Smartest on Parade - incl. Pink 176 Smartest on Parade - incl. Pink 51 Colt 3 years and under 114 Colt 3 years and under 177 Colt 3 years and under 52 Stallion 4 years and over 115 Stallion 4 years and over 178 Stallion 4 years and over 53 Filly 3 years and under 116 Filly 3 years and under 179 Filly 3 years and under 54 Mare 4 years and over 117 Mare 4 years and over 180 Mare 4 years and over 55 Gelding 3 years and under 118 Gelding 3 years and under 181 Gelding 3 years and under 56 Gelding 4 years and over 119 Gelding 4 years and over 182 Gelding 4 years and over SHETLAND THOROUGHBRED PINTO 57 Smartest on Parade - incl. Pink 120 Smartest on Parade - incl. Pink 183 Smartest on Parade - incl. Pink 58 Colt 3 years and under 121 Colt 3 years and under 184 Colt 3 years and under 59 Stallion 4 years and over 121 Stallion 4 years and over 185 Stallion 4 years and over 60 Filly 3 years and under 123 Filly 3 years and under 186 Filly 3 years and under 61 Mare 4 years and over 124 Mare 4 years and over 187 Mare 4 years and over 62 Gelding 3 years and under 125 Gelding 3 years and under 188 Gelding 3 years and under 63 Gelding 4 years and over 126 Gelding 4 years and over 189 Gelding 4 years and over
One Horse/Pony per Entry Form - Page 3 Horses Name: Halter Classes - $10 per class or $40 day ticket (pre-entry only prior to closing date) ANY OTHER REG BROKEN COAT PALOMINO Led Agility Classes - $5 190 Smartest on Parade - incl. Pink 237 Smartest on Parade - incl. Pink 281 Miniature Horse 191 Colt 3 years and under 238 Colt 3 years and under 282 Miniature Pony 192 Stallion 4 years and over 239 Stallion 4 years and over 283 Shetland 193 Filly 3 years and under 240 Filly 3 years and under 30cm Pink Ribbon Show Jumping - $5 194 Mare 4 years and over 241 Mare 4 years and over 284 Leading Rein 195 Gelding 3 years and under 242 Gelding 3 years and under 285 First Ridden 196 Gelding 4 years and over 243 Gelding 4 years and over 286 Any other age BUCKSKIN 244 * Best Coat Colour Fancy Dress - $5 197 Smartest on Parade - incl. Pink 245 * Best Mane & Tail 287 10 years and under 198 Colt 3 years and under 246 * Best Head 288 11 years to 16 years 199 Stallion 4 years and over ANY UNREGISTERED PONY 14hh & UNDER 289 17 years and over 200 Filly 3 years and under 247 Smartest on Parade - incl. Pink Ridden Handy Pony - $5 201 Mare 4 years and over 248 Colt 3 years and under 290 Leading Rein 202 Gelding 3 years and under 249 Stallion 4 years and over 291 First Ridden 203 Gelding 4 years and over 250 Filly 3 years and under 292 Riders 10 years and under 204 * Best Trot 251 Mare 4 years and over 293 Riders 11 years to 16 years 205 * Best Bred to Type 252 Gelding 3 years and under 294 Riders 17 years and over 206 * Best Head 253 Gelding 4 years and over Saddles Plus Perth Dressage Challenge DUN ANY UNREGISTERED HORSE OVER 14HH $5 (one class only) 207 Smartest on Parade - incl. Pink 254 Smartest on Parade - incl. Pink 295 Preparatory A - 10 years and under 208 Colt 3 years and under 255 Colt 3 years and under 296 Preparatory A - 11 years to 16 years 209 Stallion 4 years and over 256 Stallion 4 years and over 297 Preparatory A - 17 years and over 210 Filly 3 years and under 257 Filly 3 years and under 298 Preliminary 1A - 16 years and under 211 Mare 4 years and over 258 Mare 4 years and over 299 Preliminary 1A - 17 years and over 212 Gelding 3 years and under 259 Gelding 3 years and under 300 Novice 2A - 16 years and under 213 Gelding 4 years and over 260 Gelding 4 years and over 301 Novice 2A - 17 years and over 214 * Best Trot Breed Ridden Classes - $15.00 (3 classes) 302 Elementary 3A - 16 years and under 215 * Best Dun Factor Ponies 14.2hh and under 303 Elementary 3A - 17 years and over 216 * Best Head 261 Smartest on Parade Evolution Equestrian Show Horse Classes SILVER 262 Ridden pony ne 12hh $15 per horse/rider combination 217 Smartest on Parade - incl. Pink 263 Ridden pony over 12hh ne 13hh 304 Best presented 14hh and under 218 Colt 3 years and under 264 Ridden pony over 13hh ne 14.2hh 305 Best presented over 14hh 219 Stallion 4 years and over 265 Ridden Mare 306 Novice pony 14hh and under 220 Filly 3 years and under 266 Ridden Gelding 307 Novice horse over 14hh 221 Mare 4 years and over 267 Ridden Stallion 308 Rider/pony combination 14hh & under 222 Gelding 3 years and under Horses over 14.2hh 309 Rider/horse combination over 14hh 223 Gelding 4 years and over 268 Smartest on Parade 310 Best educated pony ne 14hh 224 * Best Trot 269 Ridden Horse over 14.2hh ne 15hh 311 Best educated horse over 14hh 225 * Best Bred to Type 270 Ridden Horses over 15hh ne 16hh 312 Pleasure pony ne 14hh 226 * Best Head 271 Ridden Horse over 16hh 313 Pleasure hack over 14hh CREMELLO/PERLINO 272 Ridden Mare 314 Lightweight pony 14hh & under 227 Smartest on Parade - incl. Pink 273 Ridden Gelding 315 Lightweight horse over 14hh 228 Colt 3 years and under 274 Ridden Stallion 316 Med/Heavyweight pony 14hh & under 229 Stallion 4 years and over Leading Rein & First Ridden - $10 (3 classes) 317 Med/Heavyweight horse over 14hh 230 Filly 3 years and under Best presented Leading Rein rider 318 Rider 10 years and under 275 231 Mare 4 years and over 8 yrs and under 319 Rider 11 years to 16 years 232 Gelding 3 years and under Best presented First Ridden rider 10 320 Rider 17 years to 25 years 276 233 Gelding 4 years and over years and under 321 Rider over 25 years 234 * Best Trot Rider & Pony combination Leading Working Hunter - $10 (one class only) 277 235 * Best Bred to Type Rein 322 Novice - 30cm 236 * Best Head Rider & Pony combination First 323 Intermediate 45cm 278 Ridden 324 Open from 75cm 279 Pleasure pony Leading Rein 280 Pleasure pony First Ridden DINNER AND AUCTION SATURDAY NIGHT Come and enjoy a lovely BBQ dinner of Steak and Sausages with fresh salads and delicious desserts. Bring along some drinks or maybe bid on some lovely local wines at the Auction. Top Quality Meal, mix with other competitors and enjoy the evening. Don't forget to bring along some extra cash so you can snap up some beautiful Auction items. Don't miss out on all the fun Saturday Night.
One Horse/Pony per Entry Form Page 4 Please print or write very clearly so that correct spelling of names etc can be easily ascertained. Horse/Pony Name: Halter Classes $10 per class OR $40 for a day ticket X classes $ OR day ticket $ Breed Ridden $15.00 $ Leading Rein/First Ridden Hack Classes - $15.00 $ Led Agility Class - $5.00 $ 30cm Pink Ribbon Show Jumping - $5.00 $ Fancy Dress - $5.00 $ Ridden Handy Pony class - $5.00 $ Saddles Plus Perth Dressage Challenge - $5.00 $ Evolution Equestrian Show Horse Classes - $15.00 $ Working Hunter - $10 per class $ Compulsory Ground fee - $5.00 per horse/rider combination per day $ Competitor Membership to MR & DHA & PC for non EA or club members - $20.00 $ BBQ Dinner Saturday Night: $25.00 per adult x $ BBQ Dinner Saturday Night: $15.00 per child x $ LATE ENTRY FEE AFTER 21 NOVEMBER 2013 $10.00 TOTAL PAYABLE $ Please sent entries and money to: The Show Secretary, PO Box 1178, MARGARET RIVER WA 6285 Cheques/Money Orders to be made payable to: Margaret River Pony Club OR Direct deposit to: BSB: 036 127 Account: 138749 Reference: surname and BR. Please include a copy of the payment receipt with the entry form. Completed entries may be emailed to: mrpcsecretary@westnet.com.au Acknowledgement email will be sent back to you so you are aware that it has been received. If you do not get an acknowledgement I may not have got your entry. Incomplete entries will be returned to sender. Please complete the following checklist ( in each box) before mailing or emailing your entry form. This will ensure that you have included all the required information and paperwork necessary for acceptance of your entries to the Sue Clarke Memorial Gala Breed Show. I have entered all the required details for each individual horse/pony on page 1, 2, 3 and 4 of the entry form. I have enclosed a copy of all breed registrations papers for each horse/pony entered I have enclosed a copy of my current financial breed membership card. I have enclosed a copy of my: Current financial EWA membership card OR I have paid the Competitor Membership to MR&DHA & PC OR I am a current member of MR&DHA&PC (either full or competitor) I have filled in, signed and enclosed the required Disclaimer statement for all riders/handlers I have enclosed my order for the Saturday evening BBQ meal I have enclosed a cheque/money order or direct deposit receipt for the correct amount as per the total payable for all combined entries.
Member Dangerous Activity Acknowledgement Full Name of participant (and of guardian if under 18 years)...... Address... State..Post Code...Date of Birth... Name of Club/Organisation... Membership No.... In consideration for being permitted to participate in any way in horse sport activities, I, the undersigned, understand, acknowledge and accept that: Horse sports are a dangerous activity and horses can act in a sudden and unpredictable (changeable) way, especially if frightened or hurt. There is a significant risk that serious INJURY or DEATH may result from horse sport activities. I understand and acknowledge the dangers associated with the consumption of alcohol or any mind altering drugs and agree not to drink alcohol or take drugs prohibited by law before or during any horse sports activities. I agree to follow the directions of any event organiser or official and that any misconduct or refusal by me to follow any direction of any organiser or official can result in the CANCELLATION of my participation in the activities and my immediate removal from my horse NO MATTER where that may occur. I agree to wear an approved helmet at all times whilst participating in the sport where this is required under the relevant EA and FEI rules and regulations. I have had sufficient opportunity to read this Dangerous Activity Acknowledgement and fully understand its terms and sign it freely and voluntarily. Dated: / / Signature of rider For Participants of Minority Age (Under Age 18) This is to certify that I, as a parent/guardian with legal responsibility for this participant, acknowledge, understand and accept ALL OF THE ABOVE and consent and agree to my minor child's involvement or participation in horse sport activities. Dated: / / Signature of guardian