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Entry Form

Spring Horse Show

Sunday, May 4, 2008

RIDER NAME________________________________________

ADDRESS __________________________________________

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EMAIL ______________________________________________

(will be used ONLY to alert you to future horse shows or schooling opportunities)

PHONE NUMBER_____________________________________

DIVISION (CIRCLE ONE)

JUNIOR                         12 AND UNDER

OPEN                             13 AND OVER

HORSE’S NAME______________________________________

NEGATIVE COGGINS__________________________________

Release:  I understand that this is a high risk sport and that I am participating at my own risk.  I hereby assume this risk and further do hereby release and hold harmless Potomac Pony Club and the owners of any property on which this event is held, from all liability for negligence resulting in accidents, damage, injury or illness to myself and to my property including the horse or horses which I will compete at this event.

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