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CENTER LINE FARM
SHOW & CLINIC ENTRY FORM EVENT: ___________________________ DATE:__________ RIDER: _________________________________________________ JR/SR STREET: ________________________________________________ TOWN: ______________________________________ STATE : ______ ZIP CODE :_____________ PHONE: _____________________________ HORSE BREED / AGE / SEX CLASS / DIV ENTRY FEES
Entries will only be accepted if complete with signature, full payment of fees and Negative Coggins Test. I enclose herewith a total of $ ____________ for the aforementioned entry, which is made at my own risk and subject to the conditions of the organizer. RELEASE: I understand that this is a high risk sport and am
participating at my own risk. I hereby release and hold harmless the
Organizer, Organizing Committee, judges and officials, the host and
property owners from any and all accidents, damages, injury or illness
to horses, owners, riders, employees, attendants, spectators, or any
other person or property loss suffered during or in connection with this
event. (Note: Parent or guardian must sign if competitor is under 18) Mail to: --------------------------------------------------------------------------------------------------------------------------------- | ||||||||||||||||||||||||||||||||||