Straight Up Stables

Rider Name

Parent or Guardian Name under 18 years

Riders Birth Date

Riders Address

City, State, Zip

Riders Email

Cell Phone

Emergency Contact Name

Emgergency Phone Number

Trainers Name

Trainers Email

Horses Full Name

Height, Sex, Breed, Age

Combined Test Division(s) Entered: $60 per division

Dressage Classes Entered: $30 per Class

Introductory: Test A,B and C
Training: Test 1,2 and 3
First: Test 1,2 and 3
Second: Test 1,2 and 3
Third: Test- Please specify below.
Fourth: Test- Please specify below.
Western Dressage: Test- Please specify below.
USEA: Test- Please specify below.

Please specify which test(s)

Jumper Rounds Entered: $20 per round

Elementary-18"
Introductory- 2'3"
Beginner Novice- 2'7"
Novice- 2'11"
Training- 3'3"

I understand ALL USEF rules for Dressage and Eventing will apply.

Yes

Parking- Please note if you will be traveling with another farm or would like parked near that farm.

Release Warning:Under Pennsylvania law an equine professional and equine activity sponsor is not liable for an injury to or death of a participant in equine activities resulting from the inherent risks equine activities. I/We acknowledge that equine activities, whether riding, working, or being around equines, is a high risk activity. I/We acknowledge that equine activities, whether riding, working or being around equines, is a high risk activity. In consideration of the acceptance of this entry, whether I am mounted or unmounted, I release and, in addition, agree to hold harmless Straight Up Stables LLC, Mark VonNieda and K. Brooks VonNieda and any possessors of land of and from any and all claims and demands of every kind, nature and character which I may have or may hereafter acquire, for any claim for bodily injury, death or property damage and from all liability for negligent acts or omissions. In addition, I specifically release Straight Up Stables LLC, Mark VonNieda and K. Brooks VonNieda and any possessors of land on which this activity occurs for injuries to any part of my body, including death, whether the same may have been caused by the negligence of Straight Up Stables LLC, Mark VonNieda and K. Brooks VonNieda or the possessors of land. I agree that Straight Up Stables LLC, Mark Von Nieda and K. Brooks VonNieda has the right to refuse this entry for any cause which the organizer shall deem sufficient.

Yes, I agree. ( Please sign and date below)

Release Signature

Release Date

PLEASE SELECT A PAYMENT METHOD

Straight Up Stables LLC
Entry Form & Release

Subtitle

Straight Up Stables
Combined Test & Dressage Show
~Entry Form and Release~
597 Lees Bridge Road, Nottingham PA
www.straightupstables.com

Straight Up Stables LLC Entry Form & Release

Subtitle

Straight Up Stables Combined Test & Dressage Show~Entry Form and Release~597 Lees Bridge Road, Nottingham PA www.straightupstables.com

Straight Up Stables LLC
Entry Form & Release

Straight Up Stables
Combined Test & Dressage Show
~Entry Form and Release~
597 Lees Bridge Road, Nottingham PA
www.straightupstables.com