Rider Name/Age:____________________________________NUMBER:__________
Address_________________________________________________
Phone Number:__________________________________________
EMAIL ADDRESS__________________________________________
Horse Name__________________________________________
Additional Horses______________________________________________________
Classes You Wish To Enter:(Additional Classes can be added on side)Circle to Audit
1.______________________________5_________________________
2_______________________________6_________________________
3.______________________________7._________________________
4.______________________________8__________________________
Entry Fees Due:
$15 Arena Fee Pre-Entry/$20 on show day
$55--ALL DAY PASS!! ALL CLASSES EXCEPT JACKPOT
$7/ Per class
$10 Jackpot Classes
$20 Extreme Trail Class--Winner gets Cash Prize
$4 Per Audit Class
Make Checks Payable To WEST VALLEY HORSE SHOW.
SEND ENTRY FORM AND PAYMENT TO:
2523 N 192ND AVE
BUCKEYE, AZ 85326
TOTAL DUE _____________________________Check #____________________ CASH
PAYPAL AND CREDIT CARDS CAN BE ACCEPTED FOR PRE-ENTRIES BY CALLING 623-628-7663 OR EMAILING CCARL52@HOTMAIL.COM
This Entry Constitutes an agreement of the following:
Under Arizona Law, a participant in equine activities assumes the risk of any injury, harm, damage, or death and any legal responsibility that may occur to participant resulting from the inherent risks associated with equine activities. Pursuant to Arizona Revised Statute, ARS 12-553, equine professionals are not liable for damages resulting from inherent risks of equine activities.
I understand the inherent danger of Equine Activities and helmet wear is highly recommended for all riders.
Signed:__________________________________________________Date_____________
Parent/Legal Guardian_____________________________________________________
