2007 DEERFIELD FAIR HORSE SHOW
ENTRY FORM
SEPTEMBER 27, 28-29-30 2007
MAIL TO:
DEERFIELD FAIR HORSE SHOW, c/o Lurine
Combs, 16 Steam Mill Road, Auburn NH 03032
ENTRIES CLOSE AUGUST 15
ONLY ONE OWNER PER ENTRY FORM. PLEASE TYPE OR PRINT CLEARLY.
| Office Use | Name of Horse or Pony | Breed | Breed Reg. No. | Color | Sex | Height | Yr. Foaled |
| Classes for 1st Rider or Driver, 1/block | First Rider / Driver Name | Amateur No. & Name Assoc. | Junior D.O.B. | UPHA# | |||
| $ | $ | $ | $ |
First Rider/Driver Signature (Parent or
agent must sign for Jr. Member |
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| Classes for 2nd Rider or Driver, 1/block | Second Rider / Driver Name | Amateur No. & Name Assoc. | Junior D.O.B. | UPHA# | |||
| $ | $ | $ | $ |
Second Rider/Driver Signature (or agent)
Signature |
|||
| Ofc. Use | Name of Horse or Pony | Breed | Breed Reg. No. | Color | Sex | Height | Yr. Foaled |
| Classes for 1st Rider or Driver, 1/block | First Rider / Driver Name | Amateur No. & Name Assoc. | Junior D.O.B. | UPHA# | |||
| $ | $ | $ | $ |
First Rider/Driver Signature (Parent or
agent must sign for Jr. Member |
|||
| Classes for 2nd Rider or Driver, 1/block | Second Rider / Driver Name | Amateur No. & Name Assoc. | Junior D.O.B. | UPHA# | |||
| $ | $ | $ | $ |
Second Rider/Driver Signature (or agent)
Signature |
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| *Each person signing this form acknowledges that they have read the rules that follow and agree to the applicable terms and conditions as set forth herein | Quan | Item | Amount | |||||
| Owner's Name (Please Print): | Total Entry Fees | |||||||
| *Owner (or Agent) Signature: | Post entry @ $10.00 per horse | |||||||
| Fed EN/Social Security No.: | Telephone: ( ) | Box Stalls @ $80.00 | ||||||
| Address: | Tack Stalls @ $85.00 | |||||||
| City | State | Zip | Camper@ $70.00 | |||||
| Send Acknowledgement to (check one) ¨Owner ¨Trainer | Campers w/
one slideout $100.00 Campers w/slideoputs onboth sides $140.00 |
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| Trainer's Name (Please Print): | Trailers/Van @ $60.00 | |||||||
| *Trainer (or Agent) Signature: | NHH & TA fee @ $3.00 per horse | |||||||
| Address | ||||||||
| City | State | Zip | Total | |||||
| Telephone | Fax | |||||||
|
Both Owner and Trainer Signatures are required. If Owner and Trainer, sign both places. |
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Deerfield Fair Horse Show Waiver ~ Every entry at this show shall constitute an agreement and affirmation that all participants (which include, without limitation, the owner, lessee, trainer, manager, agent, coach, driver, rider, handler and the horse), for themselves, their principals, representatives, employees and agents; (1) Shall be subject to the constitution and rules of – the affiliating association and the rules of this show, (2) Represent that every horse, rider, driver, and handler is eligible as entered, (3) Agree to be bound by the constitution and rules of the New England Horsemen’s Council, the New Hampshire Horse and Trail Association and this Show, and will accept as final the decision of the committees on any entry, (4) They authorize the affiliating association and/or the management to market, transfer, assign or otherwise make use of any photographs, likenesses, films, broadcast, cablecasts, audiotapes or videotapes taken of the horse(s) and participant(s) while on the grounds, incident to, or in transit between the stabling facility and the event site, in any way they see fit for the promotion, coverage or benefit of the event, sport, or the affiliating association, without compensation to any of them, so long as the use neither jeopardizes amateur status nor endorses a specific product or service, and hereby expressly and irrevocably waive and release any rights in connection with such use, including any claim to invasion of privacy, right of publicity, or to misappropriation, and (5) agree that they participate voluntarily in the competition fully aware that horse sports and the competition inherent dangerous risk of serious injury or death, and by participating they expressly assume any and all risks of injury or loss, and they agree to indemnify and hold the affiliating association, this show and their officials, directors, employees and agents; harmless from and against all claims including for any injury or loss suffered during or in connection with the competition, whether or not claim, injury or loss resulted, directly or indirectly, from negligent acts or omissions of said officials, directors, employees or agents of the affiliating association or this show.
I agree that each foregoing reference to the “Competition” shall include the Deerfield Fair Association Horse Show and that “Loss” shall include “By Fire”. I further agree to forfeit and pay to the Deerfield Fair Horse Show the sum of up to $1,000.00 as for liquidated damages, if the animal or any of the animals which I may exhibit are suffering from any contagious or infectious disease. I further agree to reimburse the Deerfield Fair Horse Show for any property damages that may occur.
DEERFIELD FAIR HORSE SHOW WAIVER ~ Any person or entity executing this Entry Form, hereinafter referred releasor, hereby releases, remises and forever discharges, and by these presents does for himself/herself, his/her successors and assigns, release, remise and forever discharge the Deerfield Fair Horse Show, officers, Show Committees, Show Officials, and employees, and members hereinafter referred to releasee(s), their heirs, executors, administrators, successors and assigns, of and from all, and all manner of action and actions, cause and causes or action, suits, claims and demands whatsoever, in law or in equity, which said releasor may ever have against said releasee(s) for any damages to person or property which said releaser may suffer as a result of participation in any and all functions held in connection with Deerfield Fair Horse Show held in Deerfield, New Hampshire. Said release is hereby given in consideration for the releasor being allowed by the releasee(s) to participate in any and all activities connected with the Deerfield Fair Horse Show. Said release is not intended in any way to release the aforesaid releasee(s) from any and all liability occasioned by their own gross negligence and/or willful misconduct.
JUNIOR (MINOR) EXHIBITOR CONSENT ~ PERSON SIGNING FOR A JUNIOR (MINOR) HEREBY CONSENTS TO THE ENTRY OF THE CHILD IN THIS HORSE SHOW AND AGREES TO THE APPLICABLE TERMS, CONDITIONS, WAIVERS AND CONSENT AS SET FORTH HEREIN, AND ACCEPTS RESPONSIBILITY HEREUNDER FOR THE PARTICIPATION OF SAID JUNIOR (MINOR).