Coggins Y/N |
Stall #______ |
Rider #______ |
2010 THREE PHASE EVENT ENTRY FORM
MAY 15 & 16, 2010
Kentucky Equestrian Center, 850 Kiddvill Rd., Winchester, KY 40391
Entries Must Be Post Marked By Midnight April 30, 2010
Registered Name of Horse________________________________________________Sex/Age________________
Registration # and Organization______________________________________Organization Member #____________
Breed ______________________________________Gait Type:_________________________________________
Horse Owner’s Name______________________________________________________Phone#_______________
Address________________________________________City/State/Zip___________________________________
Rider of Horse: Name____________________________________Phone#______________________________ Address_______________________________________Email_____________________________ DOB/Youth_____
| Division | Exhibitor/Rider Name (Write in next to division entered) | Fees | Entry Fee |
| Three Phase Event | 100.00 | ||
| Beginner Novice Division | |||
| Novice Division | |||
| Training Division | |||
| Additional Dressage Tests | Write in Test of Choice | ||
| Test #1 | $35.00 | ||
| Test #2 | $25.00 | ||
| Total Fees |
| Show Fees | Amount/Description | Total |
| Fee | Total amount from above | |
| Stalls | $75.00 for show (includes two bags of shavings) | |
| Early Arrival/Late Departure | $20.00 a day (arrival before noon 5/14 and after noon 5/17) | |
| Grounds Fee | $15.00/horse/day (trailering in with no stall) #of Horses_____________ | |
| Dinner Tickets | $15.00 Sat. night catered dinner exhibitors #_________ Guests #__________ | |
| Horse Inspection Fee | $10.00 per horse, one time fee | |
| RV hook up | $60.00 for entire event (arrival after noon 5/14, departure before noon 5/17) | |
| Total Amount Due | Enclosed with entry form | |
| Credit cards may be called in to Kristie - 859-383-0133 | ||
| Card Type: Visa/Master | Card # ________________________________________Exp.__________ | |
| Name on Card | ______________________________________________ 3 digit________ |
Checks payable to Three Phase Event, Inc. and mailed to P.O. Box 111, North Middletown, KY 40357 Credit cards excepted, but must be phoned in by May 1, 2010 entry deadline
Event questions and Info: Carolyn Kenton: 859-321-7783 Or Kristie Wehmeyer: 859-383-0133
Ride time will be available by email after May 10th (made sure email is filled in above if you want notification)
Every entry shall constitute an agreement that the person making it, owners, exhibitors, leasee, managers, agent, coach, rider and the horse shall be subject to the local rules of the show. Further, it shall constitute a declaration that the horse and/or rider is eligible as entered and that the owner and all of his/her representatives are bound by the rules of the show and accept as final the decision of the Three Phase Event on any question arising under said Rules, and agree to hold the show, their officials, directors and volunteers harmless for any action taken.
CANCELLATION POLICY: (must be received in writing or email prior to April 30 , 2010) Full refund if received prior to April 30, 2010; 50% refund with verified veterinary form if received by May 10, 2010; no refunds of fees if received on or after May 11, 2010.
Under Kentucky Equine Law, an equine activity sponsor or equine professional is not liable for any injury to, or the death of, a participant in equine activities resulting from the inherent risks of equine activities.
SIGNATURE OF OWNER/AGENT_________________________________________________________________
Signature of Parent/Guardian if youth rider___________________________________________________________