Entry Form  March 25,2007
Deer Creek Dressage/Prix Caprilli Show

Rider:________________________Jr/Sr:___________Horse___________________

Address:_______________________City/State/Zip___________________________

Phone:______________ E-mail:__________________

Judge: Debbie Cinnoto

Show Fees: $15.00

Dressage Test (please circle your choices):

Intro A

Intro B

Training Level

Test __1 __2__3__4

1^st Level Test 1

Eventing Tests

Beg Novice - A

Beg Novice - B

Novice A

Novice B

Training A

Training B

Prix Caprilli Test (pleasecircle your choices):

Test 1 Cross rails

Test 2 Max Height 2 foot

Classes will only run with 3 or more entries

$15 per Test

# of tests_____ Total $______

Office Fee - $5.00

Total $ ______

Please mail, email or call your entry in by Friday, Nov. 3, 2006 no later than 5:00 p.m.

The undersigned entrant states as follows:? I acknowledge that competitive horse riding contains inherent risks of injury and damage to me personally, to the horse and to equipment, caused by my own negligence, or the negligence of others.? Knowing these facts, I nevertheless, in consideration of your acceptance of this entry, hereby for myself, my heirs, executors and administrators, waive release and discharge of Deer Creek Stables, the management and all individual members in any way connected with the event described herein and assign from any and all right, claim or liability for damages, for any and all injuries that might be sustained by me, including injury to animals, or from any and all claims of any kind or nature that I might have as a result of, or arising out of my participation in this event.

I do acknowledge that I have read the foregoing paragraph and know and understand the contents thereof.

Rider Signature:

Date:

Parental Consent