Oak Rise Farm, LLC                                        Entry Form

371 Shirley Hill Rd, Goffstown, NH 03045                   July 24, 2010 Hunter Show

(603) 656-9730   Sue Yianakopolos                            8:30 Start Time

email:  oakrise@comcast.net                                         Judge: Gina Plantz

www.oakrisefarm.com                                      Course Designer: Gretchen Anderson

Regular Classes            $13

All Medal Classes         $18  **NH Medal Classes Affiliated with NHHJA

*(Entries close the Thursday before the show. Post entries will be charged $5 for the day. Refunds of entry fees will not be made unless a veterinarian or doctor’s certificate of lameness, injury, or illness is shown.)

List Classes you are entering:

1.        Leadline Equitation                                                 12. Low Hunter Jr/Adult (2’3”)

2.        Leadline Pleasure                                                    13. Modified Jr./Adult Hunter (2’3”)

3.        Walk-Trot Equitation                                             14. Modified Jr./Adult Equitation (2’3”)

4.        Walk-Trot Pleasure                                                 15. NH Modified Adult Medal (2’3”)

5.        Walk-Trot Cross rails Equitation                           16. NH Children’s Medal (2’3”)

6.        Novice Equitation on the flat                                  17. NH Pony Medal (2’3”) sm/med (2’6”) large

7.        Low Hunter (18”)                                                   18. Special Equitation on the flat

8.        Novice Equitation over fences (18”)                       19. Low Hunter (2’6”)

9.        Novice Hunter over fences (18”)                            20. Special Hunter (2’6”)

10.     NH Novice Medal (18”)                                         21 Special Equitation (2’6”)

11.   Modified Jr./Adult Eq on the flat                           22. NH Adult Medal (2’9”)

                                23. NH Junior Medal (3’)

Number of Regular Classes       __________ x $13                  _____________ Total Fee

Number of Medal Classes        __________ x $18                  _____________ Total Fee

Post Entry Fee  ($5.00)                                                             _____________ Total Fee

Under NH 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 from the inherent risks associated with equine activities. Pursuant to R.S.A. 508:19 Equine Professionals are not liable for damages resulting from the inherent risks of equine activities.

I/we hold harmless Oak Rise Farm, LLC its managers, members, volunteers and agents from an against all claims, demands, actions, and causes of action for damages that may be sustained by those indicated on the entry form or anyone else, including any and all claims arising from Oak Rise Farm, LLC or its agents own negligence.  This includes personal injury, death or property damage.

______________________________                        ______________________________

Name of Rider                                                              Printed Name of Parent/Guardian

______________________________                        ________________    ____________

Name of Horse/Pony                                                    NHHJA Member #      Date

______________________________                        ______________________________

Signature of Rider                                                         Signature of Parent/Guardian